Koyama Tomonori, Tachimori Hisateru, Osada Hirokazu, Takeda Toshinobu, Kurita Hiroshi
Department of Mental Health Administration, National Institute of Mental Health, National Center for Neurology and Psychiatry, Kodaira, Tokyo, Japan.
Psychiatry Clin Neurosci. 2007 Feb;61(1):99-104. doi: 10.1111/j.1440-1819.2007.01617.x.
Asperger syndrome (AS) and autistic disorder are two subtypes of pervasive developmental disorders (PDD), but there has been considerable debate over whether AS and autistic disorder without mental retardation (IQ > or = 70), called high-functioning autism (HFA), are distinct conditions or not. The aim of the present paper was to clarify this issue through a comparison of cognitive function and autistic symptom profiles. Based on the DSM-IV and ICD-10 definitions of language acquisition, 36 age- and IQ-balanced subjects with AS (mean age, 12.8 years; mean full-scale IQ, 98.3) were compared with 37 subjects with HFA (mean age, 12.6 years; mean full-scale IQ, 94.6) on the Japanese version of the Wechsler Intelligence Scales and the Childhood Autism Rating Scale-Tokyo Version (CARS-TV). Compared with the HFA subjects, the AS subjects scored significantly higher on Verbal IQ, Vocabulary, and Comprehension, but scored significantly lower on Coding. Although the total CARS-TV score did not differ significantly between the two groups, AS subjects scored significantly lower (i.e. less abnormal) on Verbal communication and Non-verbal communication than did the HFA subjects. A history of normal language acquisition in early childhood could predict his/her better verbal ability in mid-childhood or later. Autistic cognitive characteristics shared by both AS and HFA subjects appear to support the validity of the current diagnostic classification of PDD.
阿斯伯格综合征（AS）和自闭症障碍是广泛性发育障碍（PDD）的两种亚型，但对于AS以及无智力障碍（智商≥70）的自闭症障碍（称为高功能自闭症，HFA）是否为不同病症一直存在大量争论。本文旨在通过比较认知功能和自闭症症状特征来阐明这一问题。基于《精神疾病诊断与统计手册第四版》（DSM-IV）和《国际疾病分类第十版》（ICD-10）中语言习得的定义，在日本版韦氏智力量表和《儿童自闭症评定量表 - 东京版》（CARS-TV）上，将36名年龄和智商匹配的AS患者（平均年龄12.8岁；平均全量表智商98.3）与37名HFA患者（平均年龄12.6岁；平均全量表智商94.6）进行比较。与HFA患者相比，AS患者在言语智商、词汇和理解方面得分显著更高，但在译码方面得分显著更低。尽管两组之间CARS-TV总分无显著差异，但AS患者在言语交流和非言语交流方面的得分显著低于（即异常程度更低）HFA患者。儿童早期正常语言习得史可预测其童年中期或后期更好的言语能力。AS和HFA患者共有的自闭症认知特征似乎支持了当前PDD诊断分类的有效性。
