社会经济差异与自闭症谱系障碍和智力残疾的患病率
Socioeconomic Disparities and Prevalence of Autism Spectrum Disorders and Intellectual Disability.
作者信息
Delobel-Ayoub Malika, Ehlinger Virginie, Klapouszczak Dana, Maffre Thierry, Raynaud Jean-Philippe, Delpierre Cyrille, Arnaud Catherine
机构信息
Registre des Handicaps de l'Enfant en Haute-Garonne, CHU de Toulouse, Toulouse, France.
INSERM, U1027, Toulouse, France.
出版信息
PLoS One. 2015 Nov 5;10(11):e0141964. doi: 10.1371/journal.pone.0141964. eCollection 2015.
BACKGROUND AND OBJECTIVES
Study of the impact of socioeconomic status on autism spectrum disorders (ASD) and severe intellectual disabilities (ID) has yielded conflicting results. Recent European studies suggested that, unlike reports from the United States, low socioeconomic status is associated with an increased risk of ASD. For intellectual disabilities, the links with socioeconomic status vary according to the severity. We wished to clarify the links between socioeconomic status and the prevalence of ASD (with or without ID) and isolated severe ID.
METHODS
500 children with ASD and 245 children with severe ID (IQ <50) aged 8 years, born 1995 to 2004, were recruited from a French population-based registry. Inclusions were based on clinical diagnoses reported in medical records according to the International Classification of Diseases, 10th Revision. Socioeconomic status was measured by indicators available at block census level which characterize the population of the child's area of residence. Measures of deprivation, employment, occupation, education, immigration and family structure were used. Prevalences were compared between groups of census units defined by the tertiles of socioeconomic level in the general population.
RESULTS
Prevalence of ASD with associated ID was higher in areas with the highest level of deprivation and the highest percentage of unemployed adults, persons with no diploma, immigrants and single-parent families. No association was found when using occupational class. Regarding ASD without associated ID, a higher prevalence was found in areas with the highest percentage of immigrants. No association was found for other socioeconomic indicators. The prevalence of isolated severe ID was likely to be higher in the most disadvantaged groups defined by all indicators.
CONCLUSION
The prevalence of ASD with associated ID and of severe isolated ID is more likely to be higher in areas with the highest level of deprivation.
背景与目的
关于社会经济地位对自闭症谱系障碍（ASD）和重度智力残疾（ID）影响的研究结果相互矛盾。近期欧洲的研究表明，与美国的报告不同，社会经济地位较低与ASD风险增加有关。对于智力残疾，其与社会经济地位的关联因严重程度而异。我们希望阐明社会经济地位与ASD（伴或不伴ID）及孤立性重度ID患病率之间的联系。
方法
从法国基于人群的登记处招募了500名8岁的ASD儿童和245名重度ID（智商<50）儿童，这些儿童出生于1995年至2004年。纳入标准基于根据《国际疾病分类》第十次修订版在医疗记录中报告的临床诊断。社会经济地位通过街区人口普查层面可用的指标来衡量，这些指标表征儿童居住地区的人口特征。使用了贫困、就业、职业、教育、移民和家庭结构等指标。比较了由一般人群社会经济水平三分位数定义的人口普查单位组之间的患病率。
结果
在贫困程度最高、成年失业者比例最高、无文凭者比例最高、移民比例最高和单亲家庭比例最高的地区，伴有ID的ASD患病率更高。使用职业阶层进行分析时未发现关联。对于不伴有ID的ASD，在移民比例最高的地区患病率更高。其他社会经济指标未发现关联。在所有指标定义的最弱势群体中，孤立性重度ID的患病率可能更高。
结论
在贫困程度最高的地区，伴有ID的ASD和严重孤立性ID的患病率更有可能更高。
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