Population, Policy and Practice Programme, UCL Great Ormond Street Institute of Child Health,London, WC1N 1EH,UK.
University of Exeter Medical School,Heavitree Road,Exeter EX1 2LU,UK.
Psychol Med. 2019 Jun;49(8):1275-1285. doi: 10.1017/S0033291718001757. Epub 2018 Sep 11.
There is a growing concern about the mental health of children and young people (CYP) in the UK, with increasing demand for counselling services, admissions for self-harm and referrals to mental health services. We investigated whether there have been similar recent trends in selected mental health outcomes among CYP in national health surveys from England, Scotland and Wales.
Data were analysed from 140 830 participants (4-24 years, stratified into 4-12, 13-15, 16-24 years) in 36 national surveys in England, Scotland and Wales, 1995-2014. Regression models were used to examine time trends in seven parent/self-reported variables: general health, any long-standing health condition, long-standing mental health condition; Warwick-Edinburgh Mental Wellbeing Score (WEMWBS), above-threshold Strengths and Difficulties Questionnaire Total (SDQT) score, SDQ Emotion (SDQE) score, General Health Questionnaire (GHQ) score.
Across all participants aged 4-24, long-standing mental health conditions increased in England (0.8-4.8% over 19 years), Scotland (2.3-6.0%, 11 years) and Wales (2.6-4.1%, 7 years) (all p < 0.001). Among young children (4-12 years), the proportion reporting high SDQT and SDQE scores decreased significantly among both boys and girls in England [SDQE: odds ratio (OR) 0.97 (0.96-0.98), p < 0.001] and girls in Scotland [SDQE: OR 0.96 (0.93-0.99), p = 0.005]. The proportion with high SDQE scores (13-15 years) decreased in England [OR 0.98 (0.96-0.99), p = 0.006] but increased in Wales [OR 1.07 (1.03-1.10), p < 0.001]. The proportion with high GHQ scores decreased among English women (16-24 years) [OR 0.98 (0.98-0.99), p = 0.002].
Despite a striking increase in the reported prevalence of long-standing mental health conditions among UK CYP, there was relatively little change in questionnaire scores reflecting psychological distress and emotional well-being.
英国越来越关注儿童和青少年(CYP)的心理健康问题,咨询服务、自残入院和精神健康服务的转介需求不断增加。我们调查了英格兰、苏格兰和威尔士的全国健康调查中 CYP 最近是否也出现了类似的心理健康结果趋势。
对英格兰、苏格兰和威尔士 36 项全国性调查中的 140830 名参与者(4-24 岁,分为 4-12 岁、13-15 岁、16-24 岁)的数据进行了分析。使用回归模型检查七个父母/自我报告变量的时间趋势:一般健康状况、任何长期健康状况、长期心理健康状况;沃里克-爱丁堡心理健康量表(WEMWBS)、阈上强度和困难问卷总分(SDQT)得分、SDQ 情绪(SDQE)得分、一般健康问卷(GHQ)得分。
在所有 4-24 岁的参与者中,长期心理健康状况在英格兰(19 年增加 0.8-4.8%)、苏格兰(11 年增加 2.3-6.0%)和威尔士(7 年增加 2.6-4.1%)均有所增加(均 P < 0.001)。在幼儿(4-12 岁)中,英格兰男孩和女孩的高 SDQT 和 SDQE 评分报告比例显著下降[SDQE:比值比(OR)0.97(0.96-0.98),P < 0.001],苏格兰女孩[SDQE:OR 0.96(0.93-0.99),P = 0.005]。高 SDQE 评分比例(13-15 岁)在英格兰下降[OR 0.98(0.96-0.99),P = 0.006],但在威尔士上升[OR 1.07(1.03-1.10),P < 0.001]。英格兰女性(16-24 岁)的高 GHQ 评分比例下降[OR 0.98(0.98-0.99),P = 0.002]。
尽管英国 CYP 报告的长期心理健康状况的流行率显著增加,但反映心理困扰和情绪健康的问卷评分相对变化不大。