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父母的精神症状是否能预测有精神障碍的儿童的结局?一项自然临床研究。

Do Parental Psychiatric Symptoms Predict Outcome in Children With Psychiatric Disorders? A Naturalistic Clinical Study.

机构信息

VU University Amsterdam and the Amsterdam Public Health Institute, The Netherlands.

Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands.

出版信息

J Am Acad Child Adolesc Psychiatry. 2018 Sep;57(9):669-677.e6. doi: 10.1016/j.jaac.2018.05.017. Epub 2018 Jul 17.

Abstract

OBJECTIVE

Parental psychiatric symptoms can negatively affect the outcome of children's psychopathology. Studies thus far have mainly shown a negative effect of maternal depression. This study examined the associations between a broad range of psychiatric symptoms in mothers and fathers and the child's outcome.

METHOD

Internalizing and externalizing psychiatric symptoms were assessed in 742 mothers, 440 fathers, and their 811 children at the first evaluation in 3 child and adolescent psychiatric outpatient clinics and at follow-up (on average 1.7 years later). Predictions of child's symptoms scores were tested at follow-up by parental symptom scores at baseline, parental scores at follow-up, and offspring scores at baseline.

RESULTS

Children whose mother or father scored above the (sub)clinical threshold for psychiatric symptoms at baseline had higher symptom scores at baseline and at follow-up. Offspring follow-up scores were most strongly predicted by offspring baseline scores, in addition to parental psychiatric symptoms at follow-up. Offspring symptom scores at follow-up generally were not predicted by parental scores at baseline. Maternal and paternal associations were of similar magnitude.

CONCLUSION

Higher symptom scores at follow-up in children of parents with psychopathology were mainly explained by higher symptom scores at baseline. Continuing parent-offspring associations could be a result of reciprocal effects, ie, parental symptoms influencing offspring symptoms and offspring symptoms influencing parental symptoms. Nevertheless, the results show that these children are at risk for persisting symptoms, possibly indicating the need to treat maternal and paternal psychopathology.

摘要

目的

父母的精神症状可能会对儿童精神病理学的结果产生负面影响。迄今为止,大多数研究都表明母亲抑郁会产生负面影响。本研究探讨了母亲和父亲广泛的精神症状与孩子结果之间的关联。

方法

在 3 家儿童和青少年精神病门诊诊所,对 742 名母亲、440 名父亲及其 811 名子女进行了内隐和外显精神症状评估,并在第一次评估(平均 1.7 年后)进行了随访。通过父母在基线时的症状评分、随访时的父母评分和子女在基线时的评分,来预测子女在随访时的症状评分。

结果

在基线时父母的精神症状评分超过(亚)临床阈值的儿童,其在基线和随访时的症状评分均较高。除了随访时父母的精神症状外,子女的随访评分主要由子女的基线评分预测。子女的随访评分一般不能由父母的基线评分预测。母亲和父亲的关联具有相似的重要性。

结论

患有精神病理学父母的子女在随访时的症状评分较高,主要是由于基线时的症状评分较高。父母与子女之间持续存在的关联可能是相互影响的结果,即父母的症状影响子女的症状,子女的症状影响父母的症状。然而,这些结果表明这些孩子存在持续症状的风险,可能表明需要治疗父母的精神病理学。

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