Dang Hoang-Minh, Weiss Bahr, Trung Lam T
Vietnam National University, 144 Xuan Thuy Road, Cau Giay District, Hanoi, Vietnam.
Vanderbilt University, Nashville, TN, USA.
Soc Psychiatry Psychiatr Epidemiol. 2016 Jan;51(1):39-47. doi: 10.1007/s00127-015-1114-2. Epub 2015 Aug 28.
Functional impairment is a key indicator of need for mental health services among children and adolescents, often a stronger predictor of service usage than mental health symptoms themselves. Functional impairment may be of particular importance in low- and middle-income countries (LMIC) because of its potential to focus policy on treatment of child mental health problems which is generally given low priority in LMIC. However, few studies have assessed functional impairment in LMIC. The present study assessed rates of functional impairment among children in Vietnam, as a case example of an LMIC, as well as effects of other risk/protective factors of particular relevance to LMIC (e.g., whether the family lived in an urban or rural area; family structure variables such as grandparents living with the family).
1314 parents of children 6-16 years old from 10 Vietnamese provinces were interviewed.
The overall rate of functional impairment among Vietnamese children was 20 %, similar to rates in high-income countries such as Germany and the United States, suggesting that LMIC status may not be associated with dramatic increases in functional impairment in children. Functional impairment was significantly greater among mental health cases than non-cases, with increases of over 550 % associated with mental health caseness. A number of other risk factors (e.g., marital status) had smaller but significant effects.
Mental health problems are a major but not the sole contributor to functional impairment among Vietnamese children. The pragmatic significance of this research lies in its potential to affect public awareness and policy related to child mental health in LMIC.
功能损害是儿童和青少年心理健康服务需求的关键指标,通常比心理健康症状本身更能预测服务使用情况。在低收入和中等收入国家(LMIC),功能损害可能尤为重要,因为它有可能使政策聚焦于儿童心理健康问题的治疗,而在LMIC中,儿童心理健康问题通常未得到足够重视。然而,很少有研究评估LMIC中的功能损害情况。本研究以越南这个LMIC国家为例,评估了儿童功能损害的发生率,以及与LMIC特别相关的其他风险/保护因素的影响(例如,家庭是居住在城市还是农村地区;家庭结构变量,如祖父母是否与家庭同住)。
对来自越南10个省份的1314名6至16岁儿童的家长进行了访谈。
越南儿童功能损害的总体发生率为20%,与德国和美国等高收入国家的发生率相似,这表明LMIC的状况可能与儿童功能损害的大幅增加无关。心理健康病例中的功能损害明显高于非病例,与心理健康病例相关的功能损害增加超过550%。其他一些风险因素(如婚姻状况)的影响较小但具有显著性。
心理健康问题是越南儿童功能损害的主要但非唯一因素。这项研究的实际意义在于其有可能影响LMIC中与儿童心理健康相关的公众意识和政策。