Department of Medical Sciences, Child and Adolescent Psychiatry, Uppsala University Hospital, 751 85, Uppsala, Sweden.
Department of Medical Sciences, Psychiatry, Uppsala University Hospital, 751 85, Uppsala, Sweden.
Eur Child Adolesc Psychiatry. 2024 Jun;33(6):1783-1792. doi: 10.1007/s00787-023-02282-w. Epub 2023 Aug 20.
The continuity of mental disorders in street-working children is rarely studied. This study therefore investigated homotypic continuity, recurrence of the same disorder, and heterotypic continuity, when a new disorder follows on the previous, of mental disorders from childhood to adulthood in street-working boys from Duhok City, Kurdistan Region of Iraq. Mental disorders were assessed by structured diagnostic interviews in 40 street-working boys in 2004-2005 and again in 2021, when the participants' mean ages were 12.1 (SD 1.8) and 29.7 (SD 2.3), respectively. Mental disorders were common; 24 participants (60%) satisfied the criteria for at least one diagnosis at baseline and 28 (70%) at follow-up. Comorbidity increased from 1.2 (SD 1.4) disorders initially to 2.5 (SD 1.8) at follow-up. Only anxiety disorders showed homotypic continuity. Depressive disorders exhibited the greatest increase over time whereas externalizing disorders exhibited a decreasing tendency. The number of mental disorders in adulthood was related to the number of mental disorders in childhood but not to the number of childhood traumas experienced, having previously worked for more than two hours per day, having worked for over two years on the streets, or having at least one dead parent as a child. Parental ratings on the Child Behaviour Check List (CBCL) from childhood were also unrelated to the number of adult disorders. More longitudinal studies with bigger samples of both genders are needed to fully evaluate the continuity of mental disorders in street-working children and to determine whether the number of mental disorders in childhood is a stronger predictor of being mentally disordered in adult life than psychosocial risk factors or experiences of internalizing or externalizing symptoms in childhood.
街头工作儿童的精神障碍连续性很少被研究。因此，本研究调查了伊拉克库尔德地区杜胡克市街头工作男孩从儿童期到成年期的精神障碍的同型连续性，即同一障碍的复发，以及异型连续性，即新障碍紧随先前障碍之后。在 2004-2005 年和 2021 年，通过结构化诊断访谈对 40 名街头工作男孩进行了精神障碍评估，当时参与者的平均年龄分别为 12.1（SD 1.8）和 29.7（SD 2.3）。精神障碍很常见；24 名参与者（60%）在基线时符合至少一种诊断标准，28 名（70%）在随访时符合。共病从最初的 1.2（SD 1.4）种疾病增加到随访时的 2.5（SD 1.8）。只有焦虑障碍显示出同型连续性。抑郁障碍随着时间的推移而增加，而外化障碍则呈下降趋势。成年时的精神障碍数量与儿童时的精神障碍数量有关，但与儿童时期经历的创伤数量无关，以前每天工作超过两小时，在街头工作超过两年，或儿童时期至少有一位父母去世。儿童时期的父母对儿童行为检查表（CBCL）的评分也与成年时的障碍数量无关。需要进行更多的纵向研究，样本量更大，包括两性，以充分评估街头工作儿童精神障碍的连续性，并确定儿童时期的精神障碍数量是否比社会心理风险因素或儿童时期内化或外化症状的经历更能预测成年后的精神障碍。
