Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taiwan.
Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taiwan.
Epidemiol Psychiatr Sci. 2019 Jan 30;29:e15. doi: 10.1017/S2045796018000793.
There has been a lack of prevalence estimates of DSM-5 mental disorders in child populations at the national level worldwide. This study estimated the lifetime and 6-month prevalence of mental disorders according to the DSM-5 diagnostic criteria in Taiwanese children.
Taiwan's National Epidemiological Study of Child Mental Disorders used the stratified cluster sampling to select 69 schools in Taiwan resulting in a nationally representative sample of 4816 children in grades 3 (n = 1352), 5 (n = 1297) and 7 (n = 2167). All the participants underwent face-to-face psychiatric interviews using the Kiddie-Schedule for Affective Disorders and Schizophrenia-Epidemiological version, modified for the DSM-5, and they and their parents completed questionnaires. The inverse probability censoring weighting (IPCW)-adjusted prevalence was reported to minimise non-response bias.
The IPCW-adjusted prevalence rates of mental disorders decreased by 0.1-0.5% than raw weighted prevalence. The IPCW-adjusted weighted lifetime and 6-month prevalence rates for overall mental disorders were 31.6 and 25.0%, respectively. The most prevalent mental disorders (lifetime, 6-month) were anxiety disorders (15.2, 12.0%) and attention-deficit hyperactivity disorder (10.1, 8.7%), followed by sleep disorders, tic disorders, oppositional defiant disorder and autism spectrum disorder. The prevalence rates of new DSM-5 mental disorders, avoidant/restrictive food intake disorder and disruptive mood dysregulation disorder were low (<1%).
Our findings, similar to the DSM-IV prevalence rates reported in Western countries, indicate that DSM-5 mental disorders are common in the Taiwanese child population and suggest the need for public awareness, early detection and prevention.
全球范围内，针对儿童群体的 DSM-5 精神障碍的流行率数据，在国家层面较为缺乏。本研究旨在根据 DSM-5 诊断标准，评估台湾地区儿童的终身和 6 个月精神障碍流行率。
台湾地区儿童精神障碍全国流行病学研究采用分层聚类抽样方法，在台湾地区选取 69 所学校，对各年级（3 年级：n=1352；5 年级：n=1297；7 年级：n=2167）的 4816 名儿童进行了全国代表性抽样调查。所有参与者均接受了基于 DSM-5 修订版的儿童心境障碍和精神分裂症的 Kiddie-Schedule 面对面精神病学访谈，并由他们及其家长完成问卷调查。采用逆概率加权校正（Inverse Probability Censoring Weighting，IPCW）来调整流行率，以最大程度减少无应答偏倚。
经 IPCW 校正后的流行率较原始加权流行率降低了 0.1%-0.5%。总体精神障碍的 IPCW 校正后终身和 6 个月流行率分别为 31.6%和 25.0%。最常见的精神障碍（终身、6 个月）为焦虑障碍（15.2%、12.0%）和注意缺陷多动障碍（10.1%、8.7%），其次为睡眠障碍、抽动障碍、对立违抗性障碍和自闭症谱系障碍。新的 DSM-5 精神障碍、回避/限制型食物摄入障碍和破坏性情绪失调障碍的患病率较低（<1%）。
与西方国家 DSM-IV 报告的流行率相似，本研究结果表明，DSM-5 精神障碍在台湾地区儿童中较为常见，提示需提高公众意识，早期发现和预防。
