受虐待儿童精神障碍的临床特征及危险因素

Kuo- Li, Cheng-Hsien Sung, Shih‐Kai Liu, Yuan-Chang Hsu, Chih-Nan Chen
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摘要

目的:本调查旨在探讨受虐待儿童的临床特征及可能的危险因素,包括虐待类型、家庭因素和精神病理。方法:回顾1997 - 2016年儿童之家受虐待儿童年度项目综合评估的临床病例报告。综合评估包括虐待史、家庭状况、精神病学访谈、体格检查和心理评估。我们将受虐待儿童分为I轴精神障碍组和非I轴精神障碍组,比较临床特征和危险因素的差异。结果:377例患者平均年龄9.1±3.0岁。大多数是男性(60.5%)和小学生(69.9%)。只有22.5%的父母在婚姻状态上保持已婚。I轴精神障碍组的年龄(p < 0.05)和全智力(p < 0.001)均显著低于非I轴精神障碍组。此外,第I轴精神障碍组的研究参与者的位置变化次数显著增加(p < 0.05),并且在一个位置停留的时间更长(p < 0.05)。在这两组中,大约40%的参与者身高不超过25%。在权重维度中找不到该特征。结论:虽然精神障碍问题增加了儿童虐待问题的复杂性,但促进、保护和恢复心理健康可以被视为这些弱势儿童的重要关注点。
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Clinical features and risk factors of psychiatric disorders among maltreated children
Objective: In this survey, we intended to study the clinical features and possible risk factors including types of maltreatment, family factors, and psychopathology of maltreated children. Methods: We reviewed the clinical case reports of comprehensive assessment in annual projects of maltreated children placed in the children's homes between 1997 and 2016. The comprehensive assessment included history of maltreatment, family condition, psychiatric interview, physical examination, and psychological assessment. We divided maltreated children into Axis I psychiatric disorder and non-Axis I psychiatric disorder groups for comparing the difference in clinical features and risk factors. Results: Among the 377 participants, the average age was 9.1 ± 3.0 years. The majority were male (60.5%) and pupils of elementary school (69.9%). Only 22.5% of their parents still maintained as married in marital status. In Axis I psychiatric disorder group, both age (p < 0.05) and full intelligence (p < 0.001) were significantly lower than non-Axis I psychiatric disorder group. Besides, the study participants in the Axis I psychiatric disorder group had significantly more times of changes in placement (p < 0.05) and stayed longer in a placement (p < 0.05). In both groups, around 40% of all the participants were 25 percentile or less in height. The feature was not found in weight dimension. Conclusion: While the problem of psychiatric disorder adds complexity to child maltreatment issues, the promotion, protection, and restoration of mental health can be regarded as a vital concern in these vulnerable children.
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