Centre for Adolescent Health, Royal Children's Hospital, Parkville, Victoria, Australia.
Department of Mental Health, Royal Children's Hospital, Parkville, Victoria, Australia.
J Adolesc Health. 2018 Dec;63(6):779-784. doi: 10.1016/j.jadohealth.2018.06.026. Epub 2018 Sep 29.
There are only a few reports of adolescents with somatic disorders (SDs) whose symptoms are sufficiently severe to require hospital admission. The aim of this study was to describe the symptom profile, health service utilization, and outcome of adolescents with SDs admitted to a tertiary children's hospital.
A retrospective cohort study of all adolescents admitted to the Adolescent Medicine Unit of a tertiary children's hospital was undertaken from July 2013 to June 2014. In a two-stage process, medical records were examined to identify patients who met the diagnostic criteria for SD. Evidence of functional recovery was obtained for the period from 18 to 30 months after discharge and rated as completely recovered, partially recovered, or functionally disabled.
A total of 60 admissions (53 patients, 79% female) were identified with SD, accounting for 12% of the unit's admissions and 2% of hospital admissions over 12 years old. Nearly half (45%) the presenting symptoms were neurological and 39% involved pain. In total, 20% of admissions were for complex symptoms involving multiple body systems. The majority (81%) of adolescents with follow-up documentation (n = 37) demonstrated complete or partial recovery. Patients whose families fully accepted the diagnosis were more likely to accept counseling following discharge (p < .001) and were almost 20 times more likely to have completely recovered compared to adolescents whose families partially accepted or rejected the diagnosis (odds ratio 17.36, p = .003).
Hospitalized adolescents with SD utilize substantial resources due to the requirement for comprehensive assessment, including multidisciplinary communication. Recovery can be anticipated for the majority, especially if supported by parents.
仅有少数报告描述了症状严重到需要住院的青少年躯体障碍(SD)病例。本研究旨在描述因 SD 而住院的青少年的症状特征、卫生服务利用情况和结局。
本研究为 2013 年 7 月至 2014 年 6 月期间在一家三级儿童医院青少年医学科接受治疗的所有青少年患者进行的回顾性队列研究。在两阶段的过程中,对病历进行了检查,以确定符合 SD 诊断标准的患者。在出院后 18 至 30 个月期间获得了功能恢复的证据,并将其评定为完全恢复、部分恢复或功能残疾。
共发现 60 例(53 名患者,79%为女性)SD 住院病例,占该科室住院患者的 12%,占 12 岁以上住院患者的 2%。近一半(45%)的首发症状为神经系统症状,39%为疼痛。共有 20%的住院病例涉及多个身体系统的复杂症状。有随访记录的(n=37)大多数青少年表现为完全或部分恢复。接受完整诊断的家庭更有可能在出院后接受咨询(p<0.001),与接受部分诊断或拒绝诊断的家庭相比,其青少年完全恢复的可能性几乎高出 20 倍(优势比 17.36,p=0.003)。
因需要全面评估(包括多学科交流),因 SD 而住院的青少年会耗费大量资源。如果得到父母的支持,大多数患者都有望康复。