Rotterdam and Amsterdam, The Netherlands From the Departments of Plastic and Reconstructive Surgery and Child and Adolescent Psychiatry, Sophia Children&s Hospital/Erasmus Medical University Center, and the Faculty of Behavioral and Social Sciences, University of Amsterdam.
Plast Reconstr Surg. 2012 Oct;130(4):885-893. doi: 10.1097/PRS.0b013e318262f21f.
The main objective of the present study was to assess the prevalence rates of attention deficit hyperactivity disorder, oppositional defiant disorder, conduct disorder, and features of autism spectrum disorders in trigonocephalic patients, using validated instruments and by ruling out the confounding influence of IQ. The second aim was to assess the association between extracranial anomalies and cognitive and/or behavioral problems in patients with trigonocephaly.
Objectives were studied in 82 trigonocephalic patients aged 4 to 18 years at the Erasmus Medical Center in Rotterdam, The Netherlands. Features of autism spectrum disorders were assessed using the Social Communication Questionnaire. Attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder were assessed with the Diagnostic Interview Schedule for Children-Parent Version. The presence and nature of extracranial anomalies were ascertained by a clinician.
Mental retardation (IQ <70) was present in 9 percent of patients with trigonocephaly. Findings indicated a 70 percent versus 24 percent prevalence of psychopathology (attention deficit hyperactivity disorder, oppositional defiant disorder, conduct disorder, or features of autism spectrum disorder) in patients with IQ levels of, respectively, <85 and ≥85. In the latter group, psychopathology was not significantly more common than expected based on prevalence rates reported in community samples. Extracranial anomalies were significantly correlated with lower IQ levels. However, when adjusted for IQ, the presence of extracranial malformations was not associated with an increased risk of behavioral problems.
The relatively high prevalence of behavioral problems in patients with trigonocephaly seems to be mainly attributable to the co-occurrence of trigonocephaly and low intelligence.
本研究的主要目的是使用经过验证的工具，排除智商的混杂影响，评估三角头畸形患者中注意缺陷多动障碍、对立违抗性障碍、品行障碍和自闭症谱系障碍特征的患病率。第二个目的是评估在三角头畸形患者中，颅外异常与认知和/或行为问题之间的关系。
在荷兰鹿特丹伊拉斯谟医疗中心，研究了 82 名年龄在 4 至 18 岁的三角头畸形患者的目标。使用社会沟通问卷评估自闭症谱系障碍特征。使用儿童诊断访谈表-父母版评估注意缺陷多动障碍、对立违抗性障碍和品行障碍。颅外异常的存在和性质由临床医生确定。
智力障碍（智商<70）见于 9%的三角头畸形患者。研究结果表明，智商分别<85 和≥85 的患者中，精神病理学（注意缺陷多动障碍、对立违抗性障碍、品行障碍或自闭症谱系障碍特征）的患病率分别为 70%和 24%。在后一组中，精神病理学的发病率并不比社区样本报告的患病率高。颅外异常与较低的智商水平显著相关。然而，当调整智商时，颅外畸形的存在与行为问题的风险增加无关。
三角头畸形患者中行为问题的相对高发似乎主要归因于三角头畸形和智力低下的同时存在。
