儿童青少年情绪相关精神障碍的早期识别与治疗

doi:10.11852/zgetbjzz2023-1195

摘要/Abstract

摘要： 近年来,焦虑症、抑郁症、双相及相关障碍等情绪相关精神障碍的患病率在儿童青少年群体中逐渐增高,若不及时干预,可能会对个人、家庭以及社会造成严重影响。因此,早期识别与干预治疗对儿童青少年情绪相关精神障碍的预防和缓解至关重要。本文通过回顾梳理以往相关文献,对儿童青少年情绪相关精神障碍的类型以及其生理与遗传、家庭与学校环境等影响因素进行了概述,总结早期识别儿童青少年情绪相关精神障碍的方法及治疗策略,为今后制定更加科学高效的识别与干预方案提供依据。

关键词: 情绪相关精神障碍, 儿童青少年, 早期识别, 干预治疗

Abstract: It has been found that children and adolescents are highly susceptible to emotion-related mental disorders such as anxiety disorder, major depressive disorder, bipolar and related disorder. If left untreated, it may severely impact the normal functioning of individuals, family and society, indicating the importance of early detection and interventionin preventing and treatingchildren and adolescents who are at high risk for emotion-related mental disorders. This article reviews different types and risk factors of emotion-related mental disorders in biological, family and school contexts, and identifies effective early detection methods and intervention strategies for children and adolescents with emotion-related mental disorders.Further implications and recommendations for early detection and intervention are also discussed.

Key words: emotion-related mental disorders, children and adolescents, early detection, early intervention

中图分类号:

R749

金宇. 儿童青少年情绪相关精神障碍的早期识别与治疗[J]. 中国儿童保健杂志, 2023, 31(12): 1280-1285.

JIN Yu. Early identification and treatment of emotion-related mental disorders in children and adolescents[J]. Chinese Journal of Child Health Care, 2023, 31(12): 1280-1285.

