Taurines Regina, Schwenck Christina, Westerwald Eva, Sachse Michael, Siniatchkin Michael, Freitag Christine
Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Würzburg University, Würzburg, Germany.
Atten Defic Hyperact Disord. 2012 Sep;4(3):115-39. doi: 10.1007/s12402-012-0086-2. Epub 2012 Aug 1.
According to DSM-IV TR and ICD-10, a diagnosis of autism or Asperger Syndrome precludes a diagnosis of attention-deficit/hyperactivity disorder (ADHD). However, despite the different conceptualization, population-based twin studies reported symptom overlap, and a recent epidemiologically based study reported a high rate of ADHD in autism and autism spectrum disorders (ASD). In the planned revision of the DSM-IV TR, dsm5 (www.dsm5.org), the diagnoses of autistic disorder and ADHD will not be mutually exclusive any longer. This provides the basis of more differentiated studies on overlap and distinction between both disorders. This review presents data on comorbidity rates and symptom overlap and discusses common and disorder-specific risk factors, including recent proteomic studies. Neuropsychological findings in the areas of attention, reward processing, and social cognition are then compared between both disorders, as these cognitive abilities show overlapping as well as specific impairment for one of both disorders. In addition, selective brain imaging findings are reported. Therapeutic options are summarized, and new approaches are discussed. The review concludes with a prospectus on open questions for research and clinical practice.
根据《精神疾病诊断与统计手册第四版修订版》（DSM-IV TR）和《国际疾病分类第十版》（ICD-10），自闭症或阿斯伯格综合征的诊断排除了注意力缺陷/多动障碍（ADHD）的诊断。然而，尽管概念不同，但基于人群的双胞胎研究报告了症状重叠情况，并且最近一项基于流行病学的研究报告称，自闭症和自闭症谱系障碍（ASD）中ADHD的发病率很高。在《精神疾病诊断与统计手册第四版修订版》（DSM-IV TR）的计划修订版DSM-5（www.dsm5.org）中，自闭症障碍和ADHD的诊断将不再相互排斥。这为对这两种障碍的重叠和区别进行更具区分性的研究提供了基础。本综述呈现了关于共病率和症状重叠的数据，并讨论了常见的和特定障碍的风险因素，包括近期的蛋白质组学研究。然后，对这两种障碍在注意力、奖赏处理和社会认知方面的神经心理学发现进行了比较，因为这些认知能力对其中一种障碍既表现出重叠的损伤，也表现出特定的损伤。此外，还报告了选择性脑成像的发现。总结了治疗选择，并讨论了新的方法。综述最后提出了关于研究和临床实践中未解决问题的展望。
