Shinshu University Hospital, Mental Health Clinic for Children, Shinshu University Hospital, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan.
Psychiatry Clin Neurosci. 2009 Dec;63(6):762-8. doi: 10.1111/j.1440-1819.2009.02029.x.
The aim of the present study was to verify the comorbidity of conduct disorder (CD) and behavioral/developmental disorders in children and adolescents, and to examine the traits of CD comorbid with them.
Subjects were 64 children (60 boys, four girls) who were resident at three institutions for delinquent children or who were conduct-disordered outpatients of a university hospital aged under 18 years. A diagnostic interview was carried out by experienced child psychiatrists and the intelligence score and the Adverse Childhood Experiences score were measured by a licensed psychologist.
A total of 57 children were diagnosed as having CD, of whom 26 (45.6%) were diagnosed with comorbid attention-deficit-hyperactivity disorder (ADHD), 12 were diagnosed with comorbid pervasive developmental disorder (PDD, 21,1%), and 19 (33.3%) had no comorbidity of either disorder. Six children (18.8% of CD comorbid with ADHD) met the criteria for both ADHD and PDD. The group with comorbid PDD was significantly younger at onset (F = 6.51, P = 0.003) and included unsocialized type more frequently (chi(2) = 6.66, P = 0.036) compared with the other two groups.
Clinicians should be aware that not only ADHD but also PDD may be comorbid with CD. Establishment of the correct diagnosis is important because recognizing the presence of PDD will enable us to provide appropriate treatment and guidance, which may improve prognosis.
本研究旨在验证品行障碍（CD）与行为/发育障碍在儿童和青少年中的共病情况，并探讨与 CD 共病的特征。
研究对象为 64 名（60 名男性，4 名女性）年龄在 18 岁以下的、居住在三家少年犯教养院或某大学医院品行障碍门诊的儿童。由经验丰富的儿童精神科医生进行诊断访谈，由持照心理学家测量智商和儿童不良经历得分。
共有 57 名儿童被诊断为 CD，其中 26 名（45.6%）被诊断为共患注意缺陷多动障碍（ADHD），12 名被诊断为共患广泛性发育障碍（PDD，21.1%），19 名（33.3%）无任何共患障碍。6 名儿童（ADHD 共病 CD 的 18.8%）符合 ADHD 和 PDD 的双重诊断标准。共患 PDD 的患儿起病年龄明显更小（F = 6.51，P = 0.003），且更常为非社会化型（卡方= 6.66，P = 0.036）。
临床医生应认识到，不仅 ADHD，而且 PDD 也可能与 CD 共病。正确诊断很重要，因为识别 PDD 的存在将使我们能够提供适当的治疗和指导，这可能会改善预后。
