Mukaddes N M, Bilge S, Alyanak B, Kora M E
University of Istanbul, Turkey.
Child Psychiatry Hum Dev. 2000 Summer;30(4):273-87. doi: 10.1023/B:CHUD.0000037154.77861.21.
The aim of our study is to report the relation between pathological care and impairment in social interaction, communication, language development, and stereotypical behaviors. Fifteen cases (9 boys, 6 girls) who have the symptoms listed above and who were misdiagnosed with pervasive developmental disorder (PDD), were referred to our clinic for evaluation and treatment. After the cases were evaluated by a semi-structured interview, symptoms related to pathological care were fortified; maternal depressive symptoms associated with child neglect and overexposure to television viewing. The cases and the mothers/primary caretakers were treated in a standardized psycho-educational program of 3 months. After this period improvements were observed in all of the symptom clusters. Twelve cases (80%) had improvements in eye contact. Eleven cases (73.3%) began to engage in reciprocal play and ten cases (66.6%) showed social imitative behaviors. Six cases (40%) began to form sentences. Stereotypic behaviors diminished in six cases (40%) and disappeared in nine cases (60%). According to our findings, although the symptoms of PDD and reactive attachment disorder (RAD) resemble each other, presence of pathological care and good response to treatment in RAD can be important for the differential diagnosis with PDD.
我们研究的目的是报告病理性照料与社交互动、沟通、语言发展及刻板行为障碍之间的关系。15例（9名男孩，6名女孩）出现上述症状且曾被误诊为广泛性发育障碍（PDD）的患儿被转介至我们的诊所进行评估和治疗。通过半结构化访谈对这些患儿进行评估后，与病理性照料相关的症状得到强化；与忽视孩子及过度让孩子看电视相关的母亲抑郁症状。对这些患儿及其母亲/主要照料者进行了为期3个月的标准化心理教育项目治疗。在此期间过后，所有症状群均有改善。12例（80%）患儿的眼神交流有改善。11例（73.3%）开始参与互动游戏，10例（66.6%）表现出社会模仿行为。6例（40%）开始造句。6例（40%）的刻板行为减少，9例（60%）消失。根据我们的研究结果，尽管PDD和反应性依恋障碍（RAD）的症状相似，但病理性照料的存在以及RAD对治疗的良好反应对于与PDD的鉴别诊断可能很重要。
