Jalling Camilla, Kristiansson Marianne
Department of Clinical Neuroscience at Karolinska Institutet, Stockholm, Sweden.
The Swedish National Board of Institutional Care, Solna, Sweden.
Front Psychiatry. 2025 Aug 18;16:1657469. doi: 10.3389/fpsyt.2025.1657469. eCollection 2025.
This study sought to examine the prevalence of diagnosed and undiagnosed psychiatric disorders, comorbidity, and acute psychiatric conditions among young males in compulsory residential care due to criminality, substance misuse, or other socially destructive behavior pattern.
An online cross-sectional survey measured diagnosed and undiagnosed mental disorders listed in DSM-5, and other psychiatric conditions among children and youth admitted to the Swedish National Board of Institutional Care. Psychologists at the residential homes answered one questionnaire per young male participant by retrieving information from records and other relevant files.
Data for 183 residing young males were analyzed. The prevalence of diagnosed mental disorders was high (77%), and psychiatric comorbidity was present among 46%. ADHD was the most common diagnosis (57%), followed by SUD (20%), CD (14%), ASD (14%), and PTSD (12%). Furthermore, a large proportion of the young males had displayed clinical symptoms without being diagnosed, and 10% had been in a state of acute psychiatric distress.
Several findings in this study align with previous research, such as the prevalence of diagnosed conditions and co-morbidities. Some results did diverge, however, and ADHD and SUD were found to have higher prevalences in our study, while CD was considerably lower compared to previous findings. It remains unclear why CD prevalence was low, but it may have to do with the high prevalence of ADHD, and a general reluctance to assess for CD. In Sweden, where this study was carried out, both clinical and general awareness of ADHD has increased over the last two decades, alongside revised diagnostic criteria in DSM-5, which may have improved identification, and assessment, and led to an increase in diagnoses. It may also, in part, have led to clinicians prioritizing assessments of ADHD over CD.
本研究旨在调查因犯罪、药物滥用或其他具有社会破坏性的行为模式而被强制收容的年轻男性中已确诊和未确诊的精神疾病、共病情况以及急性精神状况的患病率。
一项在线横断面调查对《精神疾病诊断与统计手册》第5版(DSM - 5)中列出的已确诊和未确诊的精神障碍以及瑞典国家机构照料委员会收治的儿童和青少年中的其他精神状况进行了测量。寄宿家庭的心理学家通过从记录和其他相关文件中检索信息,为每位年轻男性参与者填写一份问卷。
对183名居住在寄宿机构的年轻男性的数据进行了分析。已确诊精神障碍的患病率很高(77%),46%的人存在精神共病。注意力缺陷多动障碍(ADHD)是最常见的诊断(57%),其次是物质使用障碍(SUD,20%)、品行障碍(CD,14%)、孤独症谱系障碍(ASD,14%)和创伤后应激障碍(PTSD,12%)。此外,很大一部分年轻男性虽有临床症状但未被确诊,10%的人处于急性精神痛苦状态。
本研究的几项发现与先前的研究一致,例如已确诊疾病和共病的患病率。然而,一些结果确实存在差异,我们的研究发现ADHD和SUD的患病率较高,而CD的患病率与先前的研究结果相比则低得多。目前尚不清楚CD患病率低的原因,但可能与ADHD的高患病率以及普遍不愿评估CD有关。在开展本研究的瑞典,在过去二十年中,临床和公众对ADHD的认识都有所提高,同时DSM - 5中的诊断标准也进行了修订,这可能改善了识别和评估,并导致诊断增加。这也可能在一定程度上导致临床医生将对ADHD 的评估置于CD之上。