Institute of Child Development, University of Minnesota, United States.
Institute of Child Development, University of Minnesota, United States.
Child Abuse Negl. 2018 Oct;84:23-33. doi: 10.1016/j.chiabu.2018.07.019. Epub 2018 Jul 21.
To examine both mental and physical health profiles of children diagnosed as maltreated in the community, we studied diagnoses in the electronic health records (EHRs) of youth assigned maltreatment-related diagnoses (N = 406) and well-matched youth without a maltreatment-related diagnosis (N = 406) during a four-year period in a large healthcare system that covers eight hospitals and over 40 clinics. Data extracted automatically from the EHRs was supplemented by manual chart review. The odds of the maltreated group being assigned a code for mental illness was 2.69 times higher than the odds for the comparison group, with large differences in mood and anxiety disorders and suicidality. The odds of having an injury or poisoning diagnosis were 3.45 times higher in maltreated than in comparison youth. Maltreated youth were also less likely to have been immunized. Nevertheless, contrary to our hypothesis, maltreated youth had significantly lower rates of diagnoses across almost all major physical disease categories assessed and did not differ from comparison youth in terms of body mass index (BMI). Furthermore, maltreated youth were assigned fewer diagnoses than comparison youth whether they came in for at least one preventive visit or not. Findings suggest a need for health care professionals to be prepared to address the high rates of mental disorders in maltreated youth, to be more vigilant about possible physical disorders in this population, and to take greater advantage of opportunities to immunize these youth.
为了研究被社区诊断为受虐待儿童的心理健康和身体健康状况，我们研究了在一个大型医疗保健系统中，4 年间被分配虐待相关诊断（N=406）和未被分配虐待相关诊断的健康儿童（N=406）的电子健康记录（EHR）中的诊断。从 EHR 中自动提取的数据通过手动图表审查进行了补充。与对照组相比，受虐待组被分配精神疾病代码的几率高 2.69 倍，情绪和焦虑障碍以及自杀率差异较大。受虐待儿童受伤或中毒的几率比对照组高 3.45 倍。受虐待的儿童也不太可能接受免疫接种。然而，与我们的假设相反，受虐待的儿童在评估的几乎所有主要身体疾病类别中的诊断率都明显较低，并且与对照组儿童在体重指数（BMI）方面没有差异。此外，无论是否接受过至少一次预防就诊，受虐待的儿童比对照组儿童的诊断次数都要少。研究结果表明，医疗保健专业人员需要准备好应对受虐待儿童中精神障碍的高发病率，对该人群中可能出现的身体疾病更加警惕，并更好地利用为这些儿童接种疫苗的机会。
