精神疾病與智能障礙：流行病學與醫療照護需求分析

Psychiatric Disorders and Intellectual Disability: Epidemiological and Healthcare Need Analysis

蔡艷清(Im-Cheng Choi) ； 嚴嘉楓(Chia-Feng Yen) ； 林金定(Jin-Ding Lin)

《身心障礙研究季刊》 2卷2期 (2004/04) Pp. 95-108

https://doi.org/10.30072/JDR.200404.0003

摘要

智能障礙者合併精神疾病的問題漸漸受到西方國家高度的重視，精神醫學也針對此一議題尋求深入研究與探討。國內智能障礙者的精神衛生問題正屬於萌芽階段，相關的研究較為缺乏，本篇論文以文獻回顧的方式探討智能障礙者精神疾病的盛行情形和影響因素，並分析智能障礙者精神疾病的醫療照護需求。文獻回顧結果顯示，智障者普遍遭受精神疾病和行為異常的困擾，且種類繁多複雜，兒童、青少年和成年智障者罹患的精神疾病種類不同。目前一般成年人精神疾病的診斷標準普遍運用於智能障礙者，然而目前精神疾病相關評估工具琳瑯滿目，智能障礙者精神疾病盛行率的測量因診斷標準不一致以及缺乏具代表性的樣本，致使各國對盛行率測量的結果不一；而在影響智能障礙者罹患精神疾病之影響因素的各種研究調查中，也顯示因診斷標準的差異致使各研究在結果上也有些差異存在。本研究亦發現隨著西方國家對智能障礙者的照護策略趨向於社區化後，智能障礙者精神疾病需求有降低的傾向，尤其反映在住院利用率上，一般的精神服務被認為無法反映出智能障礙者精神衛生照護的需求，而專業的智能障礙精神衛生服務為目前少數先進國家另一個醫療照護發展的方向。

關鍵字

智能障礙者 ； 精神疾病 ； 醫療照護需求

並列摘要

Western countries have paid more attention to identify and respond to the issue of mental health and intellectual disability in recent decades. In Taiwan, very little has been done to this issue. This present paper aims to review the epidemiological characteristics and examines the healthcare needs toward intellectual disability and psychiatric disorders based on literature reviews. The reviews found that most studies have stated that people with intellectual disability are more often afflicted by psychiatric disorders than the general population. The studies of psychiatric disorders among this group reported huge variations in prevalence rates and associated risk factors, an important reason for the differences is the methodologist dissimilarity, particularly in assessment tools and the sampling methods used. As deinstitutionalization has been carried out in many western countries, healthcare needs of people with dual diagnosis decreased, particularly in inpatient care. Consequently, the development of specialist psychiatric care has been a new service strategy for this group in some advanced counties.

並列關鍵字

intellectual disability ； psychiatric disorders ； psychiatric health needs

參考文獻

蔡艷清、嚴嘉楓、林金定(2003)。啟智專業工作者之實務工作經驗分析。身心障礙研究。1，43-52。

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