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自闭症谱系障碍中的共病情况和诊断变化。

Co-occurring conditions and change in diagnosis in autism spectrum disorders.

机构信息

Center for Autism and Developmental Disabilities Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

出版信息

Pediatrics. 2012 Feb;129(2):e305-16. doi: 10.1542/peds.2011-1717. Epub 2012 Jan 23.

DOI:10.1542/peds.2011-1717
PMID:22271695
Abstract

OBJECTIVE

This study aimed to investigate descriptive characteristics and co-occurring neurodevelopmental and psychiatric conditions in young children, children, and adolescents with a current and consistent or past but not current (PBNC) diagnosis of autism spectrum disorder (ASD) and how such characteristics and conditions may engender a change in diagnosis of an ASD.

METHODS

Cross-sectional data of 1366 children with a parent-reported current or PBNC ASD diagnosis were obtained from the National Survey of Children's Health 2007 data set across 3 developmental stages: young children (aged 3-5 years), children (aged 6-11 years), and adolescents (aged 12-17 years). Multinomial logistic regression was used to examine demographic characteristics and co-occurring conditions that differentiate the groups with a current ASD from groups with a PBNC ASD.

RESULTS

Results indicated the co-occurring conditions that distinguish groups currently diagnosed with an ASD from groups with a PBNC ASD diagnosis. In young children, current moderate/severe learning disability, and current moderate/severe developmental delay; in children, past speech problem, current moderate/severe anxiety, and past hearing problem; and in adolescents, current moderate/severe speech problem, current mild seizure/epilepsy, and past hearing problem.

CONCLUSIONS

These findings suggest that the presence of co-occurring psychiatric and neurodevelopmental conditions are associated with a change in ASD diagnosis. Questions remain as to whether changes in diagnosis of an ASD are due to true etiologic differences or shifts in diagnostic determination.

摘要

目的

本研究旨在调查当前和持续存在或过去但不存在(PBNC)自闭症谱系障碍(ASD)诊断的幼儿、儿童和青少年的描述性特征以及并发的神经发育和精神疾病状况,并探讨这些特征和状况如何导致 ASD 诊断的变化。

方法

从全国儿童健康调查 2007 年数据集的 3 个发育阶段(幼儿期[3-5 岁]、儿童期[6-11 岁]和青少年期[12-17 岁])获得了 1366 名父母报告当前或 PBNC ASD 诊断的儿童的横断面数据。采用多项逻辑回归分析来检查区分当前 ASD 组和 PBNC ASD 组的人口统计学特征和并发情况。

结果

结果表明了区分当前 ASD 组和 PBNC ASD 组的并发情况。在幼儿期,当前中重度学习障碍和当前中重度发育迟缓;在儿童期,过去的言语问题、当前的中重度焦虑和过去的听力问题;在青少年期,当前中重度言语问题、当前轻度癫痫/癫痫和过去的听力问题。

结论

这些发现表明并发精神和神经发育疾病与 ASD 诊断的变化有关。目前仍存在疑问的是,ASD 诊断的变化是由于真正的病因差异还是诊断确定的转变所致。

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