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儿童和青少年精神疾病诊断中躯体共病的新见解:一项探索性研究。

Novel Insights into Somatic Comorbidities in Children and Adolescents Across Psychiatric Diagnoses: An Explorative Study.

作者信息

Muskens Jet B, Ester Wietske A, Klip Helen, Zinkstok Janneke, van Dongen-Boomsma Martine, Staal Wouter G

机构信息

Karakter Child and Adolescent Psychiatry University Centre Nijmegen, Nijmegen, The Netherlands.

Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands.

出版信息

Child Psychiatry Hum Dev. 2025 Jun;56(3):704-714. doi: 10.1007/s10578-023-01587-w. Epub 2023 Sep 1.

Abstract

Many children with psychiatric disorders display somatic symptoms, although these are frequently overlooked. As somatic morbidity early in life negatively influences long-term outcomes, it is relevant to assess comorbidity. However, studies of simultaneous psychiatric and somatic assessment in children are lacking. The aim of this study was to assess the prevalence of somatic comorbidities in a clinical sample of children and adolescents with psychiatric disorders in a naturalistic design. Data were assessed from 276 children with various psychiatric disorders (neurodevelopmental disorders, affective disorders, eating disorders and psychosis) aged 6-18 years. These data were collected as part of routine clinical assessment, including physical examination and retrospectively analyzed. For a subsample (n = 97), blood testing on vitamin D3, lipid spectrum, glucose and prolactin was available. Results of this cross-sectional study revealed that food intake problems (43%) and insomnia (66%) were common. On physical examination, 20% of the children were overweight, 12% displayed obesity and 38% had minor physical anomalies. Blood testing (n = 97) highlighted vitamin D3 deficiency (< 50 nmol/L) in 73% of the children. None of the predefined variables (gender, age, medication and socioeconomic factors) contributed significantly to the prevalence of somatic comorbidities. The main somatic comorbidities in this broad child- and adolescent psychiatric population consisted of (1) problems associated with food intake, including obesity and vitamin D3 deficiency and (2) sleeping problems, mainly insomnia. Child and adolescent psychiatrists need to be aware of potential somatic comorbidities and may promote a healthy lifestyle.

摘要

许多患有精神疾病的儿童会出现躯体症状,尽管这些症状常常被忽视。由于生命早期的躯体疾病会对长期预后产生负面影响,因此评估共病情况具有重要意义。然而,目前缺乏关于儿童精神和躯体同时评估的研究。本研究的目的是在自然主义设计中,评估患有精神疾病的儿童和青少年临床样本中躯体共病的患病率。对276名年龄在6至18岁之间患有各种精神疾病(神经发育障碍、情感障碍、饮食失调和精神病)的儿童的数据进行了评估。这些数据是作为常规临床评估的一部分收集的,包括体格检查,并进行了回顾性分析。对于一个子样本(n = 97),可以获得维生素D3、血脂谱、血糖和催乳素的血液检测结果。这项横断面研究的结果显示,饮食摄入问题(43%)和失眠(66%)很常见。在体格检查中,20%的儿童超重,12%表现为肥胖,38%有轻微身体异常。血液检测(n = 97)显示73%的儿童维生素D3缺乏(< 50 nmol/L)。没有一个预先定义的变量(性别、年龄、药物治疗和社会经济因素)对躯体共病的患病率有显著影响。在这个广泛的儿童和青少年精神疾病人群中,主要的躯体共病包括:(1)与饮食摄入相关的问题,包括肥胖和维生素D3缺乏;(2)睡眠问题,主要是失眠。儿童和青少年精神科医生需要意识到潜在的躯体共病,并可能促进健康的生活方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a196/12095410/5655353366f8/10578_2023_1587_Figa_HTML.jpg

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