参考文献

[1] 罗学荣. 儿童青少年精神障碍研究进展与学科发展[J]. 四川精神卫生, 2023,36(2):97-103.
Luo XR.Research progress and discipline development of mental disorders inchildren and adolescents[J]. Sichuan Mental Health, 2023,36(2):97-103.(in Chinese)
[2] Li F, Cui Y, Li Y, et al. Prevalence of mental disorders in school children and adolescents in China: Diagnostic data from detailed clinical assessments of 17,524 individuals[J]. J Child Psychol Psyc, 2022,63(1):34-46.
[3] 吴宝铮. 儿童青少年情绪障碍患者人格特征的研究[J]. 中国生育健康杂志, 2017,28(6):552-553.
[4] 周李烘, 江文庆, 李华芳, 等. 常见抗精神病药物对儿童青少年患者血清催乳素水平影响的研究进展[J]. 神经疾病与精神卫生, 2023,23(9):650-654.
Zhou LH, Jiang WQ, Li HF, et al.Research progress on the effect of common antipsychotics on serum prolactin levels in child and adolescents[J]. Journal of Neuroscience and Mental Health, 2023,23(9):650-654. (in Chinese)
[5] 余卫, 张在竹. 医学领域年龄人群划分标准浅析[J]. 中国医学科学院学报, 2023,45(2):285-289.
Yu W, Zhang ZZ. Age-based grouping criteria in medicine[J].Acta Academiae Medicinae Sinicae, 2023,45(2):285-289. (in Chinese)
[6] 罗淳. 关于人口年龄组的重新划分及其蕴意[J]. 人口研究, 2017,41(5):16-25.
Luo C. Re-partitioning population age group and its implications[J].Population Research, 2017,41(5):16-25. (in Chinese)
[7] 陶芳标. 儿童少年卫生学[M]. 北京:人民卫生出版社, 2017.
[8] 陆林. 守护儿童青少年心理健康,我们在行动[J]. 科技导报, 2021,39(18):1.
[9] 郑秀秀, 张岩, 朱桂东, 等. 综合心理干预对儿童情绪障碍患者治疗的效果分析[J]. 国际精神病学杂志, 2019,46(2):279-282.
Zheng XX, Zhang Y, Zhu GD, et al. Analysis of effect of comprehensive psychological intervention in children with emotional disorders[J].Journal of International Psychiatry, 2019,46(2):279-282.(in Chinese)
[10] 王萌, 陶芳标, 伍晓艳. 儿童青少年焦虑抑郁共病研究进展[J]. 中华预防医学杂志, 2022,56(7):1011-1016.
Wang M, Tao FB, Wu XY.Research progress on the comorbidity of anxiety and depression in children and adolescents[J]. Chin J Prev Med, 2022, 56(7): 1011-1016. (in Chinese)
[11] Zhou K, Chen J, Huang C, et al. Prevalence of and factors influencing depression and anxiety among Chinese adolescents: A protocol for a systematic review[J]. BMJ Open, 2023,13(3):e68119.
[12] Ghandour RM, Sherman LJ, Vladutiu CJ, et al. Prevalence and treatment of depression, anxiety, and conduct problems in US children[J]. J Pediatr, 2019, 206:256-267.
[13] 杨智慧, 周永红. 国外孤独症儿童焦虑的诊断及相关因素研究综述[J]. 心理月刊, 2022,17(23):228-230.
[14] Kowalchuk A, Gonzalez SJ, Zoorob RJ. Anxiety disorders in children and adolescents[J]. Am Fam Physician, 2022,106(6):657-664.
[15] 顾涛, 鲍喜燕, 沈素梅, 等. 儿童青少年强迫障碍的临床特征和治疗新进展[J]. 中国医药科学, 2023,13(16):52-55.
Gu T, Bao XY, Shen SM, et al.Clinical characteristics and new progress in the therapy of obsessive-compulsive disorder in children and adolescents[J]. China Medicine and Pharmacy, 2023,13(16):52-55. (in Chinese)
[16] Schuyler M, Geller DA. Childhood obsessive-compulsive disorder[J]. Psychiatr Clin North Am, 2023,46(1):89-106.
[17] Luo L, Feng B, Yang S, et al. Clinical characteristics of moderate-severe obsessive-compulsive disorder in children and adolescents in China[J]. J Int Med Res, 2020,48(5):1220722231.
[18] Paulus FW, Ohmann S, Mohler E, et al. Emotional dysregulation in children and adolescents with psychiatric disorders. A narrative review[J]. Front Psychiatry, 2021,12:628252. DOI:10.3389/fpsyt.2021.628252.
[19] Cichon L, Janas-Kozik M, Siwiec A, et al. Clinical picture and treatment of bipolar affective disorder in children and adolescents[J]. Psychiatr Pol, 2020,54(1):35-50.
[20] Sekhon S, Gupta V. Mood disorder[M]. Stat Pearls Publishing, 2023.
[21] Benton TD, Muhrer E, Jones JD, et al. Dysregulation and suicide in children and adolescents[J]. Child Adolesc Psychiatr Clin N Am, 2021,30(2):389-399.
[22] Becker M, Correll CU. Suicidality in childhood and adolescence[J]. Dtsch Arztebl Int, 2020,117(15):261-267.
[23] 刘昱君, 刘林平. 多学科视角下的儿童和青少年自杀研究[J]. 青年研究, 2021(2):61-72.
[24] 邢学玮, 向九如, 刘红叶, 等. 初中生情绪问题对外化问题行为的影响:心理韧性的调节作用[J]. 中小学心理健康教育, 2023(24):18-24.
