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评估杜氏肌营养不良症男孩的心理健康:意大利临床样本中的情绪、行为和神经发育概况。

Assessing mental health in boys with Duchenne muscular dystrophy: Emotional, behavioural and neurodevelopmental profile in an Italian clinical sample.

作者信息

Colombo Paola, Nobile Maria, Tesei Alessandra, Civati Federica, Gandossini Sandra, Mani Elisa, Molteni Massimo, Bresolin Nereo, D'Angelo Grazia

机构信息

Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Via Don Luigi Monza 20, Bosisio Parini, Lecco, Italy.

Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Via Don Luigi Monza 20, Bosisio Parini, Lecco, Italy.

出版信息

Eur J Paediatr Neurol. 2017 Jul;21(4):639-647. doi: 10.1016/j.ejpn.2017.02.007. Epub 2017 Mar 24.

Abstract

OBJECTIVE

To evaluate through a comprehensive protocol, the psychopathological profile of DMD boys. The primary aim of this observational study was to describe the emotional and behavioural profile and the neurodevelopmental problems of Italian boys with Duchenne Muscular Dystrophy (DMD); the secondary aim was to explore the relation between psychopathological profile and DMD genotype.

METHOD

47 DMD boys, aged 2-18, were included in the study and assessed through structured and validated tools including Wechsler scales or Griffiths for cognitive ability, Child Behavior Check List (CBCL), Youth Self Report (YSR) and Strengths and Difficulties Questionnaire (SDQ) for emotional and behavioural features. Patients "at risk" based on questionnaires scores were evaluated by a clinical structured interview using Development and Well Being Assessment (DAWBA) or Autism Diagnostic Observation Schedule (ADOS), as required.

RESULTS

The 47 enrolled patients, defined with a Full Scale Intelligence Quotient (FSIQ) of 80.38 (one SD below average), and presenting a large and significant difference in FSIQ in relation to the site of mutation along the dystrophin gene (distal mutations associated with a more severe cognitive deficit), were showing Internalizing Problems (23.4%) and Autism Spectrum Disorders (14.8%). Interestingly, an association of internalizing problems with distal deletion of the DMD gene is documented.

CONCLUSION

Even though preliminary, these data show that the use of validated clinical instruments, that focus on the impact of emotional/behaviour problems on everyday life, allows to carefully identify clinically significant psychopathology.

摘要

目的

通过综合方案评估杜氏肌营养不良症(DMD)男孩的心理病理学特征。这项观察性研究的主要目的是描述患有杜氏肌营养不良症的意大利男孩的情绪和行为特征以及神经发育问题;次要目的是探讨心理病理学特征与DMD基因型之间的关系。

方法

47名年龄在2至18岁之间的DMD男孩被纳入研究,并通过结构化且经过验证的工具进行评估,包括用于认知能力评估的韦氏智力量表或格里菲斯量表,以及用于评估情绪和行为特征的儿童行为检查表(CBCL)、青少年自我报告(YSR)和优势与困难问卷(SDQ)。根据问卷得分处于“风险”状态的患者,根据需要通过使用发育与幸福感评估(DAWBA)或自闭症诊断观察量表(ADOS)的临床结构化访谈进行评估。

结果

47名入组患者的全量表智商(FSIQ)为80.38(比平均水平低一个标准差),并且在肌营养不良蛋白基因上的突变位点与FSIQ存在很大且显著的差异(远端突变与更严重的认知缺陷相关),这些患者表现出内化问题(23.4%)和自闭症谱系障碍(14.8%)。有趣的是,记录到内化问题与DMD基因远端缺失之间存在关联。

结论

尽管这些数据是初步的,但它们表明,使用专注于情绪/行为问题对日常生活影响的经过验证的临床工具,能够仔细识别具有临床意义的精神病理学问题。

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