Armitage Jessica M, Newlove-Delgado Tamsin, Ford Tamsin, McManus Sally, Collishaw Stephan
Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK.
Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff University, Cardiff, UK.
J Child Psychol Psychiatry. 2025 Feb;66(2):167-177. doi: 10.1111/jcpp.14040. Epub 2024 Jul 24.
While research has described the profile of children with poor mental health, little is known about whether this profile and their needs have changed over time. Our aim was to investigate whether levels of difficulties and functional impact faced by children with a psychiatric disorder have changed over time, and whether sociodemographic and family correlates have changed.
Samples were three national probability surveys undertaken in England in 1999, 2004 and 2017 including children aged 5-15 years. Psychiatric disorders were assessed using the Development and Well-Being Assessment (DAWBA), a standardised multi-informant diagnostic tool based on the tenth International Classification of Diseases (ICD-10). The impact and difficulties of having a disorder (emotional, behavioural or hyperkinetic) were compared over time using total difficulty and impact scores from the Strengths and Difficulties Questionnaire (SDQ). Analyses explored the impact of having any disorder, as well as for each disorder separately. Regression analyses compared associations between disorders and sociodemographic factors over time.
Parent- and adolescent-reported total SDQ difficulty and impact scores increased between 1999 and 2017 for children and adolescents with disorders. No differences were noted when using teacher ratings. No differences in total SDQ difficulty score were found for children without a disorder. Comparison of sociodemographic correlates across the surveys over time revealed that ethnic minority status, living in rented accommodation and being in the lowest income quintile had a weaker association with disorder in 2017 compared to 1999.
Our study reveals a concerning trend; children with a disorder in 2017 experienced more severe difficulties and greater impact on functioning at school, home and in their daily lives, compared to children with a disorder in earlier decades. Research is needed to identify and understand factors that may explain the changing nature and level of need among children with a disorder.
尽管已有研究描述了心理健康状况不佳的儿童的特征，但对于这一特征及其需求是否随时间变化却知之甚少。我们的目的是调查患有精神疾病的儿童所面临的困难程度和功能影响是否随时间变化，以及社会人口统计学和家庭相关因素是否发生了变化。
样本来自1999年、2004年和2017年在英格兰进行的三项全国概率调查，调查对象为5至15岁的儿童。使用发育与幸福感评估（DAWBA）对精神疾病进行评估，这是一种基于第十版国际疾病分类（ICD - 10）的标准化多信息诊断工具。使用优势与困难问卷（SDQ）的总困难和影响得分，对随时间患有疾病（情绪、行为或多动）的影响和困难进行比较。分析探讨了患有任何疾病的影响，以及分别针对每种疾病的影响。回归分析比较了不同时间疾病与社会人口统计学因素之间的关联。
1999年至2017年期间，患有疾病的儿童和青少年中，家长和青少年报告的SDQ总困难和影响得分有所增加。使用教师评分时未发现差异。未患疾病的儿童在SDQ总困难得分上没有差异。随着时间推移对各次调查中的社会人口统计学相关因素进行比较发现，与1999年相比，2017年少数族裔身份、居住在出租房以及处于最低收入五分位数与疾病的关联较弱。
我们的研究揭示了一个令人担忧的趋势；与几十年前患有疾病的儿童相比，2017年患有疾病的儿童经历了更严重的困难，对学校、家庭和日常生活功能的影响更大。需要开展研究以识别和理解可能解释患有疾病儿童需求性质和程度变化的因素。
