Lambert M, Bock T, Naber D, Löwe B, Schulte-Markwort M, Schäfer I, Gumz A, Degkwitz P, Schulte B, König H H, Konnopka A, Bauer M, Bechdolf A, Correll C, Juckel G, Klosterkötter J, Leopold K, Pfennig A, Karow A
Arbeitsbereich Psychosen, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Zentrum für Psychosoziale Medizin, Universitätsklinikum Hamburg-Eppendorf (UKE).
Fortschr Neurol Psychiatr. 2013 Nov;81(11):614-27. doi: 10.1055/s-0033-1355843. Epub 2013 Nov 5.
Numerous birth-control studies, epidemiological studies, and observational studies have investigated mental health and health care in childhood, adolescence and early adulthood, including prevalence, age at onset, adversities, illness persistence, service use, treatment delay and course of illness. Moreover, the impact of the burden of illness, of deficits of present health care systems, and the efficacy and effectiveness of early intervention services on mental health were evaluated. According to these data, most mental disorders start during childhood, adolescence and early adulthood. Many children, adolescents and young adults are exposed to single or multiple adversities, which increase the risk for (early) manifestations of mental diseases as well as for their chronicity. Early-onset mental disorders often persist into adulthood. Service use by children, adolescents and young adults is low, even lower than for adult patients. Moreover, there is often a long delay between onset of illness and first adequate treatment with a variety of linked consequences for a poorer psychosocial prognosis. This leads to a large burden of illness with respect to disability and costs. As a consequence several countries have implemented so-called "early intervention services" at the interface of child and adolescent and adult psychiatry. Emerging studies show that these health-care structures are effective and efficient. Part 1 of the present review summarises the current state of mental health in childhood, adolescence and early adulthood, including prevalence, age at onset, adversities, illness persistence, service use, and treatment delay with consequences.
众多的节育研究、流行病学研究和观察性研究调查了儿童期、青少年期和成年早期的心理健康与医疗保健情况,包括患病率、发病年龄、逆境、疾病持续时间、服务利用情况、治疗延迟以及病程。此外,还评估了疾病负担、当前医疗保健系统的缺陷以及早期干预服务对心理健康的疗效和有效性。根据这些数据,大多数精神障碍始于儿童期、青少年期和成年早期。许多儿童、青少年和年轻人面临单一或多种逆境,这增加了精神疾病(早期)表现及其慢性化的风险。早发性精神障碍往往会持续到成年期。儿童、青少年和年轻人对服务的利用率较低,甚至低于成年患者。此外,从发病到首次获得充分治疗之间往往存在很长的延迟,这会带来一系列不良后果,导致心理社会预后较差。这会在残疾和成本方面造成巨大的疾病负担。因此,一些国家在儿童青少年精神病学和成人精神病学的交叉领域实施了所谓的“早期干预服务”。新出现的研究表明,这些医疗保健结构是有效且高效的。本综述的第一部分总结了儿童期、青少年期和成年早期心理健康的现状,包括患病率、发病年龄、逆境、疾病持续时间、服务利用情况以及治疗延迟及其后果。