Ilomäki Essi, Hakko Helinä, Ilomäki Risto, Räsänen Pirkko
Department of Psychiatry, University of Oulu, FI-90014 Oulu, Finland.
Int J Circumpolar Health. 2012 Mar 20;71:17393. doi: 10.3402/ijch.v71i0.17393.
Conduct disorder (CD) refers to a pattern of severe antisocial and aggressive behaviour manifested in childhood or adolescence, with heavy costs to society. Though CD is a common psychiatric diagnosis among adolescents of both genders, gender differences in comorbidity of CD have been little studied. In this study we examined gender differences among adolescents with CD in causes for hospitalization, comorbid psychiatric diagnoses and somatic conditions.
The original study sample consisted of 508 inpatient adolescents in Northern Finland (age 12-17); 155 of them (65 girls, 92 boys) fulfilled the DSM-IV criteria for CD.
Diagnosis of CD and psychiatric comorbidities were obtained from the K-SADS-PL and somatic conditions from the EuropAsi.
As compared to boys with CD, suicidality (including suicidal ideation and behaviour) was significantly more commonly the cause of hospitalization among girls with CD (43% vs. 24%, p=0.013). Among somatic conditions, there was a significant predominance in self-reported allergies among girls (60% vs. 25%, p<0.001). Girls had more often diagnosed comorbid post-traumatic stress disorder (13% vs. 3%, p=0.025) and marginally significantly more major depressive disorder (36% vs. 23%, p=0.086).
Girls with CD seem to have an increased tendency to develop both comorbid psychiatric and somatic conditions as well as suicidality. New clinical aspects in treatment of CD and comorbid disorders among girls are discussed.
品行障碍(CD)是指在儿童期或青少年期表现出的严重反社会和攻击性行为模式,给社会带来沉重代价。尽管CD是青少年中常见的精神疾病诊断,但关于CD共病的性别差异研究较少。在本研究中,我们调查了患有CD的青少年在住院原因、共病精神疾病诊断和躯体状况方面的性别差异。
原始研究样本包括芬兰北部508名住院青少年(年龄12 - 17岁);其中155人(65名女孩,92名男孩)符合CD的DSM-IV标准。
CD和精神共病诊断通过K-SADS-PL获得,躯体状况通过EuropAsi获得。
与患有CD的男孩相比,自杀倾向(包括自杀意念和行为)在患有CD的女孩中更常成为住院原因(43%对24%,p = 0.013)。在躯体状况方面,女孩自我报告的过敏显著居多(60%对25%,p < 0.001)。女孩更常被诊断为共病创伤后应激障碍(13%对3%,p = 0.025),且患重度抑郁症的比例略高(36%对23%,p = 0.086)。
患有CD的女孩似乎更易出现共病精神和躯体状况以及自杀倾向。文中讨论了女孩CD及共病障碍治疗中的新临床问题。