Mansour Rosleen, Dovi Allison T, Lane David M, Loveland Katherine A, Pearson Deborah A
Department of Psychiatry & Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, United States.
Department of Educational Psychology, University of Houston, United States.
Res Dev Disabil. 2017 Jan;60:52-64. doi: 10.1016/j.ridd.2016.11.009. Epub 2016 Nov 24.
Comorbid diagnoses identified in pediatric samples have been correlated with a range of outcomes, including greater levels of emotional, behavioral, and educational impairment and the need for more intensive treatment. Given that previous research has documented high levels of comorbid Attention-Deficit/Hyperactivity Disorder (ADHD) in children with Autism Spectrum Disorders (ASD), this study closely examines the relationship between parent-reported ADHD symptoms (i.e., Conners' Parent Rating Scale, Revised [CPRS-R]) and the prevalence of additional comorbid psychiatric diagnoses in a pediatric ASD sample (n=99). Regression analyses revealed that greater severity of ADHD symptomatology was significantly related to a greater number of comorbid psychiatric diagnoses, as identified using the Diagnostic Interview for Children and adolescents, 4th Edition (DICA-IV). Additionally, more severe ADHD symptoms were also associated with higher levels of symptom severity on Child Behavior Checklist (CBCL) syndrome subscales. Interestingly, increasing severity of ASD symptomatology, as measured by the Autism Diagnostic Interview, Revised (ADI-R), was not associated with a higher prevalence of comorbid psychiatric diagnoses or CBCL syndrome severity. Our study concluded that higher levels of ADHD severity-not ASD severity-were associated with a higher prevalence of comorbid psychiatric symptomatology in school-age children with ASD. These findings may encourage clinicians to thoroughly assess ADHD symptomatology in ASD children to better inform treatment planning.
在儿科样本中确定的共病诊断与一系列结果相关，包括更高水平的情绪、行为和教育障碍，以及对更强化治疗的需求。鉴于先前的研究记录了自闭症谱系障碍（ASD）儿童中共病注意力缺陷多动障碍（ADHD）的高发生率，本研究仔细考察了家长报告的ADHD症状（即康纳斯父母评定量表修订版[CPRS-R]）与儿科ASD样本（n = 99）中其他共病精神科诊断的患病率之间的关系。回归分析显示，使用儿童和青少年诊断访谈第4版（DICA-IV）确定，ADHD症状的严重程度越高，与共病精神科诊断的数量越多显著相关。此外，更严重的ADHD症状也与儿童行为检查表（CBCL）综合征子量表上更高的症状严重程度相关。有趣的是，通过自闭症诊断访谈修订版（ADI-R）测量的ASD症状严重程度增加，与共病精神科诊断的患病率较高或CBCL综合征严重程度无关。我们的研究得出结论，在患有ASD的学龄儿童中，较高水平的ADHD严重程度而非ASD严重程度与共病精神症状的较高患病率相关。这些发现可能会鼓励临床医生对ASD儿童的ADHD症状进行全面评估，以便更好地为治疗计划提供信息。
