Division of Children's and Women's Health, Department of Clinical and Experimental Medicine, Linköping University, 581 83, Linköping, Sweden.
Department of Research, Södra Älvsborgs Hospital, Borås, Sweden.
Eur Child Adolesc Psychiatry. 2019 Nov;28(11):1517-1525. doi: 10.1007/s00787-019-01313-9. Epub 2019 Mar 20.
In the adult population, psychiatric disorders are associated with somatic illness. Explanatory life style factors have been found, but also a failure to recognize somatic illness in this group. Another factor is side effects from long-term use of antipsychotic drugs. Given the psychiatric-somatic comorbidity in the adult population, it is of interest to investigate whether an association exists already during childhood. The aim of the present study was to investigate the frequency of somatic illness in children and adolescents with a psychiatric diagnose. Data were obtained from the regional health care database Vega, Sweden. Psychiatric and somatic diagnoses obtained during 2011-2013 for individuals aged 3-18 years were extracted. Descriptive statistics were used to examine difference in somatic morbidity between children with and without psychiatric diagnoses. Logistic regression was used in age-stratified models to test the association between psychiatric and somatic diagnoses. Anxiety and behavioral disorders were associated with all somatic conditions investigated at nearly all ages. The same applied to substance use, investigated at age 9-18 years. Affective disorders were associated with all somatic conditions at age 12-18 years. Psychotic conditions were associated with asthma, bowel disorders and myalgia in adolescents. Children with psychiatric disorders are at remarkably high risk for concurrent somatic illness. The associations span across many types of conditions and across all ages. The results support the need for awareness of somatic morbidity in child and adolescent psychiatric clinical settings, and the need for coordinated health care for children with comorbid states.
在成年人群体中，精神疾病与躯体疾病有关。已经发现了解释性的生活方式因素，但也存在在这一人群中未能识别躯体疾病的情况。另一个因素是长期使用抗精神病药物的副作用。鉴于成年人群体中的精神-躯体共病，研究是否在儿童时期已经存在关联是很有意义的。本研究的目的是调查患有精神科诊断的儿童和青少年中躯体疾病的频率。数据来自瑞典的区域医疗保健数据库 Vega。提取了 2011-2013 年期间年龄在 3-18 岁的个体的精神和躯体诊断。使用描述性统计来检查有和没有精神科诊断的儿童之间躯体发病率的差异。使用分层模型中的逻辑回归来测试精神和躯体诊断之间的关联。焦虑和行为障碍与几乎所有年龄段调查的所有躯体状况有关。同样适用于物质使用障碍，在 9-18 岁时调查。情感障碍与 12-18 岁时的所有躯体状况有关。精神障碍与青少年的哮喘、肠道疾病和肌痛有关。患有精神疾病的儿童并发躯体疾病的风险极高。这些关联跨越了许多类型的疾病和所有年龄段。研究结果支持在儿童和青少年精神科临床环境中需要注意躯体发病率，并需要为患有合并症的儿童提供协调的医疗保健。
