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青少年时期的阿斯伯格综合征与精神分裂症的关系。

The relationship between Asperger's syndrome and schizophrenia in adolescence.

机构信息

Eteva the Joint Municipal Authority for Disability Services, Kokontie 18, 04200, Kerava, Finland.

出版信息

Eur Child Adolesc Psychiatry. 2013 Apr;22(4):217-23. doi: 10.1007/s00787-012-0338-x. Epub 2012 Oct 13.

DOI:10.1007/s00787-012-0338-x
PMID:23065028
Abstract

Asperger's syndrome (AS), a pervasive developmental disorder (PDD), has nowadays been widely advocated in media. Therefore, psychiatrists treating adolescents frequently meet patients as well as their families reporting of symptoms resembling those of Asperger's syndrome. It is known that symptoms of Asperger's syndrome have some overlap with those of schizophrenia, but less is known about comorbidity between these two syndromes. We describe a sample of 18 adolescents with early onset schizophrenia. Diagnosis of schizophrenia was based on assessment with Kiddie Schedule for Affective Disorders and Schizophrenia. The diagnostic interview for Social and Communication Disorders version 11 was used to assess autism spectrum disorders. Ten adolescents fulfilled symptom criteria of Asperger's syndrome after the onset of schizophrenia, while only two persons had Asperger's syndrome before the onset of schizophrenia, a prerequisite for diagnosis. 44% of the adolescents fulfilled the diagnosis of some PDD in childhood. Most of them were, however, unrecognized before the onset of schizophrenia. On the other hand, all 18 patients had one or more symptoms of PDDS in adolescence. Adolescents with schizophrenia have often symptoms consistent with AS, although only few of them have fulfilled the diagnostic criteria in their childhood, a prerequisite for the diagnosis of AS. There is a risk for misdiagnosis of adolescents with autistic symptoms if detailed longitudinal anamnesis is not obtained.

摘要

阿斯伯格综合征(AS),一种广泛存在的发育障碍(PDD),如今在媒体中得到了广泛的宣传。因此,治疗青少年的精神科医生经常会遇到报告类似于阿斯伯格综合征症状的患者及其家人。众所周知,阿斯伯格综合征的症状与精神分裂症的症状有些重叠,但对于这两种综合征之间的共病情况了解较少。我们描述了 18 名早期发病的精神分裂症青少年的样本。精神分裂症的诊断是基于 Kiddie 情感障碍和精神分裂症量表评估的。使用社交和沟通障碍诊断访谈 11 版评估自闭症谱系障碍。10 名青少年在精神分裂症发病后符合阿斯伯格综合征的症状标准,而只有 2 人在精神分裂症发病前符合阿斯伯格综合征的诊断标准。44%的青少年在儿童时期被诊断为某种 PDD。然而,大多数人在精神分裂症发病前未被识别。另一方面,所有 18 名患者在青少年时期都有一个或多个 PDDS 症状。患有精神分裂症的青少年常有符合 AS 的症状,尽管其中只有少数人在儿童时期符合 AS 的诊断标准,这是 AS 诊断的前提。如果未获得详细的纵向病史,可能会误诊有自闭症症状的青少年。

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