Department of Psychiatry, University of Cambridge, Douglas House, 18b Trumpington Road, Cambridge, CB2 8AH, UK,
Soc Psychiatry Psychiatr Epidemiol. 2013 Oct;48(10):1527-38. doi: 10.1007/s00127-013-0695-x. Epub 2013 May 5.
This study aimed to review evidence on the prevalence of and risk factors for conduct problems in Brazil.
We searched electronic databases and contacted Brazilian researchers up to 05/2012. Studies were included in the review if they reported the prevalence of or risk factors for conduct problems, conduct disorder, or oppositional defiant disorder for 100 + Brazilian children aged ≤18 years, systematically sampled in schools or the community. Prevalence rates and sex differences were meta-analysed. Risk factor studies were reviewed one by one.
The average prevalence of conduct problems in screening questionnaires was 20.8%, and the average prevalence of conduct disorder/oppositional defiant disorder was 4.1%. There was systematic variation in the results of screening studies according to methodology: recruitment location, informants, instruments, impairment criterion for case definition, and response rates. Risk factors previously identified in high-income countries were mainly replicated in Brazil, including comorbid mental health problems, educational failure, low religiosity, harsh physical punishment and abuse, parental mental health problems, single parent family, and low socioeconomic status. However, boys did not always have higher risk for conduct problems than girls.
Studies using screening questionnaires suggest that Brazilian children have higher rates of conduct problems than children in other countries, but diagnostic studies do not show this difference. Risk factors in Brazil were similar to those in high-income countries, apart from child sex. Future research should investigate developmental patterns of antisocial behaviour, employ a variety of research designs to identify causal risk mechanisms, and examine a broader range of risk factors.
本研究旨在回顾巴西品行问题的流行率和危险因素的证据。
我们检索了电子数据库，并于 2012 年 5 月前联系了巴西研究人员。如果研究报告了 100 名以上 18 岁以下的巴西儿童的品行问题、品行障碍或对立违抗性障碍的流行率或危险因素，且这些儿童是在学校或社区中系统抽样的，则将这些研究纳入综述。流行率和性别差异进行了荟萃分析。逐个审查了危险因素研究。
在筛查问卷中品行问题的平均流行率为 20.8%，品行障碍/对立违抗性障碍的平均流行率为 4.1%。根据方法的不同，筛查研究的结果存在系统差异：招募地点、信息提供者、工具、病例定义的损伤标准和应答率。在高收入国家中确定的危险因素主要在巴西得到了复制，包括合并的心理健康问题、教育失败、低宗教信仰、严厉的身体惩罚和虐待、父母的心理健康问题、单亲家庭和低社会经济地位。然而，男孩的品行问题风险并不总是高于女孩。
使用筛查问卷的研究表明，巴西儿童的品行问题发生率高于其他国家的儿童，但诊断研究并未显示出这种差异。巴西的危险因素与高收入国家的危险因素相似，除了儿童性别。未来的研究应调查反社会行为的发展模式，采用多种研究设计来确定因果风险机制，并检查更广泛的风险因素。
