Newman D L, Moffitt T E, Caspi A, Magdol L, Silva P A, Stanton W R
Department of Psychology, University of Wisconsin, Madison 53706, USA.
J Consult Clin Psychol. 1996 Jun;64(3):552-62.
Mental health data were gathered at ages 11, 13, 15, 18, and 21 in an epidemiological sample using standardized diagnostic assessments. Prevalence of Diagnostic and Statistical Manual of Mental Disorders (3rd ed. revised; American Psychiatric Association, 1987) mental disorders increased longitudinally from late childhood (18%) through mid-(22%) to late-adolescence (41%) and young adulthood (40%). Nearly half of age-21 cases had comorbid diagnoses; and comorbidity was associated with severity of impairment. The incidence of cases with adult onset was only 10.6%: 73.8% of adults diagnosed at age 21 had a developmental history of mental disorder. Relative to new cases, those with developmental histories were more severely impaired and more likely to have comorbid diagnoses. The high prevalence rate and significant impairment associated with a diagnosis of mental disorder suggests that treatment resources need to target the young adult sector of the population. The low new-case incidence in young adulthood, however, suggests that primary prevention and etiological research efforts need to target children and adolescents.
在一项流行病学样本中，通过标准化诊断评估在11岁、13岁、15岁、18岁和21岁时收集心理健康数据。《精神疾病诊断与统计手册》（第3版，修订版；美国精神病学协会，1987年）中精神障碍的患病率从儿童晚期（18%）到青少年中期（22%）再到青少年晚期（41%）和青年期（40%）呈纵向上升。21岁时近一半的病例有共病诊断；共病与损害严重程度相关。成年起病病例的发生率仅为10.6%：21岁时被诊断为精神障碍的成年人中有73.8%有精神障碍的发育史。相对于新发病例，有发育史的患者损害更严重，更有可能有共病诊断。精神障碍诊断相关的高患病率和显著损害表明，治疗资源需要针对青年人群体。然而，青年期新发病例的低发生率表明，一级预防和病因学研究工作需要针对儿童和青少年。
