Papachristou Ec, Anagnostopoulos Dk
Center for Health Services Research, Medical School, University of Athens.
Community Mental Health Centre Byron-Kessariani, A΄ Psychiatric Department, University of Athens, Eginition Hospital, Athens, Greece.
Psychiatriki. 2014 Apr-Jun;25(2):139-50.
The percentage of people with mental retardation in the general population is estimated at about 2.3%, with adolescence (15-20 years) constituting the development period during which a peak in rates of mental retardation is observed. The increased prevalence of adolescence may be explained from the fact that the specified requirements of the school initially, and society later, inevitably lead to comparative evaluation of the teen with mental retardation in relation to peers, thus making mental retardation more apparent. Adolescents with mental retardation face a number of physical and psychological needs which are not often distinguishable and as a consequence undergo the deterioration of their already burdened quality of life. In particular, mental health problems occur 3 to 4 times more often in adolescents with mental retardation compared with adolescents of the general population. This review presents the most recent epidemiological findings regarding the correlation between behavioral disorders, substance use and the possible comorbidity in adolescents with intellectual disability, both at community level and residential care level. Epidemiological data indicate that behavioral disorders are among the most common types of psychopathology in mentally retarded adolescents with the severity and symptoms varying depending on the personal characteristics of each adolescent. Regarding substance use, the available data show that the rates of substance use (alcohol, smoking, illicit drugs) are lower in this specific population group but the differences over the last years tend to be eliminated. Finally, according to the few surveys that were examined referring to the comorbidity of behavioral disorders and substance use in adolescents with intellectual disability, the results were contradictory. Specifically, while behavioral disorders continued to be one of the most common types of psychopathology, the related substances disorders indicated lower rates compared to normal intelligence adolescents with behavioral disorders. Risk factors that increase the chances of developing either simple or more complicated types of psychopathology in adolescents with mental retardation have been found to be based on individual, family and social levels. On the other hand, the individual characteristics of adolescents (intellectual level, attention capacity, understandable linguistic expression, overall progress until adolescence), the existence of a supportive family environment and the presence of social support and awareness through the creation of special counseling, education and medical services, are the most important protective factors which contribute to the prevention of several forms of psychopathology in adolescents with mental retardation. For the writing of the literature review, the following electronic databases were used: PubMed, Scopus, Psycinfo, Cochrane Library, Web of Science and Google Scholar. The key words used were: Intellectual Disability, Behavioral disorders, Adolescents, Mental Retardation, Learning disabilities, Developmental Disabilities, Disruptive behaviour disorders, Conduct disorder, Substance Abuse, Substance Misuse, Oppositional defiant disorder, Alcohol and illicit drug use, Smoking Use, Young people, Teenagers, Youths.
一般人群中智力发育迟缓者的比例估计约为2.3%,其中青少年期(15 - 20岁)是智力发育迟缓发生率出现峰值的发育阶段。青少年期患病率上升的原因可能是,学校最初以及社会后来提出的特定要求,不可避免地导致对智力发育迟缓青少年与同龄人进行比较评估,从而使智力发育迟缓更加明显。智力发育迟缓的青少年面临一些身体和心理需求,这些需求往往难以区分,结果导致他们本已负担沉重的生活质量恶化。特别是,与普通人群的青少年相比,智力发育迟缓的青少年出现心理健康问题的频率要高出3至4倍。本综述介绍了关于社区层面和寄宿照料层面智力残疾青少年行为障碍、物质使用及可能的共病之间相关性的最新流行病学研究结果。流行病学数据表明,行为障碍是智力发育迟缓青少年中最常见的精神病理学类型之一,其严重程度和症状因每个青少年的个人特征而异。关于物质使用,现有数据显示,这一特定人群中物质使用(酒精、吸烟、非法药物)的发生率较低,但近年来这种差异趋于消除。最后,根据所审查的少数几项关于智力残疾青少年行为障碍与物质使用共病情况的调查,结果相互矛盾。具体而言,虽然行为障碍仍然是最常见的精神病理学类型之一,但与有行为障碍的正常智力青少年相比,相关物质障碍的发生率较低。已发现,增加智力发育迟缓青少年发生简单或更复杂精神病理学类型几率的风险因素基于个人、家庭和社会层面。另一方面,青少年的个人特征(智力水平、注意力、可理解的语言表达、到青少年期的总体进步情况)、支持性家庭环境的存在以及通过创建特殊咨询、教育和医疗服务而提供的社会支持和认识,是有助于预防智力发育迟缓青少年多种形式精神病理学的最重要保护因素。为撰写本综述,使用了以下电子数据库:PubMed、Scopus、Psycinfo、Cochrane图书馆、科学引文索引和谷歌学术。使用的关键词有:智力残疾、行为障碍、青少年、智力发育迟缓、学习障碍、发育障碍、破坏性行为障碍、品行障碍、物质滥用、物质误用、对立违抗障碍、酒精和非法药物使用、吸烟、年轻人、青少年、青年。