根据《精神疾病诊断与统计手册》第5版(DSM-5),儿童神经发育障碍患病率的当前知识状态:一项符合PRISMA标准的系统评价
Current state of knowledge on the prevalence of neurodevelopmental disorders in childhood according to the DSM-5: a systematic review in accordance with the PRISMA criteria.
作者信息
Francés Lorena, Quintero Javier, Fernández Alberto, Ruiz Antoni, Caules Jessica, Fillon Gabriella, Hervás Amaia, Soler C Virgínia
机构信息
Child and Adolescent Psychiatrist, Menorca (Balearic Islands, Spain). Av. Del Metge Camps 20, 07740, Es Mercadal, Balearic Islands, Spain.
Head of the Psychiatry Service, Infanta Leonor Hospital Madrid, Madrid, Spain.
出版信息
Child Adolesc Psychiatry Ment Health. 2022 Mar 31;16(1):27. doi: 10.1186/s13034-022-00462-1.
OBJECTIVE
To interpret the current evidence on the prevalence of neurodevelopmental disorders (NDDs) through a systematic review based on both DSM-5 (2013) and PRISMA criteria.
METHOD
Empirical studies complying with the PRISMA guidelines were identified from four databases (PubMed, Scopus, Science Direct, and ProQuest) and systematically reviewed. In total, 17 articles were selected for the study.
RESULTS
In the scientific literature, there have been only a few studies measuring the prevalence of NDDs according to the DSM-5 (2013) criteria in people under 18 years old. The reported prevalence rates were as follows: intellectual disability (ID), 0.63%; attention-deficit/hyperactivity disorder (ADHD), 5-11%; autism spectrum disorder (ASD), 0.70-3%; specific learning disorder (SLD), 3-10%; communication disorders (CDs), 1-3.42%; and motor disorders (MDs), 0.76-17%. Although there is extensive literature on specific disorders, NDDs have rarely been assessed as a whole. All of the reviewed studies support the idea that such disorders can be considered chronic, heterogeneous, underdiagnosed conditions and that comorbidity of multiple NDDs is the norm. Likewise, it is estimated that the prevalence of the most studied disorders, such as ADHD, ASD and SLD, remains stable over time and is consistent in different cultures, ages, ethnicities and sexes.
CONCLUSION
The studies reviewed lead us to conclude that the prevalence rate of NDDs fluctuates globally between 4.70 and 88.50%; these variations depend on methodological aspects such as estimation procedures, as well as on sociocontextual phenomena. It is also important to consider that the prevalence found is probably highly influenced by the activity of the countries in the diagnosis and training of professionals who care for children and adolescents. Hence, there is a need for a secondary intervention in the fields of public health and education to minimize socioemotional consequences, prevent academic failure, and reduce the economic cost to society.
目的
通过基于《精神疾病诊断与统计手册》第五版(2013年)和系统评价与Meta分析的首选报告项目(PRISMA)标准的系统评价,解读当前关于神经发育障碍(NDDs)患病率的证据。
方法
从四个数据库(PubMed、Scopus、Science Direct和ProQuest)中识别符合PRISMA指南的实证研究,并进行系统评价。总共选择了17篇文章进行研究。
结果
在科学文献中,仅有少数研究根据《精神疾病诊断与统计手册》第五版(2013年)标准测量18岁以下人群中NDDs的患病率。报告的患病率如下:智力残疾(ID),0.63%;注意力缺陷多动障碍(ADHD),5%-11%;自闭症谱系障碍(ASD),0.70%-3%;特定学习障碍(SLD),3%-10%;沟通障碍(CDs),1%-3.42%;运动障碍(MDs),0.76%-17%。尽管有大量关于特定障碍的文献,但很少将NDDs作为一个整体进行评估。所有纳入综述的研究均支持这样一种观点,即这些障碍可被视为慢性、异质性、诊断不足的疾病,并且多种NDDs共病是常态。同样,据估计,研究最多的障碍,如ADHD、ASD和SLD的患病率随时间保持稳定,且在不同文化、年龄、种族和性别中一致。
结论
纳入综述的研究使我们得出结论,NDDs的患病率在全球范围内波动于4.70%至88.50%之间;这些差异取决于估计程序等方法学方面,以及社会背景现象。还需考虑的是,所发现的患病率可能受到各国在儿童和青少年护理专业人员诊断和培训方面活动的高度影响。因此,有必要在公共卫生和教育领域进行二级干预,以尽量减少社会情感后果,防止学业失败,并降低社会经济成本。