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6岁儿童精神障碍的患病率及共病情况:2004年佩洛塔斯出生队列研究

Prevalence and comorbidity of psychiatric disorders among 6-year-old children: 2004 Pelotas Birth Cohort.

作者信息

Petresco Sandra, Anselmi Luciana, Santos Iná S, Barros Aluísio J D, Fleitlich-Bilyk Bacy, Barros Fernando C, Matijasevich Alicia

机构信息

Post-Graduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro 1160, Pelotas, RS, 96020-220, Brazil,

出版信息

Soc Psychiatry Psychiatr Epidemiol. 2014 Jun;49(6):975-83. doi: 10.1007/s00127-014-0826-z. Epub 2014 Feb 1.

Abstract

PURPOSE

Most studies published on the prevalence of psychiatric disorders in children were conducted in high-income countries despite the fact that nearly 90 % of the world's population aged under 18 live in low- and middle-income countries. The study aimed to assess the prevalence of psychiatric disorders among children of 6 years of age, to examine the distribution of psychiatric disorders by gender and socioeconomic status and to evaluate the occurrence of psychiatric comorbidities.

METHODS

The 2004 Pelotas Birth Cohort originally comprised 4,231 live births from Pelotas, southern Brazil. A total of 3,585 (84.7 % of 4,231 births) children aged 6 years were assessed using the Development and Well-Being Assessment (DAWBA).

RESULTS

Nearly 13 % of the children presented a psychiatric diagnosis according to DSM-IV, being more prevalent among males than females (14.7 and 11.7 %, respectively, p = 0.009). Anxiety disorders were the most prevalent of all disorders (8.8 %) and specific phobias (5.4 %) and separation anxiety disorder (3.2 %) were the most common subtypes. Attention deficit hyperactivity disorder (2.6 %), oppositional defiant disorder/conduct disorder (2.6 %), and depression (1.3 %) were also diagnosed. More than one psychiatric disorder was presented by 17 % of children. Socioeconomically disadvantaged children had a higher prevalence of psychiatric disorders.

CONCLUSION

Our findings underline the early onset of psychiatric disorders among children and the frequent occurrence of psychiatric comorbidity. Early prevention is needed in the field of mental health in Brazil and should start during infancy.

摘要

目的

尽管世界上近90%的18岁以下人口生活在低收入和中等收入国家,但大多数关于儿童精神障碍患病率的研究是在高收入国家进行的。本研究旨在评估6岁儿童精神障碍的患病率,按性别和社会经济地位检查精神障碍的分布情况,并评估精神共病的发生情况。

方法

2004年佩洛塔斯出生队列最初包括来自巴西南部佩洛塔斯的4231例活产儿。使用发育与幸福评估(DAWBA)对3585名(4231例出生儿童中的84.7%)6岁儿童进行了评估。

结果

根据《精神疾病诊断与统计手册》第四版(DSM-IV),近13%的儿童有精神疾病诊断,男性患病率高于女性(分别为14.7%和11.7%,p = 0.009)。焦虑症是所有疾病中最常见的(8.8%),特定恐惧症(5.4%)和分离焦虑症(3.2%)是最常见的亚型。还诊断出注意缺陷多动障碍(2.6%)、对立违抗性障碍/品行障碍(2.6%)和抑郁症(1.3%)。17%的儿童患有不止一种精神疾病。社会经济条件不利的儿童精神障碍患病率更高。

结论

我们的研究结果强调了儿童精神障碍的早发性和精神共病的频繁发生。巴西心理健康领域需要早期预防,应从婴儿期开始。

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