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与智障儿童抑郁和焦虑相关的因素。

Factors associated with depression and anxiety in children with intellectual disabilities.

机构信息

Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA.

出版信息

J Intellect Disabil Res. 2019 May;63(5):408-417. doi: 10.1111/jir.12583. Epub 2018 Dec 26.

Abstract

BACKGROUND

Individuals with intellectual disabilities (ID) are at increased risk for depression and anxiety disorders; however, there is a paucity of research that pertains to associative factors for these mental health disorders in this population. The objective of this investigation was to determine factors associated with depression and anxiety problems in children with ID.

METHODS

Children 6-17 years with ID (n = 423; 63% male) from the 2016 National Survey of Children's Health were included in this cross-sectional study. Outcome measures included depression and anxiety problems. Predictor variables included sociodemographics, ID severity, co-morbid conditions (autism spectrum disorders, epilepsy, cerebral palsy, Down syndrome and attention-deficit/hyperactivity disorder), physical factors (i.e. physical activity, sleep duration and pain) and social factors (e.g. participation in activities and bully victimisation). Multivariable logistic regression was performed to determine the association between all factors and depression and/or anxiety problems among children with ID.

RESULTS

The prevalence of depression and/or anxiety problems was 35.4%. After adjusting for sociodemographics, Hispanic race was associated with lower odds [odds ratio (OR), 0.3; 95% confidence interval (CI), 0.1-0.8] of depression and/or anxiety problems. After adjusting for race, co-morbid conditions, and physical and social factors, autism spectrum disorders (OR, 4.4; 95% CI, 1.1-10.1), Down syndrome (OR, 0.2; 95% CI, 0.1-0.8), attention-deficit/hyperactivity disorder (OR, 5.9; 95% CI, 2.5-14.3), pain (OR, 7.0; 95% CI, 2.9-17.1) and bully victimisation (OR 2.3; 95% CI, 1.0-5.3) were each associated with depression and/or anxiety problems.

CONCLUSIONS

The present study identified both treatable and modifiable, as well as unmodifiable, factors associated with depression and/or anxiety problems in children with ID.

摘要

背景

智障人士(ID)患抑郁症和焦虑症的风险增加;然而,关于该人群精神健康障碍相关因素的研究很少。本研究的目的是确定与智障儿童抑郁和焦虑问题相关的因素。

方法

本横断面研究纳入了 2016 年全国儿童健康调查中年龄在 6-17 岁的 ID 儿童(n=423;63%为男性)。结果测量包括抑郁和焦虑问题。预测变量包括社会人口统计学、ID 严重程度、合并症(自闭症谱系障碍、癫痫、脑瘫、唐氏综合征和注意缺陷多动障碍)、身体因素(如体育活动、睡眠时间和疼痛)和社会因素(如参与活动和被欺凌)。多变量逻辑回归用于确定 ID 儿童所有因素与抑郁和/或焦虑问题之间的关联。

结果

抑郁和/或焦虑问题的患病率为 35.4%。在调整了社会人口统计学因素后,西班牙裔种族与抑郁和/或焦虑问题的可能性较低有关(比值比[OR],0.3;95%置信区间[CI],0.1-0.8)。在调整了种族、合并症以及身体和社会因素后,自闭症谱系障碍(OR,4.4;95%CI,1.1-10.1)、唐氏综合征(OR,0.2;95%CI,0.1-0.8)、注意缺陷多动障碍(OR,5.9;95%CI,2.5-14.3)、疼痛(OR,7.0;95%CI,2.9-17.1)和被欺凌(OR,2.3;95%CI,1.0-5.3)与抑郁和/或焦虑问题均相关。

结论

本研究确定了与智障儿童抑郁和焦虑问题相关的可治疗和可改变的因素,以及不可改变的因素。

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