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使用 MINI kid 工具评估中国哮喘儿童的神经精神共病及其临床特征。

Evaluation of neuropsychiatric comorbidities and their clinical characteristics in Chinese children with asthma using the MINI kid tool.

机构信息

Department of Pediatrics, Guizhou Provincial People's Hospital, Medical College of Guizhou University, No. 83, Zhongshan Road, Nanming District, Guiyang, 550002, China.

Otolaryngological Department, Guizhou Provincial People's Hospital, Medical College of Guizhou University, Guiyang, China.

出版信息

BMC Pediatr. 2019 Nov 22;19(1):454. doi: 10.1186/s12887-019-1834-7.

Abstract

BACKGROUND

The mental health and quality of life in children with asthma have attracted widespread attention. This study focused on the evaluation of mental health conditions and their clinical characteristics in Chinese children with asthma.

METHODS

A total of 261 children with asthma aged 6 to 16 years old and 261 age- and gender-matched children from the general population were recruited to participate in this study from Guizhou Provincial People's Hospital. The parents of all subjects were interviewed using the MINI Kid and were required to finish a clinical characteristics questionnaire. Logistic regression analysis was performed to evaluate risk factors.

RESULTS

The prevalence of mental health conditions in the asthma group was significantly higher than that in the control group (26.4% vs 14.6%, P < 0.001). A total of 10 mental health conditions was identified in the asthma group, the most common of which was ADHD (11.5%; 30/261), followed by oppositional defiant disorder (ODD) (10.7%; 28/261), separation anxiety disorder (6.1%; 16/261), social anxiety disorder (3.8%; 10/261), specific phobias (2.3%; 6/261), agoraphobia without panic (1.5%; 4/261), (mild) manic episodes (1.1%; 3/261), major depressive episodes (MDEs) (0.8%; 2/261), movement (tic) disorder (0.8%; 2/261), and dysthymia (0.4%; 1/261). A total of 6 neuropsychiatric conditions was detected in the control group, including ODD (5.7%; 15/261), ADHD (4.6%; 12/261), social anxiety disorder (3.1%; 8/261), seasonal anxiety disorder (SAD) (2.3%; 6/261), specific phobias (1.1%; 3/261), and agoraphobia without panic (0.4%; 1/261). The prevalence rates of ODD, ADHD, and SAD differed significantly between the two groups (P < 0.05). Multiple regression analysis revealed that severe persistent asthma (OR = 3.077, 95% CI 1.286-7.361), poor asthma control (OR = 2.005, 95% CI 1.111-3.619), and having asthma for > 3 years (OR = 2.948, 95% CI 1.580-5.502) were independent risk factors for the presence of mental health conditions in asthmatic children.

CONCLUSIONS

Children with asthma have a higher rate of mental health conditions than non-asthmatic children. Standardized diagnosis and treatment may help reduce the risk of neuropsychiatric conditions.

摘要

背景

儿童哮喘的心理健康和生活质量受到广泛关注。本研究聚焦于评估中国哮喘儿童的心理健康状况及其临床特征。

方法

本研究共纳入 261 名年龄在 6 至 16 岁的哮喘儿童和 261 名年龄和性别匹配的来自普通人群的儿童,均来自贵州省人民医院。所有研究对象的父母均通过 MINI Kid 进行访谈,并完成临床特征问卷。采用 logistic 回归分析评估风险因素。

结果

哮喘组的心理健康状况患病率明显高于对照组(26.4% vs 14.6%,P < 0.001)。哮喘组共发现 10 种心理健康状况,最常见的是 ADHD(11.5%;30/261),其次是对立违抗性障碍(ODD)(10.7%;28/261)、分离焦虑症(6.1%;16/261)、社交焦虑症(3.8%;10/261)、特定恐惧症(2.3%;6/261)、广场恐惧症(无惊恐发作)(1.5%;4/261)、(轻度)躁狂发作(1.1%;3/261)、重性抑郁发作(MDEs)(0.8%;2/261)、运动(抽动)障碍(0.8%;2/261)和心境恶劣(0.4%;1/261)。对照组共发现 6 种神经精神疾病,包括 ODD(5.7%;15/261)、ADHD(4.6%;12/261)、社交焦虑症(3.1%;8/261)、季节性焦虑症(SAD)(2.3%;6/261)、特定恐惧症(1.1%;3/261)和广场恐惧症(无惊恐发作)(0.4%;1/261)。两组的 ODD、ADHD 和 SAD 患病率差异有统计学意义(P < 0.05)。多因素回归分析显示,严重持续性哮喘(OR=3.077,95%CI 1.286-7.361)、哮喘控制不佳(OR=2.005,95%CI 1.111-3.619)和哮喘持续时间>3 年(OR=2.948,95%CI 1.580-5.502)是哮喘儿童出现心理健康状况的独立危险因素。

结论

哮喘儿童的心理健康状况发生率高于非哮喘儿童。标准化诊断和治疗可能有助于降低神经精神疾病的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91c6/6873764/6bbeda136064/12887_2019_1834_Fig1_HTML.jpg

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