Rynkiewicz Agnieszka, Łucka Izabela
Klinika Psychiatrii Dorosłych GUMed.
Klinika Psychiatrii Rozwojowej, Zaburzeń Psychotycznych i Wieku Podeszłego GUMed.
Psychiatr Pol. 2018 Aug 24;52(4):629-639. doi: 10.12740/PP/OnlineFirst/58837.
The study aims to define the differences in clinical manifestation among adolescent girls and boys with autism spectrum disorder (ASD).
The study group consisted of 15 adolescent girls and 16 adolescent boys with diagnosis of autismor Asperger syndrome and their parents. Adolescents were assessed with ADOS (Autism Diagnostic Observation Schedule, Polish adaptation of the assessment), algorithms of ADOS and ADOS-2 (revised version) were compared. Structured interview was conducted with parents, they fulfilled AQ (Autism Quotient), ASAS (Australian Scale for Asperger Syndrome), GQ-ASC (Girls' Questionnaire for Autism Spectrum Conditions). Medical records were analyzed. Results were analyzed using statistical methods.
Patients were assessed with ADOS Module 4. Results indicated statistically significant differences between ASD girls and ASD boys in communication section, both verbal and gestures. The mean scores of AQ for ASD girls and ASD boys were M = 33.0 and M=30.9, and of ASAS M =57% and M =61% respectively. ASD girls had more psychiatric hospitalisations than ASD boys (60% vs. 31%), and they were more often treated with antidepressants (67% vs. 31%), anxiolytics (20% vs. 6%), mood stabilizers (40% vs. 19%). ASD boys were more often treated with psychotropic medications (50% vs. 47%) and stimulants (44% vs. 20%) than ASD girls.
ASD girls are at risk of receiving non-spectrum classification in ADOS or ADOS-2 while their developmental history and clinical manifestation confirm ASD. Clinical data suggests that ASD girls present more abnormalities in sensory profile. ASD girls are at greater risk for developing anxiety, depression, suicidal ideation, and for psychiatric hospitalization. ASD boys appear to be at greater risk for co-occurring ADHD, OCD and tics.
本研究旨在明确患有自闭症谱系障碍（ASD）的青春期女孩和男孩在临床表现上的差异。
研究组由15名被诊断为自闭症或阿斯伯格综合征的青春期女孩、16名青春期男孩及其父母组成。采用ADOS（自闭症诊断观察量表，波兰语改编版评估）对青少年进行评估，并比较ADOS算法和ADOS - 2（修订版）。对家长进行结构化访谈，他们填写了AQ（自闭症商数）、ASAS（澳大利亚阿斯伯格综合征量表）、GQ - ASC（女孩自闭症谱系状况问卷）。分析医疗记录。使用统计方法分析结果。
患者接受了ADOS模块4的评估。结果表明，ASD女孩和ASD男孩在沟通部分（包括言语和手势）存在统计学上的显著差异。ASD女孩和ASD男孩的AQ平均得分分别为M = 33.0和M = 30.9，ASAS平均得分分别为M = 57%和M = 61%。ASD女孩比ASD男孩有更多的精神病住院治疗经历（60%对31%），并且她们更常接受抗抑郁药治疗（67%对31%）、抗焦虑药治疗（20%对6%）、情绪稳定剂治疗（40%对19%）。ASD男孩比ASD女孩更常接受精神药物治疗（50%对47%）和兴奋剂治疗（44%对20%）。
ASD女孩在ADOS或ADOS - 2中存在被归类为非谱系的风险，而她们的发育史和临床表现证实为ASD。临床数据表明，ASD女孩在感觉特征方面存在更多异常。ASD女孩患焦虑、抑郁、自杀观念以及精神病住院治疗的风险更高。ASD男孩似乎患注意力缺陷多动障碍（ADHD）、强迫症（OCD）和抽动症的风险更高。
