Dol Megan, Reed Madeline, Ferro Mark A
School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada.
Children (Basel). 2022 Oct 12;9(10):1547. doi: 10.3390/children9101547.
The comorbidity of mental illnesses is common in child and adolescent psychiatry. Children with internalizing-externalizing comorbidity often experience worse health outcomes compared to children with a single diagnosis. Greater knowledge of functioning among children with internalizing-externalizing comorbidity can help improve mental health care.
The objective of this exploratory study was to examine whether internalizing-externalizing comorbidity was associated with impaired functioning in children currently receiving mental health services.
The data came from a cross-sectional clinical sample of 100 children aged 4-17 with mental illness and their parents recruited from an academic pediatric hospital. The current mental illnesses in children were measured using the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID), and the level of functioning was measured using the World Health Organization Disability Assessment Schedule (WHODAS) 2.0. Linear regression was used to estimate the association between internalizing-externalizing comorbidity and level of functioning, adjusting for demographic, psychosocial, and geographic covariates.
Internalizing-externalizing comorbidity in children was associated with worse functioning compared to children with strictly internalizing comorbidities, β = 0.32 ( = 0.041). Among covariates, parent's psychological distress, β = 0.01 ( = 0.004), and distance to the pediatric hospital, β = 0.38 ( = 0.049) were associated with worse functioning in children.
Health professionals should be mindful that children with internalizing-externalizing comorbidity may experience worsening functioning that is disruptive to daily activities and should use this information when making decisions about care. Given the exploratory nature of this study, additional research with larger and more diverse samples of children is warranted.
精神疾病的共病现象在儿童和青少年精神病学中很常见。与单一诊断的儿童相比，患有内化-外化共病的儿童往往健康状况更差。对内化-外化共病儿童的功能有更深入的了解有助于改善心理健康护理。
这项探索性研究的目的是检验内化-外化共病是否与目前正在接受心理健康服务的儿童的功能受损有关。
数据来自一家学术儿科医院招募的100名4至17岁患有精神疾病的儿童及其父母的横断面临床样本。使用儿童和青少年版迷你国际神经精神病学访谈量表（MINI-KID）测量儿童当前的精神疾病，使用世界卫生组织残疾评估量表（WHODAS）2.0测量功能水平。采用线性回归估计内化-外化共病与功能水平之间的关联，并对人口统计学、心理社会和地理协变量进行调整。
与严格患有内化共病的儿童相比，患有内化-外化共病的儿童功能更差，β = 0.32（P = 0.041）。在协变量中，父母的心理困扰，β = 0.01（P = 0.004），以及到儿科医院的距离，β = 0.38（P = 0.049）与儿童功能更差有关。
卫生专业人员应注意，患有内化-外化共病的儿童可能会出现功能恶化，这会干扰日常活动，在做出护理决策时应利用这些信息。鉴于本研究的探索性质，有必要对更大、更多样化的儿童样本进行进一步研究。
