Scandurra Valeria, Emberti Gialloreti Leonardo, Barbanera Francesca, Scordo Marirosa Rosaria, Pierini Angelo, Canitano Roberto
Division of Child and Adolescent Neuropsychiatry, University Hospital of Siena, Siena, Italy.
Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
Front Psychiatry. 2019 Sep 4;10:673. doi: 10.3389/fpsyt.2019.00673. eCollection 2019.
: Autism spectrum disorder (ASD) and attention deficit and hyperactivity disorder (ADHD) are the two most common neurodevelopmental disorders observed in childhood. The DSM-5 accepts a combined diagnosis of ADHD and ASD, while the DSM-IV did not. The aim of this study was to identify and evaluate the adaptive profile of children and adolescents with a diagnosis of comorbid ADHD and ASD, in comparison with adaptive functioning in subjects with a diagnosis of only ASD or ADHD. Ninety-one children (77 boys, 14 girls), aging from 3.1 to 13.4 years (mean age: 8.3 ± 7.2), who met the criteria for a diagnosis of ASD and/or ADHD were enrolled. A neuropsychological evaluation involving cognitive and adaptive assessment was conducted using the Autism Diagnostic Observation Schedule - Second Edition (ADOS-2), the Conners' Parent Rating Scale - Revised: Long Version (CPRS-R), the Wechsler Intelligence Scale - Fourth Edition or the Griffiths Mental Developmental Scales - Extended Revised, the Vineland Adaptive Behaviour Scale - Second Edition (VABS-II). As to the adaptive skills in the three groups evaluated, a worse general profile was ascertained in the ASD and in ASD plus ADHD groups in comparison with respect to the ADHD-only group. With VABS-II evaluation, we found significant differences among the three groups across all domains and combined scores: Communication (F = 18.960; p < 0.001), Socialization (F = 25.410; p < 0.001), Daily Living Skills (F = 19.760; p < 0.001), Motor (F = 9.615; p < 0.001), and Adaptive behavior composite [ABC] (F = 29.370; p < 0.001). Implications of neurodevelopmental double diagnosis such as ASD plus ADHD are discussed.
自闭症谱系障碍(ASD)和注意力缺陷多动障碍(ADHD)是儿童期观察到的两种最常见的神经发育障碍。《精神疾病诊断与统计手册》第5版(DSM - 5)认可ADHD和ASD的合并诊断,而《精神疾病诊断与统计手册》第4版(DSM - IV)则不认可。本研究的目的是确定并评估诊断为ADHD与ASD共病的儿童和青少年的适应状况,并与仅诊断为ASD或ADHD的受试者的适应功能进行比较。招募了91名年龄在3.1至13.4岁(平均年龄:8.3±7.2)、符合ASD和/或ADHD诊断标准的儿童(77名男孩,14名女孩)。使用《自闭症诊断观察量表第二版》(ADOS - 2)、《康纳斯父母评定量表修订版:长版》(CPRS - R)、《韦氏智力量表第四版》或《格里菲斯心理发展量表扩展修订版》、《文兰适应行为量表第二版》(VABS - II)进行了一项涉及认知和适应评估的神经心理学评估。至于所评估的三组的适应技能,与仅患ADHD组相比,ASD组和ASD加ADHD组的总体状况更差。通过VABS - II评估,我们发现三组在所有领域和综合得分上均存在显著差异:沟通(F = 18.960;p < 0.001)、社交(F = 25.410;p < 0.001)、日常生活技能(F = 19.760;p < 0.001)、运动(F = 9.615;p < 0.001)以及适应行为综合得分[ABC](F = 29.370;p < 0.001)。文中讨论了ASD加ADHD等神经发育双重诊断的影响。