2014-11-012024-05-13https://scholars.lib.ntu.edu.tw/handle/123456789/648410摘要：研究背景與目的： 本計畫為三年的專案研究計畫，欲進行一全國性兒童青少年情緒行為發展障礙之流行病學研究，研究對象為學齡期兒童及國中生。主要調查之障礙為常見於兒童青少年的神經發展及精神疾病的盛行率，包含學習障礙、干擾性行為 (注意力不足過動症、對立反抗症、行為規範障礙症)、自閉症、情感性疾患 (輕鬱症、憂鬱症、躁鬱症)、焦慮症、畏懼症、飲食障礙、睡眠障礙，並且收集相關的心理、生理、社會預測／危險因子，以建立全國性兒童青少年精神疾病流行病學資料庫，提供未來兒童青少年身心健康政策的參考依據。台灣先前所建立全國性精神疾病之流行病學研究調查，主要為針對成年人或是老年人，相較而言兒童較少受到重視，僅有的針對青少年之精神疾病盛行率調查僅止於高雄市/縣的二所國中；或是針對於特定精神疾病，如藥物濫用或青少年憂鬱症之調查。另外由於精神疾病診斷與統計手冊第五版DSM-5的問世，目前全世界尚無以DSM-5為準則的大型的兒童青少年精神疾病盛行率調查。因此本研究欲順應學術的潮流，修訂為DSM-5版本精神疾病診斷工具並建立其信、效度指標以用來獲得全國性兒童青少年情緒行為障礙的盛行率。研究方法： 本計畫為以學校為單位，進行三階段群集抽樣。包含都市化市鎮與農業與偏遠鄉鎮。在控制鄉鎮以及性別平均分配預估招募4500位。都市化市鎮預估招募3000位，另外農業市鎮與偏遠鄉鎮1500位學童進入研究，篩選陽性者全數 (n=900)及10%陰性者 (n=360)，進行完整的精神科診斷會談及所有評估 (包括神經心理學功能)。另外對於篩檢時，學校缺席學童，本研究將以家訪完成評估研究之影響，評估台灣之城鄉差距於兒童青少年的多樣性的精神疾病盛行率。本研究擬修正中文版學童情感疾患和精神分裂量表 (Schedule for affective disorders and schizophrenia)，進行常見之兒童、青少年精神疾病之檢驗工具。另外，預測指標之測量，包括：親子關係母親懷孕史、發展史、身體疾患、氣質、家庭功能、多面向發展、行為症狀評估、學校同儕、家庭適應功能、自信、情緒、神經心理學功能。預期成果： 本研究擬結合發展、心理社會家庭之因素進行全面性探討台灣全國性之兒童青少年精神疾病之盛行率以及找到相關預測因子，對所篩檢出之高危險族群給予轉介相關教育、醫療單位，研究結果將提供政府當局研擬出未來對於兒童青少年精神疾病之預防與介入策略，以提供兒童青少年個人身心健康成長的優質家庭、學校及社會環境的參考，以促進台灣未來主人翁的身心健康。<br> Abstract: Background: Despite several waves of epidemiological studies in adult and elderly mental disorders in the past decades, revealing inconsistent results, little is known about the prevalence of mental disorders in the child and young adolescent population in Taiwan. However, there is an increasing trend of child and adolescent mental disorders over the past decades consistently reported across countries. With the revision of the Diagnostic and Statistical Manual of Mental Disorders to the current version—5th edition (DSM-5), there has been no epidemiological study using DSM-5 in youth population in the world. The DSM-5 was published in October 2014. It warrants an epidemiological study on child and adolescent mental disorders using the DSM-5 as diagnostic criteria in Taiwan. Aims: This 3-year school-based epidemiological study on child and adolescent mental disorders aims to obtain the prevalence rate and identify the psychosocial, individual, environmental, and familial risk factors for mental disorders including learning disability, autism spectrum disorder, attention-deficit hyperactivity disorder, oppositional defiant disorder, conduct disorder, mood disorders (major depression, dysthymia, bipolar disorder), anxiety disorders, phobia, obsessive compulsive disorder, sleep disorders, eating disorders, and substance use disorders etc in Taiwan.Methods: (1) For instrument preparation and training, we will revise the interview scale (K-SADS-E) to fit DSM-5 and ADOS (autism diagnostic observation scale) and conduct the pilot and validity studies. (2) This is a two-stage design to conduct screening for mental disorders including autism using the interview screening question among urban students (n = 3000) and rural students (n = 1500) from a three-stage cluster sampling. All the screen positive (estimated n = 900) and 10% of screen negative (estimated n = 360) will receive the full diagnostic interview (K-SADS-E and ADOS) and all neuropsychological (WISC-III, CCPT, CANTAB) studies in addition to questionnaires (SNAP-IV, SRS, SCQ, AQ, CBCL, YSR, TRF, SAICA, BRIEF, PBI, Family APGAR, SHQ and SBEQ). Moreover, clinical assessment will be conducted to obtain the pregnancy, developmental and medical history. For students who leave of absence, we will visit them at home to complete all the assessments.Anticipated results: With our endeavor and well-study design, we anticipate this study will provide the prevalence of a wide range of developmental and psychiatric disorders in children and our results will also provide a comprehensive risk factors for each psychiatric disorder identified in this study, including neurocognitive, developmental, familiar, and environmental factors. The individual, combined, and interactive effects of these predictors can be identified in this study. This study will definitely provide precious data for the government to develop a preventive program for mental disorders and a promotion program for mental health and wellbeing.青少年流行病學盛行率精神疾患