Department of Neurology, Children's Hospital of Chongqing Medical University, No. 136, Zhongshan Er Road, Yuzhong District, Chongqing City, 400014, China.
Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014, China.
BMC Psychiatry. 2021 Jan 12;21(1):31. doi: 10.1186/s12888-021-03045-0.
Dissociative (conversion) disorder in children is a complex biopsychosocial disorder with high rates of medical and psychiatric comorbidities. We sought to identify the characteristics and outcomes of children with dissociative (conversion) disorders in western China.
We conducted a retrospective cohort study of 66 children admitted with dissociative (conversion) disorders from January 2017 to July 2019, and analyzed their clinical characteristics, socio-cultural environmental variables, and personality and psychiatric/psychological characteristics. Binary logistic regression was used to analyze the variables associated with clinical efficacy.
Of these 66 patients, 38 (57.6%) were male and 28 (42.4%) were female, 46 (69.7%) had an antecedent stressor, 30 (45.5%) were left-behind adolescents, and 16 (24.2%) were from single-parent families. In addition, 30 patients (45.5%) were not close to their parents, 38 patients (59.4%) had an introverted personality, and 34 (53.1%) had unstable emotions. Thirteen families (19.7%) were uncooperative with the treatment. Patients who had cormorbid anxiety or depression exhibited significantly lower cognitive ability (P < 0.01). Logistic regression found that better treatment outcomes were positively associated with having a close relationship with parents, parental cooperation with treatment, and having a father with a lower level of education (i.e., less than junior college or higher).
The characteristics and outcomes of children with dissociative (conversion) disorders are related to socio-cultural environmental variables and psychiatric/psychological factors. Timely recognition and effective treatment of dissociative (conversion) disorders are important.
儿童分离（转换）障碍是一种复杂的生物-心理-社会障碍，合并较高的躯体和精神共病率。本研究旨在探讨中国西部儿童分离（转换）障碍的特征和结局。
本研究回顾性分析了 2017 年 1 月至 2019 年 7 月期间收治的 66 例分离（转换）障碍患儿的临床资料，分析其临床特征、社会文化环境变量、人格和精神心理特征，并采用二元逻辑回归分析与临床疗效相关的变量。
66 例患儿中，男 38 例（57.6%），女 28 例（42.4%）；发病前有明显应激事件者 46 例（69.7%），留守患儿 30 例（45.5%），单亲家庭 16 例（24.2%）；与父母关系不亲密者 30 例（45.5%），内向性格 38 例（59.4%），情绪不稳定 34 例（53.1%）；13 例家庭不配合治疗（19.7%）。共病焦虑或抑郁者认知功能显著降低（P<0.01）。Logistic 回归分析发现，与父母关系亲密、父母配合治疗、父亲文化程度较低（即高中及以下）与治疗效果较好相关。
儿童分离（转换）障碍的特征和结局与社会文化环境变量和精神心理因素有关，及时识别和有效治疗分离（转换）障碍非常重要。
