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儿童精神科住院项目住院时间的神经认知预测因子。

Neurocognitive predictors of length of stay within a children's psychiatric inpatient program.

机构信息

Department of Psychiatry & Human Behavior, E. P. Bradley Hospital/Alpert Medical School of Brown University, East Providence, RI, USA.

Department of Clinical Psychology, Antioch University New England, Keene, NH, USA.

出版信息

Child Neuropsychol. 2020 Jan;26(1):129-136. doi: 10.1080/09297049.2019.1617843. Epub 2019 May 16.

Abstract

This study investigated the neurocognitive predictors of length of stay (LOS) within a children's psychiatric inpatient program. A medical chart review was conducted for 96 children aged 6-14 years who received a neuropsychological evaluation during hospitalization. Correlation and linear regression analyses examined the influence of neurocognition (memory, construction, executive functioning [EF], and intelligence [IQ]) on subsequent LOS. Impairment/performance was calculated by the standard mean composite score and global deficit score (GDS) approaches for each domain and for overall neurocognition. Rates of impairment were similar between the two approaches (ranging from 22.9% to 45.8% across domains). Overall neurocognition (r = .347 & -.270, respectively), EF (r = .333 & -.261, respectively), and construction (r = .287 & -.240), respectively, were significantly associated with LOS utilizing the GDS and composite approaches. After controlling for clinical/demographic predictors of LOS, GDS-Total, GDS-EF/Construction, and EF/Construction composite scores significantly predicted LOS. Further, receiver operating characteristic (ROC) curve detected the GDS was able to distinguish between those children that would and would not end up having a prolonged hospitalization. The GDS and composite score approaches to neurocognitive impairment detection were similarly able to capture neurocognitive impairment and the association of impairment to LOS within a children's psychiatric inpatient program.

摘要

本研究调查了儿童精神病住院患者住院时间(LOS)的神经认知预测因素。对 96 名年龄在 6-14 岁之间的儿童进行了病历回顾,这些儿童在住院期间接受了神经心理评估。相关性和线性回归分析检查了神经认知(记忆、建构、执行功能[EF]和智力[IQ])对随后 LOS 的影响。通过标准平均综合评分和每个领域以及整体神经认知的全球缺陷评分(GDS)方法计算损伤/表现。两种方法的损伤率相似(各领域为 22.9%至 45.8%)。使用 GDS 和综合方法,整体神经认知(r =.347 和 -.270)、EF(r =.333 和 -.261)和建构(r =.287 和 -.240)分别与 LOS 显著相关。在控制 LOS 的临床/人口统计学预测因素后,GDS-总、GDS-EF/建构和 EF/建构综合评分显著预测 LOS。此外,接收者操作特征(ROC)曲线检测到 GDS 能够区分那些最终会或不会延长住院时间的儿童。神经认知损伤检测的 GDS 和综合评分方法都能够捕捉儿童精神病住院患者中的神经认知损伤以及损伤与 LOS 的关联。

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