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儿童注意缺陷多动障碍:丹麦出生队列在生命的头 12 年中的医疗保健利用。

Attention Deficit Hyperactivity Disorder in Childhood: Healthcare Use in a Danish Birth Cohort during the First 12 Years of Life.

机构信息

Clinical Nursing Research Unit, Aalborg University Hospital, Denmark.

Research Unit for Child and Adolescent Psychiatry, Psychiatry, Aalborg University Hospital, Denmark.

出版信息

J Pediatr. 2018 Jun;197:233-240. doi: 10.1016/j.jpeds.2018.01.078. Epub 2018 Mar 23.

Abstract

OBJECTIVES

To compare the mean number of medical and psychiatric hospital-based services in children with and without attention deficit hyperactivity disorder (ADHD) and to assess the effect of ADHD on hospital-based service use, including child-, parental-, and socioeconomic-related risk factors.

STUDY DESIGN

A Danish birth cohort was followed through 12 years, and children with ADHD were identified using Danish nationwide registries. Poisson regression analyses were used to assess the association of ADHD with service use and to adjust for a comprehensive set of explanatory variables.

RESULTS

Children diagnosed with ADHD used more medical and psychiatric hospital-based healthcare than those without ADHD. In children with ADHD, intellectual disability and parental psychiatric disorder were associated with increased medical and psychiatric service use. Low birth weight and low gestational age were associated with increased medical service use. Psychiatric comorbidity and having a divorced or single parent were associated with increased psychiatric service use.

CONCLUSIONS

ADHD independently affected medical and psychiatric hospital-based service use even when adjusting for a comprehensive set of explanatory variables. However, the pattern of medical and psychiatric hospital-based service use is complex and cannot exclusively be explained by the child-, parental-, and socioeconomic-related variables examined in this study.

摘要

目的

比较患有和不患有注意缺陷多动障碍(ADHD)的儿童的医疗和精神科医院服务数量平均值,并评估 ADHD 对医院服务使用的影响,包括与儿童、父母和社会经济相关的风险因素。

研究设计

对丹麦出生队列进行了 12 年的随访,通过丹麦全国性登记册确定患有 ADHD 的儿童。采用泊松回归分析评估 ADHD 与服务使用的关联,并调整了一整套解释变量。

结果

被诊断患有 ADHD 的儿童比没有 ADHD 的儿童使用更多的医疗和精神科医院医疗保健。在患有 ADHD 的儿童中,智力残疾和父母的精神障碍与医疗和精神科服务使用的增加有关。低出生体重和低胎龄与医疗服务使用的增加有关。精神共病和父母离异或单身与精神科服务使用的增加有关。

结论

即使在调整了一整套解释变量后,ADHD 仍独立影响医疗和精神科医院服务的使用。然而,医疗和精神科医院服务使用的模式很复杂,不能仅用本研究中检查的与儿童、父母和社会经济相关的变量来解释。

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