Behere Aniruddh Prakash, Basnet Pravesh, Campbell Pamela
Child and Adolescent Psychiatrist, Maine Behavioral Healthcare, Rockland, Maine.
Clinical Instructor, TUFTS School of Medicine, Boston, MA, USA.
Indian J Psychol Med. 2017 Jul-Aug;39(4):457-463. doi: 10.4103/0253-7176.211767.
To find any association between family structure and rates of hospitalization as an indicator for behavior problems in children.
Retrospective chart review of 154 patients who were admitted to the preadolescent unit at Lincoln Prairie Behavioral Health Center between July and December 2012.
We found that only 11% of children came from intact families living with biological parents while 89% had some kind of disruption in their family structure. Two-third of the children in the study population had been exposed to trauma with physical abuse seen in 36% of cases. Seventy-one percent had reported either a parent or a sibling with a psychiatric disorder. Children coming from biologically family were less likely to have been exposed to trauma. Children coming from single/divorced families were less likely to have been exposed to sexual abuse but more likely to have a diagnosis of attention deficit hyperactivity disorder (ADHD) compared to other types of families. Strong association was found between exposure to trauma and certain diagnoses in respect to hospitalization. ADHD predicted a 4 times likelihood of having more than one previous hospitalization, with mood disorder, oppositional defiant disorder, and physical abuse increasing the risk by more than twice.
Significant differences in family structure were demonstrated in our study of children being admitted to inpatient psychiatric hospitalization. The presence of trauma and family psychiatric history predicted higher rates of readmission. Our study highlighted the role of psychosocial factors, namely, family structure and its adverse effects on the mental well-being of children.
探究家庭结构与住院率之间的关联，以此作为儿童行为问题的一个指标。
对2012年7月至12月期间入住林肯草原行为健康中心青春期前病房的154例患者进行回顾性病历审查。
我们发现，只有11%的儿童来自与亲生父母生活在一起的完整家庭，而89%的儿童家庭结构存在某种破裂。研究人群中三分之二的儿童曾遭受创伤，其中36%的病例存在身体虐待。71%的儿童报告其父母或兄弟姐妹患有精神疾病。来自原生家庭的儿童遭受创伤的可能性较小。与其他类型的家庭相比，来自单亲/离异家庭的儿童遭受性虐待的可能性较小，但被诊断为注意力缺陷多动障碍（ADHD）的可能性较大。在住院方面，发现创伤暴露与某些诊断之间存在密切关联。ADHD预示着之前有不止一次住院的可能性是常人的4倍，情绪障碍、对立违抗障碍和身体虐待使这种风险增加两倍多。
在我们对住院精神科儿童的研究中，家庭结构存在显著差异。创伤和家族精神病史预示着再入院率较高。我们的研究强调了社会心理因素的作用，即家庭结构及其对儿童心理健康的不利影响。
