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儿童期慢性疾病与青少年期自我报告的内化和外化问题的关系:一项出生队列研究。

Childhood chronic condition and subsequent self-reported internalizing and externalizing problems in adolescence: a birth cohort study.

机构信息

Department of Psychiatry, Lapland Hospital District, P.O. Box 8041, FI-96101, Rovaniemi, Finland.

University of Oulu Graduate School UniOGS, University of Oulu, P.O. Box 8000, FI-90014, Oulu, Finland.

出版信息

Eur J Pediatr. 2022 Sep;181(9):3377-3387. doi: 10.1007/s00431-022-04505-9. Epub 2022 Jul 7.

Abstract

UNLABELLED

Chronic conditions are common in childhood. We investigated the associations of childhood chronic conditions reported by parents with subsequent self-reported internalizing and externalizing problems in adolescence. A sample of 6290 children (3142 boys and 3148 girls) with data on chronic condition reported by parents both at 7 and at 16 years of age was obtained from the Northern Finland Birth Cohort 1986 (NFBC 1986), which is a longitudinal 1-year birth cohort (n = 9432) from an unselected, regionally defined population. Internalizing and externalizing problems were measured at 8 years of age with Rutter Children's Behavioral Questionnaire by teachers and at 16 years of age with Youth Self-Report by adolescents. When studying the effects of history of chronic conditions on these problems at 16 years of age, childhood internalizing and externalizing problems and social relations were adjusted. A history of chronic condition predicted subsequent somatic complaints among all adolescents. Early-onset chronic conditions were related to subsequent externalizing (OR 1.35; 1.02-1.79) and attention problems (OR 1.33; 1.01-1.75) and later onset of chronic conditions with internalizing (OR 1.49; 1.22-1.82) and thought problems (OR 1.50; 1.18-1.92). The effect was specific for sex and the type of chronic condition.

CONCLUSION

Childhood chronic conditions predicted internalizing and externalizing problems in adolescence. To prevent poor mental health trajectories, children with chronic conditions during their growth to adolescence need early support and long-term monitoring.

WHAT IS KNOWN

• Childhood adversities increase the risk of mental disorders. • Internalizing and externalizing problems have been suggested for measuring childhood and adolescent psychopathologies.

WHAT IS NEW

• Having a chronic condition (CC) before the age of 7 or later but before the age of 16 had different outcomes in adolescence. The early onset predicted externalizing problems, whereas the late onset predicted internalizing problems and thought problems in adolescence. The risk of somatic complaints was increased regardless of CC onset time. These findings can reflect more restricted ability to mental processing in the younger children.

摘要

目的

描述:儿童时期常见慢性疾病。本研究旨在探讨父母报告的儿童期慢性疾病与青少年期自我报告的内化和外化问题之间的关联。

方法

我们从芬兰北部出生队列 1986 年(NFBC 1986)中获取了一份数据样本,该队列包括 6290 名儿童(3142 名男孩和 3148 名女孩),这些儿童的父母分别在 7 岁和 16 岁时报告了他们的慢性疾病。NFBC 1986 是一个基于未选择的、区域性定义的人群的为期 1 年的出生队列(n=9432)。使用教师在 8 岁时使用 Rutter 儿童行为问卷和青少年在 16 岁时使用青少年自我报告评估内化和外化问题。当研究慢性疾病史对 16 岁时这些问题的影响时,我们调整了儿童期内化和外化问题以及社会关系。

结果

有慢性疾病史的儿童在所有青少年中均预测到随后出现躯体症状。早发性慢性疾病与随后的外化问题(OR 1.35;1.02-1.79)和注意力问题(OR 1.33;1.01-1.75)有关,晚发性慢性疾病与内化问题(OR 1.49;1.22-1.82)和思维问题(OR 1.50;1.18-1.92)有关。这种效应具有特定的性别和慢性疾病类型。

结论

儿童期慢性疾病预测青少年期的内化和外化问题。为了预防不良的心理健康轨迹,患有慢性疾病的儿童在成长为青少年期间需要早期支持和长期监测。

已知内容

•童年逆境会增加精神障碍的风险。•内化和外化问题已被提议用于衡量儿童和青少年的精神病理学。

新内容

•在 7 岁之前或之后但在 16 岁之前患有慢性疾病(CC)的儿童在青春期有不同的结果。早发性疾病预测外化问题,而晚发性疾病预测青春期内化问题和思维问题。无论 CC 发病时间如何,躯体症状的风险均增加。这些发现可能反映了年幼儿童的心理处理能力受限。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8a0/9395476/328aa8db9d31/431_2022_4505_Fig1_HTML.jpg

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