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新诊断为注意缺陷多动障碍(ADHD)或/和自闭症谱系障碍(ASD)的成年人中终生同时存在的精神障碍。

Lifetime co-occurring psychiatric disorders in newly diagnosed adults with attention deficit hyperactivity disorder (ADHD) or/and autism spectrum disorder (ASD).

机构信息

1st Department of Psychiatry, National and Kapodistrian University of Athens, Medical School, "Eginition" Hospital, 72-74 Vas. Sofias Ave, 11528, Athens, Greece.

Department of Child Psychiatry, National and Kapodistrian University of Athens, Medical School, "Agia Sophia" Children's Hospital, 11527, Athens, Greece.

出版信息

BMC Psychiatry. 2020 Aug 26;20(1):423. doi: 10.1186/s12888-020-02828-1.

Abstract

BACKGROUND

Co-occurring psychiatric disorders in adults with Attention Deficit Hyperactivity Disorder (ADHD) and/or Autism Spectrum Disorder (ASD) contribute to the burden of the healthcare and possibly to the delay of diagnosis. Aim of the study was to clinically assess the prevalence and compare lifetime co-occurring psychopathology in a sample of newly diagnosed ADHD and/or ASD adults and discuss the diagnostic challenges they pose.

METHODS

The lifetime prevalence rates of ten of the most frequently co-occurring psychiatric diagnoses was registered in 336 adults of normal intelligence who underwent a thorough clinical evaluation for the diagnosis of ADHD and/or ASD for the first time in their lives. Four study groups were formed: the ADHD (n = 151), the ASD (n = 58), the ADHD+ASD (n = 28) and the nonADHD/nonASD (NN) (n = 88) group.

RESULTS

At least one co-occurring psychopathology was found in 72.8% of the ADHD group, in 50% of the ASD group, in 72.4% of the ADHD+ASD group and in 76.1% of the NN group (p = 0.004). In all groups the most frequent psychiatric disorder was depressive disorder. The only significant difference regarding the patterns of psychiatric co-occurrence between the ADHD and the nonADHD groups (ASD and NN groups) was found for SUD (p = 0.001). Also, the proportion of subjects with Bipolar Disorder was significantly greater in the NN group as compared to those with ASD (p = 0.025).

CONCLUSIONS

Our results support the high prevalence of co-occurring psychiatric disorders in adults with ADHD and/or ASD with the ASD group presenting the lowest rate. The most marked difference between the ADHD and the nonADHD groups was found for SUD. Moreover, our findings highlight the need for a thorough clinical assessment of all referred patients both in the presence and absence of ADHD and/or ASD.

摘要

背景

患有注意力缺陷多动障碍(ADHD)和/或自闭症谱系障碍(ASD)的成年人中同时存在精神障碍会增加医疗保健负担,并可能导致诊断延迟。本研究的目的是在首次被诊断为 ADHD 和/或 ASD 的新患者样本中,临床评估这些共病精神病理学的患病率,并讨论它们带来的诊断挑战。

方法

在首次接受 ADHD 和/或 ASD 诊断的 336 名正常智力成年人中,记录了十种最常见共病精神诊断的终生患病率。将这些患者分为四组:ADHD 组(n=151)、ASD 组(n=58)、ADHD+ASD 组(n=28)和非 ADHD/非 ASD(NN)组(n=88)。

结果

在 ADHD 组中,72.8%的患者至少存在一种共病精神病理学,在 ASD 组中,50%的患者存在共病精神病理学,在 ADHD+ASD 组中,72.4%的患者存在共病精神病理学,在 NN 组中,76.1%的患者存在共病精神病理学(p=0.004)。在所有组中,最常见的精神障碍是抑郁症。ADHD 组和非 ADHD 组(ASD 和 NN 组)之间在共患精神障碍模式方面唯一显著的差异是物质使用障碍(SUD)(p=0.001)。此外,NN 组中双相障碍的比例明显高于 ASD 组(p=0.025)。

结论

我们的结果支持 ADHD 和/或 ASD 成年人中同时存在精神障碍的高患病率,其中 ASD 组的患病率最低。ADHD 组和非 ADHD 组之间最显著的差异是 SUD。此外,我们的研究结果强调了对所有转诊患者进行彻底临床评估的必要性,无论是否存在 ADHD 和/或 ASD。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3366/7449076/4580ba7ca268/12888_2020_2828_Fig1_HTML.jpg

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