Minatoya Machiko, Suyama Satoshi, Kishi Reiko
Faculty of Health Sciences, Hokkaido University.
Hokkaido University Center for Environmental and Health Sciences.
Nihon Koshu Eisei Zasshi. 2020;67(10):745-751. doi: 10.11236/jph.67.10_745.
Objectives Atopic dermatitis (AD) is a common childhood disease with an increasing prevalence, affecting the quality of life of afflicted children. The onset of AD at an early age may disrupt normal sleep patterns, behavior, and relationships. Increased behavioral and discipline problems associated with AD have been documented. However, there are insufficient studies on AD at early ages, especially in Japan. This study aimed to examine the association between AD and the mental and behavioral health of children of preschool age.Methods This study was a part of a prospective cohort study (n=20,926), and children born after April 2008 (n=7,386) were the target population of this study. Those who answered the Japanese version of the International Study of Asthma and Allergies in Childhood (ISAAC) at 4 years of age (n=4,228) and answered the Strength and Difficulties Questionnaire (SDQ) at 5 years of age were included in this study (n=3,862). The subscale scores of SDQ, namely, emotional symptoms, conduct problems, peer relationship problems, and hyperactivity/inattention, along with the sum of these 4 subscale scores, (total difficulties score (TDS), were investigated in relation to the prevalence of AD. SDQ scores were treated as continuous values for linear regression analysis and as dichotomized values for logistic regression analysis. The parental history of AD was adjusted in the final models.Results The prevalence of AD at 4 years of age was 20.7% (n=799). The mean scores of emotional symptoms, conduct problems, and TDS were significantly higher among children with AD than among those without AD. Linear regression analysis revealed increased scores for emotional symptoms, conduct problems, and TDS in association with AD. Logistic regression analysis revealed a significantly increased risk for conduct problems in children with AD.Conclusion This study found associations between AD at 4 years of age and emotional symptoms, conduct problems and TDS at 5 years of age. Further studies to assess the severity of AD and children's mental and behavioral problems at older ages are essential.
目的 特应性皮炎(AD)是一种常见的儿童疾病,其患病率呈上升趋势,影响患病儿童的生活质量。AD在幼年发病可能会扰乱正常的睡眠模式、行为和人际关系。与AD相关的行为和纪律问题增多已有文献记载。然而,关于早期AD的研究不足,尤其是在日本。本研究旨在探讨AD与学龄前儿童心理和行为健康之间的关联。
方法 本研究是一项前瞻性队列研究(n = 20,926)的一部分,2008年4月以后出生的儿童(n = 7,386)是本研究的目标人群。那些在4岁时回答了日本版儿童哮喘和过敏国际研究(ISAAC)(n = 4,228)且在5岁时回答了优势与困难问卷(SDQ)的儿童纳入本研究(n = 3,862)。研究了SDQ的子量表分数,即情绪症状、行为问题、同伴关系问题和多动/注意力不集中,以及这4个子量表分数的总和(总困难分数(TDS))与AD患病率的关系。SDQ分数在进行线性回归分析时作为连续值处理,在进行逻辑回归分析时作为二分值处理。在最终模型中对AD的家族史进行了校正。
结果 4岁时AD的患病率为20.7%(n = 799)。AD患儿的情绪症状、行为问题和TDS的平均分数显著高于无AD的患儿。线性回归分析显示,与AD相关的情绪症状、行为问题和TDS分数增加。逻辑回归分析显示,AD患儿出现行为问题的风险显著增加。
结论 本研究发现4岁时的AD与5岁时的情绪症状、行为问题和TDS之间存在关联。进一步评估AD严重程度以及大龄儿童心理和行为问题的研究至关重要。