[25] 王薇, 刘忠纯. 性激素对青春期抑郁症的影响研究进展[J]. 临床精神医学杂志, 2021,31(5):419-421.
[26] Golombek K, Lidle L, Tuschen-Caffier B, et al. The role of emotion regulation in socially anxious children and adolescents: A systematic review[J]. Eur Child Adolesc Psychiatry, 2020,29(11):1479-1501.
[27] Maciejewski D, Hillegers M, Penninx B. Offspring of parents with mood disorders: Time for more transgenerational research, screening and preventive intervention for this high-risk population[J]. Curr Opin Psychiatry, 2018,31(4):349-357.
[28] Isaac A J, Rodriguez A M, D'Anna-Hernandez K, et al. Preschool-aged children's hair cortisol and parents' behavior, psychopathology,and stress[J]. Psychoneuroendocrinology, 2023,151:106052.
[29] 房燕娜, 曹乾, 兰莹利. 中国儿童青少年抑郁现状及性别、城乡差异分析[J]. 中国预防医学杂志, 2023,24(4):380-387.
Fang YN, Cao Q, Lan YL.Analysis of the status quo of depression among Chinese childrenand adolescents and its gender and urban-rural disparities[J]. Chin Prev Med, 2023, 24(4): 380-387. (in Chinese)
[30] 季冬, 陈虹, 钞淼, 等. 家庭氛围与父母受教育程度对青少年抑郁影响[J]. 中国公共卫生, 2018,34(1):38-41.
Ji D, Chen H, Chao M, et al. Effect of family atmosphere and parental education level on depression among adolescents[J]. Chinese Journal of Public Health, 2018, 34(1): 38-41. (in Chinese)
[31] 杨春, 张瑞. 抑郁障碍青少年自伤行为影响因素分析[J]. 中国学校卫生, 2021,42(6):879-882.
Yang C, Zhang R.Associated factors of non-suicidal self-injury behavior in adolescents with depression disorder[J]. Chin J Sch Health, 2021,42(6):879-882. (in Chinese)
[32] Humphreys KL, LeMoult J, Wear JG, et al. Child maltreatment and depression: A meta-analysis of studies using the Childhood Trauma Questionnaire[J]. Child Abuse Negl, 2020, 102:104361.
[33] 刘肖莉, 刘照佩, 房晓萌, 等. 青少年情绪障碍的影响因素分析[J]. 中国妇幼保健, 2019,34(12):2822-2824.
[34] Asarnow LD, Mirchandaney R. Sleep and mood disorders among youth[J]. Child Adolesc Psychiatr Clin N Am, 2021,30(1):251-268.
[35] 刘云, 刘志伟, 姚高峰, 等. 儿童青少年精神障碍患者睡眠不足及相关因素[J]. 四川精神卫生, 2021,34(5):444-447.
Liu Y, Liu ZW, Yao GF, et al.Status of sleep insufficiency and related factors in children and adolescents with mental disorders[J].Sichuan Mental Health, 2021,34(5):444-447. (in Chinese)
[36] Mangione CM, Barry MJ, Nicholson WK, et al. Screening for depression and suicide risk in children and adolescents: US preventive services task force recommendation statement[J]. JAMA, 2022, 328(15):1534-1542.
[37] Miller JN, Black DW. Bipolar disorder and suicide: A review[J]. Curr Psychiatry Rep, 2020,22(2).DOI:10.1007/s11920-020-1130-0.
[38] Mangione CM, Barry MJ, Nicholson WK, et al. Screening for depression and suicide risk in children and adolescents: US preventive services task force recommendation statement[J]. JAMA, 2022,328(15):1534-1542.
[39] Colizzi M, Lasalvia A, Ruggeri M. Prevention and early intervention in youth mental health: Is it time for a multidisciplinary and trans-diagnostic model for care?[J]. Int J Ment Health Syst, 2020,14:23.DOI:10.1186/s13033-020-00356-9.
[40] 吴宝铮. 青少年情绪障碍患者性格特征及社会心理学影响[J]. 中国公共卫生管理, 2017,33(4):557-559.
[41] Trafalis S, Giannini C, Joves J, et al. A pediatrician-friendly review of three common behavioral health screeners in pediatric practice: Findings and recommendations[J]. Pediatr Investig, 2021,5(1):58-64.
[42] Dahlberg A, Ghaderi A, Sarkadi A, et al. SDQ in the hands of fathers and preschool teachers-psychometric properties in a non-clinical sample of 3-5-year-olds[J]. Child Psychiatry Hum Dev, 2019,50(1):132-141.
[43] 马天宇, 杜亚松, 程永琛, 等. 学前儿童情绪检核量表(家长版)的效度和信度评价[J]. 中国心理卫生杂志, 2022,36(9):786-792.
Ma TY, Du YS, Cheng YC, et al.Validity and reliability of the Preschool Feelings Checklist-Scale Version (Parent Version)[J]. Chin Mental Health J, 2022,36(9):786-792. (in Chinese)
