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智力残疾成年人的精神疾病、问题行为、需求及服务利用情况

Mental illness, problem behaviour, needs and service use in adults with intellectual disability.

作者信息

Schützwohl Matthias, Koch Andrea, Koslowski Nadine, Puschner Bernd, Voß Elke, Salize Hans Joachim, Pfennig Andrea, Vogel Anke

机构信息

Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany.

Department of Psychiatry II, Ulm University, Ulm, Germany.

出版信息

Soc Psychiatry Psychiatr Epidemiol. 2016 May;51(5):767-76. doi: 10.1007/s00127-016-1197-4. Epub 2016 Mar 7.

Abstract

PURPOSE

Mental ill health in adults with intellectual disability (ID) is a neglected field in psychiatry and thus still widely understudied. This paper provides data on the prevalence of mental illness and problem behaviour and analyses support needs, mental health service use and psychotropic medication in a representative sample of adults with mild to moderate ID.

METHODS

A set of well-established instruments was used to assess the main parameters in n = 371 participants recruited within a cross-sectional epidemiological multicentre study using a stratified randomised cluster sampling.

RESULTS

Point prevalence of mental disorders was 10.8 %, that of problem behaviour 45.3 %. Most study participants needed help in specific lower order need areas (e.g., money budgeting, food, accommodation), and these need areas were mostly rated as met. The highest ratios of unmet to met need were found with respect to sexuality issues and with respect to mental health problems. The focus of psychiatric treatment was psychotropic medication.

CONCLUSIONS

Referring to ICD-10 based diagnostic criteria and consequently avoiding confusing problem behaviour with mental disorders, point prevalence of mental disorders was lower than in the general population. A systematic deficit in meeting mental health problems in adults with ID indicates the need for implementing strategies to maximise the quality of identification and management of mental disorders.

摘要

目的

成年智力残疾者的心理健康问题在精神病学领域一直被忽视,因此仍未得到充分研究。本文提供了关于精神疾病和问题行为患病率的数据,并分析了轻度至中度智力残疾成年代表性样本中的支持需求、心理健康服务利用情况和精神药物使用情况。

方法

在一项横断面流行病学多中心研究中,采用分层随机整群抽样方法招募了n = 371名参与者,并使用了一套成熟的工具来评估主要参数。

结果

精神障碍的时点患病率为10.8%,问题行为的时点患病率为45.3%。大多数研究参与者在特定的低层次需求领域(如金钱预算、食物、住宿)需要帮助,这些需求领域大多被评为已满足。在性问题和心理健康问题方面,未满足需求与已满足需求的比例最高。精神科治疗的重点是精神药物。

结论

参照基于国际疾病分类第十版(ICD - 10)的诊断标准,从而避免将问题行为与精神障碍相混淆,精神障碍的时点患病率低于一般人群。成年智力残疾者在满足心理健康问题方面存在系统性不足,这表明需要实施相关策略,以最大限度地提高精神障碍识别和管理的质量。

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