河南省某地区初中生情绪和行为相关障碍的诊断变化——1年随访

目的研究青少年情绪和行为相关障碍在1年内出现的诊断变化情况。方法于2015年4月采用整群随机抽样方法,从河南省唐河县城郊乡和舞阳县文烽乡的两所中学的初一、初二年级抽取34个班共1500名学生,采用长处和困难筛查问卷(学生版)(SDQ)进行筛查,对334例筛查阳性者依据《精神障碍诊断与统计手册(第5版)》(DSM-5)进行诊断,符合入组标准共75例,共64例完成随访,并于半年后和1年后进行两次随访,再次依据DSM-5进行诊断。结果9例注意缺陷/多动障碍患者中的3例、12例抑郁障碍患者中的5例、34例焦虑障碍患者中的4例、3例创伤及应激相关障碍中的2例出现诊断变化;其中抑郁障碍比焦虑障碍诊断变化更明显(P=0.039),多转变为强迫障碍、环性心境障碍、破坏性心境失调等。结论青少年抑郁障碍诊断易出现变化,注意缺陷/多动障碍、抑郁障碍的诊断分别预示其以后更易患上焦虑障碍、双相情感障碍。

Changes in the diagnosis of emotional and behavioral disorders in middle high school students in Henan province: one year follow-up

Objective To study the changes in the diagnosis of emotional and behavioral disorders in adolescents over one-year period.Methods In April 2015, cluster random sampling method was used to select 1 500 students from 34 classes of grade 1 and grade 2 in two middle schools in Henan province. All the selected adolescents were assessed using Strengths and Difficulties Questionnaire (SDQ), and 334 cases with positive results were further diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). A total of 75 adolescents met the final inclusion criteria, and 64 of whom completed the follow-up. During the follow-up period, patients received re-diagnosis according to DSM-5 at half and one year later, respectively.Results 3 of 9 attention deficit/hyperactivity disorder patients, 5 of 12 depressive disorder patients, 4 of 34 anxiety disorder patients, and 2 of 3 posttraumatic stress disorder and stress-related disorder patients had diagnostic changes. Depressive disorders had more diagnostic changes than that of anxiety disorders (P=0.039), and most turned into obsessive-compulsive disorder, cyclothymic disorder or disruptive mood dysregulation disorder during the prognosis process.Conclusion The diagnosis of depressive disorder in adolescents is unsettled, and those with attention deficit/hyperactivity disorder and depressive disorder are more likely to develop anxiety disorder and bipolar disorder in the future.