Rosenberg Rebecca E, Kaufmann Walter E, Law J Kiely, Law Paul A
Department of Medical Informatics, Kennedy Krieger Institute, Painter Building, First Floor, 3825 Greenspring Avenue, Baltimore, MD 21211, USA.
Autism Res Treat. 2011;2011:405849. doi: 10.1155/2011/405849. Epub 2011 Aug 18.
We used a national online registry to examine variation in cumulative prevalence of community diagnosis of psychiatric comorbidity in 4343 children with autism spectrum disorders (ASD). Adjusted multivariate logistic regression models compared influence of individual, family, and geographic factors on cumulative prevalence of parent-reported anxiety disorder, depression, bipolar disorder, and attention deficit/hyperactivity disorder or attention deficit disorder. Adjusted odds of community-assigned lifetime psychiatric comorbidity were significantly higher with each additional year of life, with increasing autism severity, and with Asperger syndrome and pervasive developmental disorder-not otherwise specified compared with autistic disorder. Overall, in this largest study of parent-reported community diagnoses of psychiatric comorbidity, gender, autistic regression, autism severity, and type of ASD all emerged as significant factors correlating with cumulative prevalence. These findings could suggest both underlying trends in actual comorbidity as well as variation in community interpretation and application of comorbid diagnoses in ASD.
我们利用一个全国性在线登记系统,对4343名自闭症谱系障碍(ASD)儿童的社区精神疾病共病累积患病率差异进行了研究。调整后的多变量逻辑回归模型比较了个体、家庭和地理因素对家长报告的焦虑症、抑郁症、双相情感障碍以及注意力缺陷/多动障碍或注意力缺陷障碍累积患病率的影响。随着年龄每增加一岁、自闭症严重程度增加,以及与自闭症障碍相比患阿斯伯格综合征和未特定的广泛性发育障碍,社区指定的终生精神疾病共病调整后的几率显著更高。总体而言,在这项关于家长报告的社区精神疾病共病诊断的最大规模研究中,性别、自闭症退化、自闭症严重程度以及ASD类型均成为与累积患病率相关的显著因素。这些发现可能既提示了实际共病的潜在趋势,也反映了社区对ASD中共病诊断的解释和应用的差异。