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儿童及青少年早期故意自我伤害的患病率、临床关联因素及母亲精神病理学:一项大型社区研究的结果

Prevalence, clinical correlates and maternal psychopathology of deliberate self-harm in children and early adolescents: results from a large community study.

作者信息

Simioni André R, Pan Pedro M, Gadelha Ary, Manfro Gisele G, Mari Jair J, Miguel Eurípedes C, Rohde Luis A, Salum Giovanni A

机构信息

Seção de Afeto Negativo e Processos Sociais, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.

Instituto Nacional de Psiquiatria do Desenvolvimento (INPD), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), São Paulo, SP, Brazil.

出版信息

Braz J Psychiatry. 2018 Jan-Mar;40(1):48-55. doi: 10.1590/1516-4446-2016-2124. Epub 2017 Aug 21.

Abstract

OBJECTIVES

Little is known about the prevalence and correlates of deliberate self-harm (DSH) in children from low- and middle-income countries. We investigated the prevalence of DSH and its clinical and maternal psychopathological associations in Brazilian children (n=2,508, ages 6-14y) in a community-based study.

METHODS

Participants of the High Risk Cohort Study for the Development of Childhood Psychiatric Disorders (HRC) and their mothers were assessed in structured interviews. Current (last month) and lifetime DSH were estimated, including analysis stratified by age groups. Logistic regressions were performed to investigate the role of the children's clinical diagnoses and maternal psychopathology on DSH prevalence estimates, adjusting for potential confounding factors.

RESULTS

The prevalence of current DSH was 0.8% (children 0.6%, adolescents 1%) and lifetime DSH was 1.6% (1.8% and 1.5%, respectively). Current and lifetime DSH were more frequent in children with depression, attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD), even in multiple models accounting for demographic variables and co-occurring psychiatric disorders. Maternal anxiety disorder was strongly associated with current and lifetime DSH in offspring; whereas current DSH, specifically in young children, was associated with maternal mood disorder.

CONCLUSION

Diagnoses of depression, ADHD and ODD were consistently associated with DSH, as was having a mother with anxiety disorder.

摘要

目的

关于低收入和中等收入国家儿童故意自伤(DSH)的患病率及其相关因素,人们了解甚少。在一项基于社区的研究中,我们调查了巴西儿童(n = 2508,年龄6 - 14岁)中DSH的患病率及其临床和母亲精神病理学关联。

方法

对儿童期精神疾病发展高危队列研究(HRC)的参与者及其母亲进行了结构化访谈评估。估计了当前(上个月)和终生DSH情况,包括按年龄组分层分析。进行逻辑回归以研究儿童临床诊断和母亲精神病理学对DSH患病率估计的作用,并对潜在混杂因素进行了调整。

结果

当前DSH的患病率为0.8%(儿童为0.6%,青少年为1%),终生DSH的患病率为1.6%(分别为1.8%和1.5%)。患有抑郁症、注意力缺陷/多动障碍(ADHD)和对立违抗障碍(ODD)的儿童中,当前和终生DSH更为常见,即使在考虑人口统计学变量和共病精神障碍的多个模型中也是如此。母亲焦虑症与后代当前和终生DSH密切相关;而当前DSH,特别是在幼儿中,与母亲情绪障碍有关。

结论

抑郁症、ADHD和ODD的诊断与DSH始终相关,母亲患有焦虑症也与之相关。

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