Department of Psychiatry and Behavioral Science, Tokyo Medical and Dental University Graduate School, Tokyo, Japan.
Department of Child and Adolescent Psychiatry, Komagino Hospital, Hachioji, Tokyo, Japan.
PLoS One. 2020 Aug 27;15(8):e0237906. doi: 10.1371/journal.pone.0237906. eCollection 2020.
BACKGROUND/AIM: To our knowledge, no case-control study has investigated the relationships between stealing, clinical implications, and psychiatric diagnosis among child and adolescent psychiatric patients with or without a history of stealing. Thus, the associations between child and adolescent psychiatric disorders and a history of stealing remain unclear. Therefore, the aim of the present study was to evaluate the relationships between stealing, clinical implications, and psychiatric diagnosis among child and adolescent psychiatric patients with or without a history of stealing.
In this retrospective case-control study, the proportions of clinical implications among child and adolescent psychiatric patients with and without a history of stealing were compared. Data regarding age, sex, primary diagnosis, junior high school student or not, both father and mother are the caregivers or not, family history, abuse history, school refusal, depressive state, and obsessive-compulsive symptoms were retrieved from medical records. Participants consisted of Japanese junior high school students and younger patients (maximum age, 15 years) at the first consultation. All patients were examined and diagnosed by psychiatrists according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, or the Fifth Edition. Stealing was reported by the patients or caregivers to the psychiatrist, or the psychiatrist had inquired about a history of stealing at the first consultation.
Among 1972 patients who consulted the clinic, at the first consultation, 56 (2.84%) had a history of stealing (cases), and 1916 (97.16%) did not (controls). Multivariate logistic regression analyses revealed that the proportions of males, junior high school students, abuse history, autism spectrum disorder (ASD), and conduct disorder were significantly higher, and the proportions of adjustment disorders and school refusal were significantly lower in cases than in controls. The multivariate adjusted odds ratio increased further when the two factors were considered together, such as ASD with abuse history and attention deficit-hyperactivity disorder (ADHD) with abuse history.
Children with a history of stealing were more likely to be diagnosed with ASD or ADHD with abuse history. Child and adolescent psychiatric outpatients with a history of stealing were more likely to be older and male. Our study should be understood without prejudice because this study is reporting associations, not causality. Therefore, a prospective study to investigate causality among ADHD, ASD, abuse history, and stealing is needed. If ADHD and ASD with abuse history can be correlated to a history of stealing, interventions can be more effective by understanding the mechanisms underlying these connections.
背景/目的：据我们所知，尚无病例对照研究调查过有或无偷窃史的儿童和青少年精神科患者的偷窃行为、临床意义和精神科诊断之间的关系。因此，儿童和青少年精神科疾病与偷窃史之间的关联仍不清楚。因此，本研究旨在评估有或无偷窃史的儿童和青少年精神科患者的偷窃行为、临床意义和精神科诊断之间的关系。
在这项回顾性病例对照研究中，比较了有和无偷窃史的儿童和青少年精神科患者的临床意义比例。从病历中检索了年龄、性别、主要诊断、初中生或非初中生、父母双方均为照顾者或非照顾者、家族史、虐待史、拒绝上学、抑郁状态和强迫症状的数据。参与者包括日本初中生和年龄最大 15 岁的首次就诊的年轻患者。所有患者均由精神科医生根据《精神障碍诊断与统计手册》第四版修订本或第五版进行检查和诊断。偷窃行为由患者或照顾者报告给精神科医生，或精神科医生在首次就诊时询问过偷窃史。
在 1972 名就诊患者中，首次就诊时有 56 名（2.84%）有偷窃史（病例），1916 名（97.16%）无偷窃史（对照）。多变量逻辑回归分析显示，病例组男性、初中生、虐待史、自闭症谱系障碍（ASD）和品行障碍的比例显著较高，而适应障碍和拒绝上学的比例显著较低。当同时考虑两个因素时，如伴有虐待史的 ASD 和伴有虐待史的注意缺陷多动障碍（ADHD），多变量调整后的比值比进一步增加。
有偷窃史的儿童更有可能被诊断为 ASD 或伴有虐待史的 ADHD。有偷窃史的儿童和青少年精神科门诊患者更有可能年龄较大且为男性。我们的研究应该在没有偏见的情况下理解，因为这项研究报告的是关联，而不是因果关系。因此，需要进行一项前瞻性研究来调查 ADHD、ASD、虐待史和偷窃之间的因果关系。如果 ADHD 和 ASD 伴有虐待史与偷窃史相关，通过了解这些关联背后的机制，干预措施可以更有效。
