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題名 | 兒童青少年拔毛症的臨床特徵=Clinical Characteristics of Children and Adolescents with Trichotillomania |
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作者 | 陳信昭; 許明隆; 楊延光; 葉宗烈; 楊明仁; Chen, Shin-jaw; Hsu, ML Mark; Yang, Yen-kuang; Yeh, Tzung-lieh; Yang, Ming-jen; |
期刊 | 臺灣精神醫學 |
出版日期 | 20020900 |
卷期 | 16:3 2002.09[民91.09] |
頁次 | 頁222-229 |
分類號 | 415.8754 |
語文 | chi |
關鍵詞 | 拔毛症; 兒童; 青少年; 共患症; Trichotillomania; Children; Adolescents; Comorbidity; |
中文摘要 | 目的:了解兒童青少年拔毛症之臨床表徵及其精神疾病共患症。 方法:透過媒體告知本研究,並寫信給醫院所在縣市的國小、國中以及高中職輔導室,藉以尋求可能的個案,並接受兒童青少年精神科醫師的臨床及半結構性精神疾病診斷性會談。 結果:總計24位個案,男性6位 (25.0%),女性18位 (75.0%)。平均發病年齡為9.2 ± 4.0歲,且有21位(87.5%) 在12歲之前發病。拔毛部位以頭髮最多(21位,87.5%),其次為眉毛(7位,29.2%)、睫毛(5位,20.8%)、四肢的毛(3位,12.5%),以及陰毛(1位,4.2%)。13位 (54.2%) 在症狀出現前曾經歷明顯的生活壓力。雖然只有3位 (13.6%) 符合DSM-Ⅲ-R拔毛症診斷準則,但有14位 (58.3%) 曾經或會談時有符合至少另一項精神疾病診斷,而有10位 (41.7%) 會談時仍至少有另一項精神疾病診斷,並有16位 (66.7%) 曾有習慣問題。但接受會談之前,曾因拔毛症求醫者只有12位 (50.0%),另有6位 (25.0%)只求助過民俗療法,更有6位 (25.0%) 從未尋求協助。 結論:兒童青少年拔毛症患者絕大多數在12歲之前發病,且合併有其他精神疾病比例高,加強民眾衛教以及對國小學童做拔毛症及精神疾病篩檢工作具有重要意義。 |
英文摘要 | Objective: To determine the clinical characteristics and psychiatric comorbidities of children and adolescents with trichotillomania. Methods: The subjects were recruited by advertising in the local newspaper and writing to the heads of counseling departments of local elementary and high schools for help in introducing the candidates. Clinical data were collected by clinical interviews and the psychiatric comorbidity was diagnosed by the Kiddie-Schedule for Affective Disorder and Schizophrenia-Epidemiological Version, K-SADS-E(Chinese language version). Results: A total of 24 subjects, including 18 girls (75%) and six boys(25%), were recruited. The mean age of onset was 9.2 ± 4.0 while 21 cases (87.5%) had onset of hair pulling before age 12. The scalp, the most commonly affected area, was involved in 21 cases (87.5%). Premorbid stressful life events were reported in 15 cases (54.2%). Although only three cases (13.6%) fit the DSM-III-R criteria of trichotillomania, at least one lifetime psychiatric disorder was diagnosed in 14 cases (58.3%) including anxiety-related disorders in ten cases. Ten cases (41.7%) had psychiatric disorders at the time of interview. In addition, 16 cases (66.7%) had habit problems, including nail-biting in ten cases. However, 12 cases (50.0%) had never sought medical treatment before. Conclusions: Children and adolescents with trichotillomania in this series were predominantly females and the onset of most cases was before age 12. The high potential risk of psychiatric comorbidity suggests the need for psychiatric survey for hair-pulling in elementary schools. |
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