[44] Jiang Z, Wang D, Xu H, et al. Diagnostic efficiency and psychometric properties of CBCL DSM-oriented scales in a large sample of Chinese school-attending students aged 5-16[J]. Asian J Psychiatr, 2023, 88:103724.
[45] Mylett ML, Boucher TQ, Scheerer NE, et al. Examining the relations between social competence, autistic traits, anxiety and depression in autistic and non-autistic children[J]. J Autism Dev Disord, 2023.DOI:10.1007/s10803-023-06012-8.
[46] Kalb LG, DiBella F, Jang YS, et al. Mental health crisis screening in youth with autism spectrum disorder[J]. J Clin Child Adolesc Psychol, 2022:1-9.DOI:10.1080/15374416.2022.2119984.
[47] McIntyre RS, Berk M, Brietzke E, et al. Bipolar disorders[J]. Lancet, 2020,396(10265):1841-1856.
[48] de Back JJ, Vaughan EP, Kemp EC, et al. The mood disorder assessment schedule: Initial validation of a new measure for early identification of bipolar spectrum disorders in inpatient adolescents[J]. J Psychiatr Res, 2023,158:63-70.
[49] 汤秀成, 胡茂荣, 吴洪军, 等. 双相情感障碍的非药物治疗[J]. 国际精神病学杂志, 2021,48(4):595-597.
[50] 柯雪婷. 认知行为护理干预对抑郁症患者睡眠质量和自杀态度的影响评价研究[J]. 世界睡眠医学杂志, 2022,9(8):1491-1494.
[51] Walter HJ, Bukstein OG, Abright AR, et al. Clinical practice guideline for the assessment and treatment of children and adolescents with anxiety disorders[J]. J Am Acad Child Adolesc Psychiatry, 2020,59(10):1107-1124.
[52] Dean OM, Gliddon E, Van Rheenen TE, et al. An update on adjunctive treatment options for bipolar disorder[J]. Bipolar Disorders, 2018,20(2):87-96.
[53] 季青宇, 江剑平. 儿童青少年心境障碍治疗研究进展[J]. 保健医学研究与实践, 2023,20(5):142-150.
[54] Miklowitz DJ, Schneck CD, Walshaw PD, et al. Effects of family-focused therapy vs enhanced usual care for symptomatic youths at high risk for Bipolar disorder[J]. JAMA Psychiatry, 2020,77(5):455.
[55] 盛秋萍, 梁舜薇, 陈熔宁, 等. 人际与社会节奏疗法对双相障碍患者的干预效果研究[J]. 中国临床心理学杂志, 2022,30(3):716-721.
Sheng QP, Liang SW, Chen RN, et al.Intervention effectiveness evaluation on interpersonal and social rhythm therapt in patients with bipolar disorder[J].Chin J Clin Psych, 2022,30(3):716-721.(in Chinese)
[56] Luccarelli J, McCoy TH, Uchida M, et al. The efficacy and cognitive effects of acute course electroconvulsive therapy are equal in adolescents, transitional age youth, and young adults[J]. J Child Adoles Psychopharmacol, 2021,31(8):538-544.
[57] 杨超, 傅岳文, 张莉, 等. 电休克治疗对儿童双相情感障碍躁狂发作患者的影响[J]. 中国健康心理学杂志, 2017,25(12):1777-1780.
Yang C, Fu YW, Zhang L, et al. Study on the effect of modified electroconvuldive therapy on patients with bipolar disorder manic phase[J]. China Journal of Health Psychology, 2017,25(12):1777-1780.(in Chinese)
[58] 李珠, 叶青, 曾华文. 重复经颅磁刺激联合心理干预对抑郁症患者的治疗效果评价[J]. 中外医疗, 2023,42(20):169-171.
[59] 蔡亚兰, 蔡飞亚, 苏华龙. 情感障碍及非药物治疗的研究进展[J]. 心理月刊, 2022,17(6):230-233.
[60] Qiu H, Liang K, Lu L, et al. Efficacy and safety of repetitive transcranial magnetic stimulation in children and adolescents with depression: A systematic review and preliminary Meta-analysis[J]. J Affect Disord, 2023,320:305-312.
[61] Feeney A, Hock RS, Fava M, et al. Antidepressants in children and adolescents with major depressive disorder and the influence of placebo response: A meta-analysis[J]. J Affect Disord, 2022,305:55-64.
[62] Zhou X, Teng T, Zhang Y, et al. Comparative efficacy and acceptability of antidepressants, psychotherapies, and their combination for acute treatment of children and adolescents with depressive disorder: A systematic review and network meta-analysis[J]. Lancet Psychiatry, 2020,7(7):581-601.
[63] 彭仰华, 周海山, 沈宴玲, 等. 坪山区3～6岁儿童心理发育问题预警征筛查现状及影响因素[J]. 中国医药科学, 2022,12(16):130-133.
Peng YH, Zhou HS, Shen YL, et al. Current situation of early warning sign screening for psychological development problems in children aged 3 to 6 years old in Pingshan District and its influencing factors[J]. China Medicine and Pharmacy, 2022, 12(16):130-133.(in Chinese)