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芬兰14岁前针对精神疾病和神经发育障碍的专科服务使用情况。

Specialized service use for psychiatric and neurodevelopmental disorders by age 14 in Finland.

作者信息

Gyllenberg David, Gissler Mika, Malm Heli, Artama Miia, Hinkka-Yli-Salomäki Susanna, Brown Alan S, Sourander Andre

出版信息

Psychiatr Serv. 2014 Mar 1;65(3):367-73. doi: 10.1176/appi.ps.201200544.

Abstract

OBJECTIVE

Most studies on the diagnostic patterns of usage of specialized services for childhood psychiatric and neurodevelopmental disorders have been cross-sectional, and the aim of this study was to provide longitudinal data.

METHODS

The Medical Birth Register and the Finnish Hospital Discharge Register were used to study the use of inpatient or public outpatient specialized services for psychiatric and neurodevelopmental disorders between birth and age 14 in 2010 (cumulative incidence) and in year 2010 at age 14 (one-year prevalence) among Finnish children born in 1996 (N=58,538 singleton live births).

RESULTS

The cumulative incidence of specialized service use for any psychiatric or neurodevelopmental disorders between birth and age 14 was 12.9%, and the one-year prevalence in 2010 at 14 years was 4.2%. The cumulative incidence by age 14 was 5.5% for learning and coordination disorders, 2.2% for anxiety disorders, 2.0% for hyperkinetic disorders, 1.7% for conduct disorders, 1.4% for depression, 1.0% for autism spectrum disorders, and .7% for stress and adjustment disorders. Learning and coordination, hyperkinetic, and autism spectrum disorders were more prevalent among boys, were often diagnosed before school age, and had 9%-51% lifetime comorbidity with each other. Depressive, anxiety, and stress and adjustment disorders had similar distributions between the sexes, were often diagnosed in early adolescence, and showed 8%-31% lifetime comorbidity with each other.

CONCLUSIONS

Every eighth Finnish child had visited specialized services for psychiatric or neurodevelopmental disorders sometime between birth and age 14. Learning and coordination disorders were diagnosed more than twice as often as anxiety, hyperkinetic, and conduct disorders.

摘要

目的

大多数关于儿童精神和神经发育障碍专科服务使用诊断模式的研究都是横断面研究,本研究的目的是提供纵向数据。

方法

利用医疗出生登记册和芬兰医院出院登记册,研究了1996年出生的芬兰儿童(N = 58,538例单胎活产)在出生至14岁期间(累积发病率)以及2010年14岁时(一年患病率)使用住院或公共门诊专科服务治疗精神和神经发育障碍的情况。

结果

出生至14岁期间因任何精神或神经发育障碍使用专科服务的累积发病率为12.9%,2010年14岁时的一年患病率为4.2%。14岁时学习与协调障碍的累积发病率为5.5%,焦虑症为2.2%,多动症为2.0%,品行障碍为1.7%,抑郁症为1.4%,自闭症谱系障碍为1.0%,应激与适应障碍为0.7%。学习与协调障碍、多动症和自闭症谱系障碍在男孩中更为普遍,常在学龄前期被诊断,且彼此之间有9%-51%的终生共病率。抑郁、焦虑以及应激与适应障碍在两性中的分布相似,常在青春期早期被诊断,且彼此之间有8%-31%的终生共病率。

结论

每八个芬兰儿童中就有一个在出生至14岁期间的某个时间访问过精神或神经发育障碍专科服务。学习与协调障碍的诊断频率是焦虑症、多动症和品行障碍的两倍多。

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