Léger M, Piat N, Jean F A, Galera C, Bouvard M P, Amestoy A
IME Le Nid Basque, 11, promenade des Falaises, 64600 Anglet, France.
Exercice libéral, 202, rue de Pessac, 33000 Bordeaux, France; Pôle universitaire de psychiatrie de l'enfant et de l'adolescent, centre hospitalier Charles-Perrens, 121, rue de La-Béchade, 33076 Bordeaux, France.
Encephale. 2020 Oct;46(5):326-333. doi: 10.1016/j.encep.2019.11.008. Epub 2020 Mar 6.
Different studies centered on social relationship issues among ADHD children struggled to provide a unicist explanation between primary social cognition process alteration on the one hand and a mere symptomatic outcome of the disorder triad on the other. Some authors support the idea of a potential "social phenotype" shared at a different intensity by Attention Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD). The point of the study is to characterize this possible social disability in a French ADHD population and compare it to control subjects and subjects with Autism Spectrum Disorder (ASD).
Three groups, composed of 319 subjects aged 6 to 12 years, were recruited in Bordeaux: 88 untreated ADHD subjects, 24 ASD subjects and 207 control subjects. The main measure was the social skill disruption through the rating of the Social Responsiveness Scale (SRS). The ADHD-RS-IV, WFIRS-P and CBCL scales were also used.
Asignificant alteration in social abilities in ADHD children in comparison with controls was noted, with an average raw total SRS score intermediary between the control group and the ASD group (respectively 65.31±20.99, 37.15±16.37 and 95 75±30.83, P<0.05). When the 5 sub-scores of the SRS were taken into account, if the ASD subjects showed the highest average scores, the alteration pattern appeared qualitatively similar between the ADHD and TSA groups, with also an intermediate dispersion for the ADHD group between the control group and the group with ASD. Finally, more severe impairment of social skills in children with ADHD was associated with increased severity of the disorder (on ADHD-RS-IV scale cotation), higher daily functional impact (WFIRS-P scale), and more frequent behavioral issues (according to CBCL).
Our results suggest the presence of social disturbances in ADHD and characterize a symptomatic profile qualitatively similar to that of ASD, but of less intensity. Overall results promote a need for a systematic dimensional assessment of social disability in ADHD.
不同围绕多动症儿童社会关系问题展开的研究，难以在一方面的初级社会认知过程改变与另一方面该障碍三联征的单纯症状结果之间提供一元论解释。一些作者支持注意缺陷/多动障碍（ADHD）和自闭症谱系障碍（ASD）以不同强度共享潜在“社会表型”这一观点。本研究的重点是在法国多动症人群中描述这种可能的社会功能障碍，并将其与对照组以及自闭症谱系障碍（ASD）患者进行比较。
在波尔多招募了三组年龄在6至12岁的319名受试者：88名未接受治疗的多动症受试者、24名自闭症谱系障碍受试者和207名对照受试者。主要测量方法是通过社会反应量表（SRS）评分来评估社会技能破坏情况。还使用了ADHD-RS-IV、WFIRS-P和CBCL量表。
与对照组相比，多动症儿童的社交能力出现显著改变，SRS原始总分平均值介于对照组和自闭症谱系障碍组之间（分别为65.31±20.99、37.15±16.37和95.75±30.83，P<0.05）。当考虑SRS的5个亚分时，如果自闭症谱系障碍受试者的平均得分最高，多动症和自闭症谱系障碍组之间的改变模式在性质上相似，多动症组在对照组和自闭症谱系障碍组之间也呈现中间离散度。最后，多动症儿童更严重的社交技能损害与该障碍严重程度增加（根据ADHD-RS-IV量表评分）、更高的日常功能影响（WFIRS-P量表）以及更频繁的行为问题（根据CBCL）相关。
我们的结果表明多动症存在社交障碍，并描述了一种在性质上与自闭症谱系障碍相似但强度较小的症状特征。总体结果表明需要对多动症的社会功能障碍进行系统的维度评估。
