Holtmann Martin, Bolte Sven, Poustka Fritz
Department of Child and Adolescent Psychiatry and Psychotherapy, J.W. Goethe University, Frankfurt/Main, Germany.
Psychopathology. 2007;40(3):172-7. doi: 10.1159/000100007. Epub 2007 Feb 22.
Symptoms as in attention deficit hyperactivity disorder (ADHD) are frequent among individuals with pervasive developmental disorders (PDD). The aim of the present study was to examine the impact of inattention, hyperactivity and impulsivity on the clinical phenotype of children and adolescents with PDD.
A total of 182 subjects (41 females) diagnosed as having PDD were split into a high (PDD+) and a lower (PDD) attention problem group using the median of the Child Behavior Checklist (CBCL) syndrome scale 'attention problems' (median T score = 75). The groups were compared with regard to the degree of coexisting psychopathology, as measured by the remaining 7 CBCL subscales, and autistic core features assessed by the Autism Diagnostic Interview-Revised (ADI-R) and the Autism Diagnostic Observation Schedule using a multivariate analysis of covariance adjusted for age, IQ and socioeconomic status.
The PDD+ subjects exhibited a significantly higher degree of general psychopathology than the subjects in the PDD subgroup, regarding both internalizing and externalizing symptoms. In addition, the PDD+ subgroup tended to exhibit more impairments on the social interaction scale of the ADI-R.
Clinicians should adjust treatment plans to ensure comprehensive and effective treatment for both PDD and associated ADHD. A dual diagnosis may be essential to the implementation of effective treatments.
广泛性发育障碍(PDD)患者中,注意力缺陷多动障碍(ADHD)样症状很常见。本研究旨在探讨注意力不集中、多动和冲动对PDD儿童及青少年临床表型的影响。
使用儿童行为检查表(CBCL)综合征量表“注意力问题”(中位数T分数=75)的中位数,将182名被诊断为患有PDD的受试者(41名女性)分为注意力问题高分组(PDD+)和低分组(PDD)。通过其余7个CBCL分量表测量共存精神病理学程度,并使用针对年龄、智商和社会经济地位进行协方差调整的多变量分析,比较两组在《自闭症诊断访谈修订版》(ADI-R)和《自闭症诊断观察量表》评估的自闭症核心特征方面的差异。
在内在化和外在化症状方面,PDD+组受试者表现出的总体精神病理学程度显著高于PDD亚组受试者。此外,PDD+亚组在ADI-R的社会互动量表上往往表现出更多损伤。
临床医生应调整治疗方案,以确保对PDD和相关ADHD进行全面有效的治疗。双重诊断对于实施有效治疗可能至关重要。