Schmitz Johanna C, Cholemkery Hannah, Medda Juliane, Freitag Christine M
1 Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters; Universitätsklinikum Frankfurt, Goethe-Universität Frankfurt am Main.
Z Kinder Jugendpsychiatr Psychother. 2017;45(3):209-217. doi: 10.1024/1422-4917/a000507. Epub 2017 Jan 27.
Epidemiological studies indicate the relevance of pre- and perinatal risk factors for the genesis of attention deficit/hyperactivity disorder and autism spectrum disorder. This study compares potential risk factors in a clinical sample of children with ADHD, ASD, the combination of both diseases, ADHD and oppositional defiant or conduct disorder (ADHD & ODD/CD) and examined whether the existence of additional risk factors promotes the occurrence of combined diseases.
We compared the pre- and perinatal risk factors of 341 patients (299 boys, 42 girls) from a clinical population, differentiating between children with ADHD (n=80), ASD (n=122), ADHD & ASD (n=55), or ADHD & ODD/CD (n=84).
We observed a higher rate of maternal smoking, a higher rate of migration, and lower parental education among the children with ADHD & ODD/CD compared to those with ASD or ADHD. The rate of migration background was higher among the children with ASD compared to children with ADHD. Miscarriage was a specific risk factor for ADHD & ASD.
Numerous risk factors described in epidemiological studies occurred only rarely in our clinical sample. The distribution of most risk factors was comparable between the examined diseases.
流行病学研究表明围产期及产前危险因素与注意力缺陷多动障碍和自闭症谱系障碍的发生有关。本研究比较了患有注意力缺陷多动障碍（ADHD）、自闭症谱系障碍（ASD）、两种疾病并存、ADHD与对立违抗或品行障碍（ADHD&ODD/CD）的儿童临床样本中的潜在危险因素，并研究了是否存在其他危险因素会促使合并疾病的发生。
我们比较了来自临床群体的341名患者（299名男孩，42名女孩）的围产期及产前危险因素，区分了患有ADHD（n=80）、ASD（n=122）、ADHD&ASD（n=55）或ADHD&ODD/CD（n=84）的儿童。
我们观察到，与患有ASD或ADHD的儿童相比，患有ADHD&ODD/CD的儿童中母亲吸烟率更高、移民率更高且父母受教育程度更低。与患有ADHD的儿童相比，患有ASD的儿童中具有移民背景的比例更高。流产是ADHD&ASD的一个特定危险因素。
流行病学研究中描述的众多危险因素在我们的临床样本中很少出现。大多数危险因素在所研究的疾病之间分布相当。
