Munir Kerim M
aUniversity Center for Excellence in Developmental Disabilities (UCEDD), Division of Developmental Medicine, Boston Children's Hospital bDepartment of Psychiatry, Boston Children's Hospital cDepartments of Pediatrics, Psychiatry and Holmes Society, Harvard Medical School, Boston, Massachusetts, USA.
Curr Opin Psychiatry. 2016 Mar;29(2):95-102. doi: 10.1097/YCO.0000000000000236.
The study summarizes supportive epidemiological data regarding the true co-occurrence (comorbidity) and course of mental disorders in children with intellectual disability/intellectual developmental disorders (ID/IDD) across the lifespan.
Published studies involving representative populations of children and adolescents with ID/IDD have demonstrated a three to four-fold increase in prevalence of co-occurring mental disorders. The effect of age, sex, and severity (mild, moderate, severe, and profound) and socioeconomic status on prevalence is currently not clearly understood. To date there are no prevalence estimates of co-occurring mental disorders in youth identified using the new DSM-5 (and proposed ICD-11) definition of ID/IDD using measures of intellectual functions and deficits in adaptive functioning with various severity levels defined on the basis of adaptive functioning, and not intellectual quotient scores.
The true relationship between two forms of morbidity remains complex and causal relationships that may be true for one disorder may not apply to another. The new conceptualization of ID/IDD offers a developmentally better informed psychobiological approach that can help distinguish co-occurrence of mental disorders within the neurodevelopmental section with onset during the developmental period as well as the later onset of other mental disorders.
本研究总结了关于智力残疾/智力发育障碍(ID/IDD)儿童在其整个生命周期中精神障碍的真正共病情况(共病)及病程的支持性流行病学数据。
涉及ID/IDD儿童和青少年代表性人群的已发表研究表明,共病精神障碍的患病率增加了三到四倍。目前尚不清楚年龄、性别、严重程度(轻度、中度、重度和极重度)以及社会经济地位对患病率的影响。迄今为止,尚无使用新的DSM-5(以及提议的ICD-11)中ID/IDD的定义(即使用智力功能测量以及基于适应功能而非智商分数定义的不同严重程度水平的适应功能缺陷)来确定的青少年共病精神障碍的患病率估计值。
两种发病形式之间的真正关系仍然复杂,一种障碍可能存在的因果关系可能不适用于另一种障碍。ID/IDD的新概念提供了一种在发育方面更具信息依据的心理生物学方法,有助于区分神经发育阶段内发病于发育时期的精神障碍共病情况以及其他精神障碍的晚发情况。