Ohio State University, Nisonger Center, United States of America.
Emory University School of Medicine, Department of Pediatrics, United States of America.
Compr Psychiatry. 2019 Jan;88:57-64. doi: 10.1016/j.comppsych.2018.10.012. Epub 2018 Nov 6.
We explored patterns of concomitant psychiatric disorders in a large sample of treatment-seeking children and adolescents with autism spectrum disorder (ASD).
Participants were 658 children with ASD (age 3-17 years; mean = 7.2 years) in one of six federally-funded multisite randomized clinical trials (RCT) between 1999 and 2014. All children were referred for hyperactivity or irritability. Study designs varied, but all used the Child and Adolescent Symptom Inventory or Early Childhood Inventory to assess Attention Deficit Hyperactivity Disorder (ADHD), Oppositional-Defiant Disorder (ODD), Conduct Disorder (CD), Anxiety Disorders, and Mood Disorders. In addition, several measures in common were used to assess demographic and clinical characteristics.
Of the 658 children, 73% were Caucasian and 59% had an IQ >70. The rates of concomitant disorders across studies were: ADHD 81%, ODD 46%, CD 12%, any anxiety disorder 42%, and any mood disorder 8%. Two or more psychiatric disorders were identified in 66% of the sample. Of those who met criteria for ADHD, 50% also met criteria for ODD and 46% for any anxiety disorder. Associations between types of concomitant disorders and a number of demographic and clinical characteristics are presented.
In this well-characterized sample of treatment-seeking children with ASD, rates of concomitant psychiatric disorders were high and the presence of two or more co-occurring disorders was common. Findings highlight the importance of improving diagnostic practice in ASD and understanding possible mechanisms of comorbidity.
我们探究了在一个寻求治疗的自闭症谱系障碍（ASD）儿童和青少年的大样本中，同时存在的精神障碍模式。
参与者为 1999 年至 2014 年间六个联邦资助的多地点随机临床试验（RCT）之一的 658 名 ASD 儿童（年龄 3-17 岁；平均 7.2 岁）。所有儿童均因多动或易怒而被转介。研究设计各异，但均使用儿童和青少年症状清单或早期儿童清单评估注意力缺陷多动障碍（ADHD）、对立违抗性障碍（ODD）、品行障碍（CD）、焦虑障碍和情绪障碍。此外，还使用了一些共同的措施来评估人口统计学和临床特征。
在 658 名儿童中，73%为白种人，59%智商>70。跨研究的并发障碍发生率为：ADHD 81%、ODD 46%、CD 12%、任何焦虑障碍 42%、任何情绪障碍 8%。66%的样本存在两种或两种以上的精神障碍。在符合 ADHD 标准的儿童中，50%也符合 ODD 标准，46%符合任何焦虑障碍标准。呈现了并发障碍类型与多种人口统计学和临床特征之间的关联。
在这个经过充分特征描述的寻求治疗的 ASD 儿童样本中，并发精神障碍的发生率很高，同时存在两种或两种以上共病障碍很常见。研究结果强调了提高 ASD 诊断实践和理解共病可能机制的重要性。
