School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada.
Department of Statistics and Actuarial Sciences, University of Waterloo, Waterloo, Ontario, Canada.
Can J Psychiatry. 2024 Oct;69(10):749-758. doi: 10.1177/07067437241271713. Epub 2024 Aug 16.
This epidemiological study estimated the lifetime prevalence of chronic physical illness (i.e., an illness that lasted or was expected to last ≥6 months) and 6-month prevalence of mental disorder and multimorbidity (i.e., ≥1 physical illness and ≥1 mental disorder) in youth. Associations between physical illness and mental disorder were quantified, including the number of illnesses. Secondary objectives examined factors associated with mental disorder, after controlling for physical illness.
Data come from 10,303 youth aged 4-17 years in the 2014 Ontario Child Health Study (OCHS). Physical illness was measured using a list of chronic conditions developed by Statistics Canada. Mental disorders were measured using the OCHS Emotional Behavioural Scales. The Health Utility Index Mark III assessed overall functional health.
Weighted prevalence estimates showed 550,090 (27.8%) youth had physical illness, 291,986 (14.8%) had mental disorder, and 108,435 (5.4%) had multimorbidity. Physical illness was not associated with mental disorder. However, youth with 2 physical illnesses, as compared to no physical illnesses, had increased odds of having any mental (OR = 1.75 [1.08, 2.85]), mood (OR = 2.50 [1.39, 4.48]) and anxiety disorders (OR = 2.40 [1.33, 4.31]). Mean functional health scores demonstrated a dose-response association across health status categories, with the highest scores among healthy youth and the lowest scores among multimorbid youth (all < .05).
Chronic physical illness and mental disorders are prevalent in youth. Youths with 2 physical illnesses have a higher likelihood of mental disorders. Higher functional health scores protected against all mental disorders. Mental health interventions for youth should promote strong overall functional health.
Physical-Mental Multimorbidity in Ontario Youth.
本流行病学研究旨在估计青少年一生中慢性躯体疾病（即持续或预计持续≥6 个月的疾病）的终生患病率，以及 6 个月内精神障碍和多种躯体疾病（即≥1 种躯体疾病和≥1 种精神障碍）的患病率。量化了躯体疾病与精神障碍之间的关联，包括疾病数量。次要目标是在控制躯体疾病后，研究与精神障碍相关的因素。
数据来自于 2014 年安大略省儿童健康研究（OCHS）中 4-17 岁的 10303 名青少年。使用加拿大统计局开发的慢性疾病清单来衡量躯体疾病。使用 OCHS 情绪行为量表来衡量精神障碍。健康效用指数 Mark III 评估整体功能健康。
加权患病率估计显示，550090 名（27.8%）青少年患有躯体疾病，291986 名（14.8%）患有精神障碍，108435 名（5.4%）患有多种躯体疾病。躯体疾病与精神障碍无关。然而，与无躯体疾病的青少年相比，患有 2 种躯体疾病的青少年出现任何精神障碍（OR=1.75[1.08,2.85]）、情绪障碍（OR=2.50[1.39,4.48]）和焦虑障碍（OR=2.40[1.33,4.31]）的可能性更高。功能健康评分均值随着健康状况类别呈剂量反应关系，健康青少年的评分最高，多种躯体疾病青少年的评分最低（均<.05）。
慢性躯体疾病和精神障碍在青少年中较为普遍。患有 2 种躯体疾病的青少年出现精神障碍的可能性更高。较高的功能健康评分可预防所有精神障碍。针对青少年的心理健康干预措施应促进整体功能健康。
