Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, Bristol, UK.
Pediatrics. 2012 Apr;129(4):e882-91. doi: 10.1542/peds.2011-1556. Epub 2012 Mar 26.
To explore the associations between probable developmental coordination disorder (DCD) defined at age 7 years and mental health difficulties at age 9 to 10 years.
We analyzed of prospectively collected data (N = 6902) from the Avon Longitudinal Study of Parents and Children. "Probable" DCD was defined by using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria as those children below the 15th centile of the Avon Longitudinal Study of Parents and Children Coordination Test, with functional limitations in activities of daily living or handwriting, excluding children with neurologic difficulties or an IQ <70. Mental health was measured by using the child-reported Short Moods and Feelings Questionnaire and the parent-reported Strengths and Difficulties Questionnaire. Multiple logistic regression models, with the use of multiple imputation to account for missing data, assessed the associations between probable DCD and mental health difficulties. Adjustments were made for environmental confounding factors, and potential mediating factors such as verbal IQ, associated developmental traits, bullying, self-esteem, and friendships.
Children with probable DCD (N = 346) had an increased odds of self-reported depression, odds ratio: 2.08 (95% confidence interval: 1.36-3.19) and parent-reported mental health difficulties odds ratio: 4.23 (95% confidence interval: 3.10-5.77). The odds of mental health difficulties significantly decreased after accounting for verbal IQ, social communication, bullying, and self-esteem.
Children with probable DCD had an increased risk of mental health difficulties that, in part, were mediated through associated developmental difficulties, low verbal IQ, poor self-esteem, and bullying. Prevention and treatment of mental health difficulties should be a key element of intervention for children with DCD.
探讨 7 岁时可能存在的发育性协调障碍（DCD）与 9 至 10 岁时心理健康困难之间的关联。
我们分析了前瞻性收集的数据（N=6902）来自阿冯纵向研究父母和孩子。“可能”的 DCD 是根据《精神障碍诊断与统计手册》第四版修订版的标准定义的，那些儿童低于阿冯纵向研究父母和孩子协调测试的第 15 百分位，日常生活活动或手写有功能障碍，不包括有神经系统困难或智商<70 的儿童。心理健康是通过儿童报告的短期情绪和感觉问卷和父母报告的优势和困难问卷来衡量的。使用多元逻辑回归模型，使用多重插补来解释缺失数据，评估了可能的 DCD 和心理健康困难之间的关联。调整了环境混杂因素，以及潜在的中介因素，如言语智商、相关的发育特征、欺凌、自尊和友谊。
患有可能的 DCD（N=346）的儿童报告抑郁的可能性增加，比值比：2.08（95%置信区间：1.36-3.19）和父母报告的心理健康困难比值比：4.23（95%置信区间：3.10-5.77）。在考虑到言语智商、社会沟通、欺凌和自尊后，心理健康困难的可能性显著降低。
患有可能的 DCD 的儿童患心理健康困难的风险增加，部分原因是与相关发育困难、言语智商低、自尊心低和欺凌有关。预防和治疗心理健康困难应该是 DCD 儿童干预的一个关键要素。
