ISGlobal, Barcelona, Spain; Maastricht University, The Netherlands; Pompeu Fabra University, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Department of Child and Adolescent Psychiatry, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.
ISGlobal, Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.
Span J Psychiatry Ment Health. 2023 Jan-Mar;16(1):24-31. doi: 10.1016/j.rpsm.2021.02.005. Epub 2021 Mar 9.
Most mental disorders have its onset during childhood, but less than one third of affected children seek professional help. The aim of this study is to (1) estimate the lifetime prevalence of mood, anxiety, conduct, and eating disorder diagnoses in 18-year-olds in 2017 and (2) the temporal trends of incidence diagnosis rates in 2009-2017 in children aged 2-18 in Catalonia, Spain.
We used a registry-based cohort including all children aged 2-18 living in Catalonia in 2009-2017, from the Catalan Health Service. Cases were identified with ICD-9 codes. Lifetime prevalence was calculated for 2017, and annual incidence for 2009-2017. Temporal trends were analyzed with multivariate negative binomial regression models.
Lifetime prevalence of diagnoses was highest for conduct disorders (5.05%), followed by anxiety (4.37%), mood (3.07%), and eating disorders (2.11%). Median age of diagnosis was 16 years for mood, anxiety and eating disorders, and 15 years for conduct disorders. Comorbidity was present in 20.74% of those diagnosed with a mental disorder. Annual incidence rates for all disorders increased in 2011-2013/2014, and then stabilized. However, incidence rate of anxiety diagnoses in 13-18-year-old children doubled between 2016 and 2017.
Lifetime prevalence of diagnoses are lower than the expected rates of mental disorders based on interview/survey European studies. Further research is needed into the factors underlying (1) the underdiagnoses of mental disorders in children and (2) the increasing trend of anxiety disorder diagnoses in older children.
大多数精神障碍都在儿童时期发病，但只有不到三分之一的患儿寻求专业帮助。本研究旨在：(1) 评估 2017 年 18 岁人群中情绪、焦虑、行为和饮食障碍诊断的终生患病率；(2) 评估 2009-2017 年期间，西班牙加泰罗尼亚地区 2-18 岁儿童的发病率诊断率的时间趋势。
我们使用了一个基于登记的队列，其中包括 2009-2017 年期间居住在加泰罗尼亚的所有 2-18 岁儿童，数据来自加泰罗尼亚卫生服务机构。采用 ICD-9 编码识别病例。计算了 2017 年的终生患病率，并计算了 2009-2017 年的年度发病率。采用多变量负二项回归模型分析时间趋势。
诊断为行为障碍的终生患病率最高（5.05%），其次是焦虑症（4.37%）、情绪障碍（3.07%）和饮食障碍（2.11%）。情绪、焦虑和饮食障碍的诊断中位年龄为 16 岁，行为障碍的诊断中位年龄为 15 岁。在被诊断为精神障碍的患者中，有 20.74%的患者合并有共病。所有疾病的年度发病率在 2011-2013/2014 年间增加，随后稳定。然而，2016 年至 2017 年间，13-18 岁儿童的焦虑症诊断发病率翻了一番。
诊断的终生患病率低于基于访谈/调查的欧洲研究预期的精神障碍发生率。需要进一步研究导致（1）儿童精神障碍漏诊率高的因素；（2）大龄儿童焦虑障碍诊断率增加的趋势。
