寻求医疗服务的移民青少年的多重疾病与心理健康负担：对全面评估的启示
寻求医疗服务的移民青少年的多重疾病与心理健康负担：对全面评估的启示
Multimorbidity and Mental Health Burden Among Immigrant Adolescents Seeking Care: Implications for Comprehensive Assessment
——《青少年健康杂志》第79卷第4期，2026年10月——
【摘要】目的：移民青少年面临多种健康风险因素。本研究旨在比较在医院内针对弱势群体设立的医疗机构中，有监护人陪同与无监护人陪同的移民青少年在多重疾病负担、心理困扰及其相关暴露因素方面的差异。方法：本研究为一项在法国马赛开展的单中心观察性队列研究（2019–2024年），纳入了384名10至17岁、在过去5年内抵达的移民青少年。采用“累积疾病评分量表”（Cumulative Illness Rating Scale）评估多重疾病状况，并使用“Protect”问卷评估心理创伤风险（作为心理困扰的主要组成部分）。结果：累积疾病评分量表的平均值为3.98（标准差：2.64）。多重疾病现象普遍，35.4%的参与者存在3个及以上器官系统的功能受损。最常见的受损部位或系统包括：眼、耳、鼻、喉或牙齿（48.7%），肌肉骨骼及皮肤系统（46.4%），以及心理健康问题（25.3%）。多重疾病与移民前（调整后比值比[OR] =1.40，p<.0005）及移民过程中（调整后OR=1.94，p=.005）的慢性病史独立相关。心理创伤风险与“无监护人陪同的移民青少年”身份（调整后OR=4.27，p<.05）以及躯体疾病负担（调整后OR=1.18，p<.05）独立相关。在该医疗机构接受诊疗期间及之后，患者前往急诊科就诊的次数有所减少。讨论：寻求医疗服务的移民青少年承受着沉重的多重疾病和心理困扰负担。尽管目前缺乏便捷的筛查工具，但这种风险仍需引起特别关注，尤其是针对无监护人陪同的青少年。亟需建立一套全面的医疗护理路径，以减少这一极度弱势群体所面临的健康不平等。
【关键词】青少年；健康状况；移民；疾病严重程度指数；创伤及应激相关障碍
[Abstract] Purpose: Immigrant adolescents are exposed to multiple health risk factors. This study aimed to compare the burden of multimorbidity and psychological distress, along with associated exposure factors, among accompanied and unaccompanied immigrant adolescents seeking care in a hospital-based unit for vulnerable populations. Methods: This monocentric observational cohort was undertaken in Marseille, France (2019–2024), and included 384 adolescents aged 10–17 years who had arrived within the previous 5 years. The Cumulative Illness Rating Scale assessed the multimorbidity, and the Protect questionnaire assessed the risk of psychological trauma as a major component of psychological distress. Results: The mean Cumulative Illness Rating Scale was 3.98 (standard deviation: 2.64). Multimorbidity was common, with 35.4% of participants having impairment of ≥ 3 organ systems. The most frequent impairments involved the eye, ear, nose, throat or teeth (48.7%), musculoskeletal and integumentary systems (46.4%), and mental health conditions (25.3%). Multimorbidity was independently associated with chronic medical history before migration (adjusted OR = 1.40, p < .0005) and during migration (adjusted OR = 1.94, p = .005). The risk of psychological trauma was independently associated with unaccompanied immigrant adolescent status (adjusted OR = 4.27, p < .05) and physical morbidity burden (adjusted OR = 1.18, p < .05). Patients had less emergency department visits during and after care in this hospital-based unit. Discussion: Immigrant adolescents seeking care experience a high burden of multimorbidity and psychological distress. This risk requires particular attention, especially for unaccompanied adolescents, despite the lack of a convenient screening tool. A comprehensive care pathway is needed to reduce health inequalities in this extremely vulnerable population.
[Key words] Adolescent, Health status, Emigration and immigration, Severity of illness index, Trauma and stressor-related disorders
论文原文：Laure Ngom, Boris Joachim, Axelle Dibas-Franck, et al. (2026). Multimorbidity and Mental Health Burden Among Immigrant Adolescents Seeking Care: Implications for Comprehensive Assessment. Journal of Adolescent Health, Volume 79, Issue 4, Pages 508-516. October 2026.
https://doi.org/10.1016/j.jadohealth.2026.05.014
（翻译兼责任编辑：MARY）
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