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LANCET:早期生活剥夺后,儿童的神经发育和精神健康发展如何?

2017-02-27 MedSci MedSci原创

早期时间有限的生活剥夺与儿童的疾病有关,但其影响是否持续到成年尚未可知。近期,一项发表在权威杂志LANCET上的研究使用英语和罗马尼亚语收养研究的数据,评估了剥夺相关的不良神经发育和心理健康是否持续到青年成年。此项研究调查了个人出生后至43个月被英国领养之前,在罗马尼亚机构的严重剥夺者的结局如何。研究者们使用适当的标准问卷,家长和收养人完成的访谈,以及直接测量智商来平评估自闭症谱系障碍,注意力不集

早期时间有限的生活剥夺与儿童的疾病有关,但其影响是否持续到成年尚未可知。


近期,一项发表在权威杂志LANCET上的研究使用英语和罗马尼亚语收养研究的数据,评估了剥夺相关的不良神经发育和心理健康是否持续到青年成年。

此项研究调查了个人出生后至43个月被英国领养之前,在罗马尼亚机构的严重剥夺者的结局如何。研究者们使用适当的标准问卷,家长和收养人完成的访谈,以及直接测量智商来平评估自闭症谱系障碍,注意力不集中和过度活跃症状,解除社交参与,行为或情绪问题,以及认知功能障碍(IQ评分<80)在儿童(6,11和15岁)和青年(22-25岁)人群中的情况。

罗马尼亚收养者被分为两组,在机构中不到6个月的人群以及在机构中超过6个月以上的人群。研究者们使用了一个没有经历剥夺的英国收养人作为比较组。使用混合效应回归模型的有序分类结果变量来比较组间症状水平和趋势。

此项研究结果发现,在机构中经历少于6个月的罗马尼亚收养者(6岁,n = 67;成年,n = 50)和英国对照组(6岁,n = 52;成年,n = 39)具有类似的低水平症状。相比之下,在一个机构中超过6个月的罗马尼亚收养者(6岁,n = 98;成年,n = 72)较英国对照的自闭症谱系障碍的症状,抑制社会参与,注意力不集中以及过度活动的发生率较高(合并p <0.0001)。
在机构中6个月以上的人群中6岁时(p = 0.0001)以及11岁时认知损伤(p = 0.0016)的下降速率较英国对照组显着更快。

高剥夺群体的低教育程度(p = 0.0195),失业(p = 0.0124)和精神卫生服务使用(当年龄<11岁,11-14岁和15-23岁时,p值分别为 0.0120,0.0032及0.0003)的概率较英国对照组显著增加。在所有评估中,在机构中花费6个月以上的人群,只有1/5的个人(n = 15)是无问题的。

此项调查研究表明:尽管一些收养者表现出的恢复力和认知障碍的缓解,但是延长早期剥夺时间与长期有害健康的影响相关,这些健康状况似乎在多年的养育和收养家庭中是不可接受的。

原始出处:
Sonuga-Barke EJ, Kennedy M, et al. Child-to-adult neurodevelopmental and mental health trajectories after early life deprivation: the young adult follow-up of the longitudinal English and Romanian Adoptees study. Lancet. 2017 Feb 22. pii: S0140-6736(17)30045-4. doi: 10.1016/S0140-6736(17)30045-4. 

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1954284, encodeId=4c3d195428461, content=<a href='/topic/show?id=ce3e2e77297' target=_blank style='color:#2F92EE;'>#健康发展#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=27772, encryptionId=ce3e2e77297, topicName=健康发展)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55683, createdName=仁医06, createdTime=Mon Jul 10 14:03:00 CST 2017, time=2017-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1828783, encodeId=71dc1828e8307, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Wed Jun 28 11:03:00 CST 2017, time=2017-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1345601, encodeId=70ec1345601a5, content=<a href='/topic/show?id=37c9e4238b9' target=_blank style='color:#2F92EE;'>#神经发育#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74238, encryptionId=37c9e4238b9, topicName=神经发育)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7532500500, createdName=12499e01m47暂无昵称, createdTime=Wed Mar 01 11:03:00 CST 2017, time=2017-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1347145, encodeId=242e134e145d8, content=<a href='/topic/show?id=88713e938c1' target=_blank style='color:#2F92EE;'>#发育#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37938, encryptionId=88713e938c1, topicName=发育)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f4c124, createdName=neurowu, createdTime=Wed Mar 01 11:03:00 CST 2017, time=2017-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=178175, encodeId=ee931e8175f9, content=幼儿2岁之前对其身心健康最重要的就是妈妈的陪伴了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=071c2012037, createdName=wmu姿, createdTime=Tue Feb 28 09:07:18 CST 2017, time=2017-02-28, status=1, ipAttribution=)]
    2017-06-28 howi
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    2017-03-01 neurowu
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    2017-02-28 wmu姿

    幼儿2岁之前对其身心健康最重要的就是妈妈的陪伴了。

    0

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