Abstract：
BACKGROUND: While research has described the profile of children with poor mental health, little is known about whether this profile and their needs have changed over time. Our aim was to investigate whether levels of difficulties and functional impact faced by children with a psychiatric disorder have changed over time, and whether sociodemographic and family correlates have changed.
METHODS: Samples were three national probability surveys undertaken in England in 1999, 2004 and 2017 including children aged 5-15 years. Psychiatric disorders were assessed using the Development and Well-Being Assessment (DAWBA), a standardised multi-informant diagnostic tool based on the tenth International Classification of Diseases (ICD-10). The impact and difficulties of having a disorder (emotional, behavioural or hyperkinetic) were compared over time using total difficulty and impact scores from the Strengths and Difficulties Questionnaire (SDQ). Analyses explored the impact of having any disorder, as well as for each disorder separately. Regression analyses compared associations between disorders and sociodemographic factors over time.
RESULTS: Parent- and adolescent-reported total SDQ difficulty and impact scores increased between 1999 and 2017 for children and adolescents with disorders. No differences were noted when using teacher ratings. No differences in total SDQ difficulty score were found for children without a disorder. Comparison of sociodemographic correlates across the surveys over time revealed that ethnic minority status, living in rented accommodation and being in the lowest income quintile had a weaker association with disorder in 2017 compared to 1999.
CONCLUSIONS: Our study reveals a concerning trend; children with a disorder in 2017 experienced more severe difficulties and greater impact on functioning at school, home and in their daily lives, compared to children with a disorder in earlier decades. Research is needed to identify and understand factors that may explain the changing nature and level of need among children with a disorder.
METHODS: Samples were three national probability surveys undertaken in England in 1999, 2004 and 2017 including children aged 5-15 years. Psychiatric disorders were assessed using the Development and Well-Being Assessment (DAWBA), a standardised multi-informant diagnostic tool based on the tenth International Classification of Diseases (ICD-10). The impact and difficulties of having a disorder (emotional, behavioural or hyperkinetic) were compared over time using total difficulty and impact scores from the Strengths and Difficulties Questionnaire (SDQ). Analyses explored the impact of having any disorder, as well as for each disorder separately. Regression analyses compared associations between disorders and sociodemographic factors over time.
RESULTS: Parent- and adolescent-reported total SDQ difficulty and impact scores increased between 1999 and 2017 for children and adolescents with disorders. No differences were noted when using teacher ratings. No differences in total SDQ difficulty score were found for children without a disorder. Comparison of sociodemographic correlates across the surveys over time revealed that ethnic minority status, living in rented accommodation and being in the lowest income quintile had a weaker association with disorder in 2017 compared to 1999.
CONCLUSIONS: Our study reveals a concerning trend; children with a disorder in 2017 experienced more severe difficulties and greater impact on functioning at school, home and in their daily lives, compared to children with a disorder in earlier decades. Research is needed to identify and understand factors that may explain the changing nature and level of need among children with a disorder.
摘要：
背景：虽然研究描述了心理健康差的儿童的概况，很少有人知道这个配置文件和他们的需求是否随着时间的推移而改变。我们的目的是调查患有精神疾病的儿童所面临的困难和功能影响程度是否随着时间的推移而改变，以及社会人口统计学和家庭关系是否发生了变化。
方法：样本是1999年，2004年和2017年在英格兰进行的三项国家概率调查，包括5-15岁的儿童。使用发育和幸福评估（DAWBA）评估精神疾病，基于第十国际疾病分类（ICD-10）的标准化多信息人诊断工具。患有疾病的影响和困难(情绪，使用优势和困难问卷（SDQ）的总困难和影响评分，随着时间的推移比较行为或运动过度）。分析探讨了任何疾病的影响，以及分别针对每种疾病。回归分析比较了疾病与社会人口统计学因素之间的相关性。
结果：父母和青少年报告的总SDQ难度和影响评分在1999年至2017年期间增加了儿童和青少年患有疾病。使用教师评分时没有发现差异。对于没有疾病的儿童，总SDQ难度评分没有差异。随着时间的推移，各种调查的社会人口统计学相关性的比较表明，少数民族地位，与1999年相比，2017年住在租来的住房和收入最低的五分之一与疾病的相关性较弱。
结论：我们的研究揭示了一个令人担忧的趋势：2017年患有疾病的儿童经历了更严重的困难，对学校功能的影响更大。在家庭和日常生活中，与前几十年患有疾病的儿童相比。需要进行研究以确定和理解可能解释疾病儿童需求变化的性质和水平的因素。
方法：样本是1999年，2004年和2017年在英格兰进行的三项国家概率调查，包括5-15岁的儿童。使用发育和幸福评估（DAWBA）评估精神疾病，基于第十国际疾病分类（ICD-10）的标准化多信息人诊断工具。患有疾病的影响和困难(情绪，使用优势和困难问卷（SDQ）的总困难和影响评分，随着时间的推移比较行为或运动过度）。分析探讨了任何疾病的影响，以及分别针对每种疾病。回归分析比较了疾病与社会人口统计学因素之间的相关性。
结果：父母和青少年报告的总SDQ难度和影响评分在1999年至2017年期间增加了儿童和青少年患有疾病。使用教师评分时没有发现差异。对于没有疾病的儿童，总SDQ难度评分没有差异。随着时间的推移，各种调查的社会人口统计学相关性的比较表明，少数民族地位，与1999年相比，2017年住在租来的住房和收入最低的五分之一与疾病的相关性较弱。
结论：我们的研究揭示了一个令人担忧的趋势：2017年患有疾病的儿童经历了更严重的困难，对学校功能的影响更大。在家庭和日常生活中，与前几十年患有疾病的儿童相比。需要进行研究以确定和理解可能解释疾病儿童需求变化的性质和水平的因素。
