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自闭症谱系障碍儿童的精神共病:与注意缺陷多动障碍儿童的比较。

Psychiatric Comorbidity in Children with Autism Spectrum Disorders: A Comparison with Children with ADHD.

作者信息

van Steensel Francisca J A, Bögels Susan M, de Bruin Esther I

机构信息

Research Institute of Child Development and Education, University of Amsterdam, Nieuwe Prinsengracht 130, 1018 VZ Amsterdam, The Netherlands.

出版信息

J Child Fam Stud. 2013 Apr;22(3):368-376. doi: 10.1007/s10826-012-9587-z. Epub 2012 May 1.

Abstract

The present study was conducted with the aim to identify comorbid psychiatric disorders in children with autism spectrum disorders (ASD) ( = 40) and to compare those comorbidity rates to those in children with attention deficit hyperactivity disorder (ADHD) ( = 40). Participants were clinically referred children aged 7-18 years. DSM-IV classifications were used for the primary diagnosis (ASD/ADHD), while comorbid psychiatric disorders were assessed using a structured diagnostic interview, the structured clinical interview for DSM-IV, childhood diagnoses (KID-SCID). Twenty-three children with ASD (57.5 %) had at least one comorbid disorder, whereas 16 children with ADHD (40.0 %) were classified as having at least one comorbid disorder. No group differences were found with respect to this comorbidity rate or for the rate of comorbid externalizing disorders (ODD and/or CD). However, children with ASD had more comorbid internalizing disorders compared to children with ADHD. More specifically, children with ASD had higher rates of anxiety disorders, but not mood disorders. No associations between comorbidity and age or between comorbidity and the intelligence quotient was found. It is important for clinicians to always be aware of, and screen for, comorbidity, and to consider treatment for these comorbid disorders. In addition, research should focus on establishing valid and reliable screening tools as well as effective treatment options for these comorbid disorders.

摘要

本研究旨在识别自闭症谱系障碍(ASD)儿童(n = 40)中共存的精神障碍,并将这些共病率与注意力缺陷多动障碍(ADHD)儿童(n = 40)的共病率进行比较。参与者为临床转诊的7至18岁儿童。主要诊断(ASD/ADHD)采用《精神疾病诊断与统计手册》第四版(DSM-IV)分类,而共存的精神障碍则使用结构化诊断访谈《DSM-IV儿童诊断用结构化临床访谈》(KID-SCID)进行评估。23名ASD儿童(57.5%)至少有一种共病障碍,而16名ADHD儿童(40.0%)被归类为至少有一种共病障碍。在这种共病率或共病外化障碍(对立违抗障碍和/或品行障碍)率方面未发现组间差异。然而,与ADHD儿童相比,ASD儿童有更多的共病内化障碍。更具体地说,ASD儿童的焦虑障碍发生率较高,但心境障碍发生率并非如此。未发现共病与年龄之间或共病与智商之间存在关联。临床医生始终意识到并筛查共病,并考虑对这些共病障碍进行治疗非常重要。此外,研究应侧重于建立针对这些共病障碍的有效且可靠的筛查工具以及有效的治疗方案。

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