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智力残疾个体的自伤行为和精神障碍的流行率。

The prevalence of self-harm and mental disorders among individuals with intellectual disabilities.

机构信息

Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.

Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.

出版信息

Nord J Psychiatry. 2023 Oct;77(7):712-720. doi: 10.1080/08039488.2023.2228292. Epub 2023 Jun 30.

Abstract

OBJECTIVE

Mental health disorders are prevalent among individuals with intellectual disabilities (ID). However, there is a lack of research on the impact of concomitant autism spectrum disorders (ASD) or attention deficit hyperactivity disorder (ADHD) on the mental health within this population. We aimed to investigate the prevalence of mental health disorders and registered healthcare visits due to self-harm among individuals with ID.

METHOD

We used administrative data for all healthcare with at least one recorded diagnosis of mental health disorder or self-harm during 2007-2017 among people with a diagnosis of Down syndrome (DS;  = 1298) and with ID without DS (IDnonDS;  = 10,671) using the rest of the population in Stockholm Region ( = 2,048,488) for comparison.

RESULTS

The highest odds ratios for a mental health disorder were present in females with IDnonDS (9.01) followed by males with IDnonDS (8.50), compared to the general population. The ORs for self-harm among individuals with IDnonDS were high (8.00 for females and 6.60 for males). There were no registered cases of self-harm among individuals with DS. The prevalence of an anxiety or affective disorder was higher among individuals with ID including DS with concomitant ASD or ADHD. Neighbourhood socio-economic status was associated with a lower occurrence of mental health disorders and self-harm in wealthier areas for all outcomes and for all groups.

CONCLUSIONS

Self-harm and psychiatric comorbidities were common among individuals with ID without DS with an attenuated difference among those with concomitant ASD or ADHD, which calls for attention.

摘要

目的

精神健康障碍在智力障碍(ID)个体中较为普遍。然而,关于同时患有自闭症谱系障碍(ASD)或注意力缺陷多动障碍(ADHD)对该人群精神健康的影响,相关研究较少。我们旨在调查 ID 个体中心理健康障碍和因自残导致的注册医疗就诊的发生率。

方法

我们使用行政数据,对 2007 年至 2017 年间所有患有唐氏综合征(DS;n=1298)和非 DS ID(n=10671)个体的精神健康障碍或自残记录至少一次的医疗就诊进行分析,以斯德哥尔摩地区的普通人群(n=2048488)作为对照。

结果

与普通人群相比,非 DS ID 女性(OR=9.01)和男性(OR=8.50)的精神健康障碍的比值比最高。非 DS ID 个体自残的 OR 较高(女性 OR=8.00,男性 OR=6.60)。DS 个体中没有自残记录。同时患有 ASD 或 ADHD 的 ID 个体(包括 DS 个体)中焦虑或情感障碍的患病率更高。在所有结局和所有群体中,社会经济地位较高的社区发生精神健康障碍和自残的概率较低。

结论

非 DS ID 个体中自残和精神共病较为常见,同时患有 ASD 或 ADHD 的个体差异较小,需要引起重视。

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