Erskine Holly E, Ferrari Alize J, Polanczyk Guilherme V, Moffitt Terrie E, Murray Christopher J L, Vos Theo, Whiteford Harvey A, Scott James G
School of Population Health, University of Queensland, Herston, Qld, Australia; Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Qld, Australia.
J Child Psychol Psychiatry. 2014 Apr;55(4):328-36. doi: 10.1111/jcpp.12186. Epub 2014 Jan 22.
The Global Burden of Disease Study 2010 (GBD 2010) is the first to include conduct disorder (CD) and attention-deficit/hyperactivity disorder (ADHD) for burden quantification.
A previous systematic review pooled the available epidemiological data for CD and ADHD, and predicted prevalence by country, region, age and sex for each disorder. Prevalence was then multiplied by a disability weight to calculate years lived with disability (YLDs). As no evidence of deaths resulting directly from either CD or ADHD was found, no years of life lost (YLLs) were calculated. Therefore, the number of disability-adjusted life years (DALYs) was equal to that of YLDs.
Globally, CD was responsible for 5.75 million YLDs/DALYs with ADHD responsible for a further 491,500. Collectively, CD and ADHD accounted for 0.80% of total global YLDs and 0.25% of total global DALYs. In terms of global DALYs, CD was the 72nd leading contributor and among the 15 leading causes in children aged 5-19 years. Between 1990 and 2010, global DALYs attributable to CD and ADHD remained stable after accounting for population growth and ageing.
The global burden of CD and ADHD is significant, particularly in male children. Appropriate allocation of resources to address the high morbidity associated with CD and ADHD is necessary to reduce global burden. However, burden estimation was limited by data lacking for all four epidemiological parameters and by methodological challenges in quantifying disability. Future studies need to address these limitations in order to increase the accuracy of burden quantification.
《2010年全球疾病负担研究》(GBD 2010)首次纳入品行障碍(CD)和注意力缺陷多动障碍(ADHD)进行负担量化。
先前的一项系统评价汇总了CD和ADHD的现有流行病学数据,并按国家、地区、年龄和性别预测了每种疾病的患病率。然后将患病率乘以残疾权重以计算残疾生存年数(YLDs)。由于未发现CD或ADHD直接导致死亡的证据,因此未计算生命损失年数(YLLs)。因此,残疾调整生命年数(DALYs)的数量等于YLDs的数量。
在全球范围内,CD导致575万YLDs/DALYs,ADHD又导致另外491,500个YLDs/DALYs。CD和ADHD合计占全球YLDs总数的0.80%,占全球DALYs总数的0.25%。就全球DALYs而言,CD是第72大主要病因,也是5至19岁儿童的15大主要病因之一。1990年至2010年期间,在考虑人口增长和老龄化因素后,CD和ADHD导致的全球DALYs保持稳定。
CD和ADHD的全球负担很重,尤其是在男童中。为应对与CD和ADHD相关的高发病率而进行适当的资源分配对于减轻全球负担很有必要。然而,负担估计受到所有四个流行病学参数数据缺乏以及残疾量化方法挑战的限制。未来的研究需要解决这些限制,以提高负担量化的准确性。