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[自闭症谱系障碍——流行病学、症状、共病及诊断]

[Autism spectrum disorders - epidemiology, symptoms, comorbidity and diagnosis].

作者信息

Rybakowski Filip, Bialek Anna, Chojnicka Izabela, Dziechciarz Piotr, Horvath Andrea, Janas-Kozik Malgorzata, Jeziorek Anetta, Pisula Ewa, Piwowarczyk Anna, Slopien Agnieszka, Sykut-Cegielska Jolanta, Szajewska Hanna, Szczaluba Krzysztof, Szymanska Krystyna, Urbanek Ksymena, Waligórska Anna, Wojciechowska Aneta, Wroniszewski Michal, Dunajska Anna

出版信息

Psychiatr Pol. 2014 Jul-Aug;48(4):653-65.

Abstract

In the new classification of American Psychiatric Association - DSM-5 - a category of autistic spectrum disorders (ASD) was introduced, which replaced autistic disorder, Asperger syndrome, childhood disintegrative disorder and pervasive developmental disorder not otherwise specified. ASD are defined by two basic psychopathological dimensions: communication disturbances and stereotyped behaviors, and the diagnosis is complemented with the assessment of language development and intellectual level. In successive epidemiological studies conducted in 21 century the prevalence of ASD has been rising, and currently is estimated at 1% in general population. The lifetime psychiatric comorbidity is observed in majority of patients. The most common coexisting diagnoses comprise disorders ofanxiety-affective spectrum, and in about 1/3 of patients attention deficit/ hyperactivity disorders could be diagnosed. Prodromal symptoms of ASD may emerge before 12 months of life, however reliability of diagnosis at such an early age is poor. Several screening instruments, based on the parental and/or healthcare professional assessments may be helpful in ASD detection. However, structured interviews and observation schedules remain the gold standard of diagnosis.

摘要

在美国精神病学协会的新分类——《精神疾病诊断与统计手册》第五版(DSM - 5)中,引入了自闭症谱系障碍(ASD)这一类别,它取代了自闭症、阿斯伯格综合征、儿童期崩解症以及未特定的广泛性发育障碍。ASD由两个基本的精神病理维度定义:沟通障碍和刻板行为,并且诊断还需辅以语言发展和智力水平的评估。在21世纪进行的一系列流行病学研究中,ASD的患病率一直在上升,目前估计在普通人群中为1%。大多数患者存在终生精神共病。最常见的共病诊断包括焦虑 - 情感谱系障碍,约1/3的患者可被诊断出注意力缺陷/多动障碍。ASD的前驱症状可能在12个月前出现,然而在如此早的年龄进行诊断的可靠性较差。基于家长和/或医疗保健专业人员评估的几种筛查工具可能有助于ASD的检测。然而,结构化访谈和观察量表仍然是诊断的金标准。

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