Department of Child and Adolescent Psychopathology, Amiens University Hospital, CHU Amiens-Picardie, Site Sud, 80054, Amiens, France.
Department of Child and Adolescent Psychiatry, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France.
Eur Child Adolesc Psychiatry. 2021 Oct;30(10):1579-1590. doi: 10.1007/s00787-020-01636-y. Epub 2020 Sep 12.
Youths with severe and persistent irritability have a particularly high rate of school failures and learning difficulties. The aim of this study was to determine whether inpatient adolescents with Disruptive Mood Dysregulation Disorder (DMDD) have more motor and/or language impairments compared to patients with other psychiatric disorders. A retrospective chart review of all consecutive cases admitted in two adolescent inpatient units between January 2017 and December 2018 was conducted (N = 191). All patients received multi-disciplinary clinical and developmental assessments. For a subtest of subjects, additional standardized tests were used to document motor and language impairments. In this clinical chart 53 adolescents with a DMDD (mean age 13.6 ± 1.5, min 12, max 16, 70% males) were compared to patients with a major depressive disorder (MDD, n = 64, mean age 15.3 ± 1.6, 52% males) and patients with a non-mood disorder (NMD, n = 61, mean age 14.4 ± 1.55, 59% males). Among inpatients with DMDD, 71% had an associated motor and/or language disorder, with combined forms in around two-thirds of cases. Compared to youths with MDD, participants with DMDD were more likely to have an associated developmental coordination disorder (67% vs. 22%, OR = 4.7) and a written language disorder (35% vs. 10%, OR = 4.6). While 31% of inpatients with DMDD had an associated communication/oral language disorder, this rate was not statistically different from those observed in the MDD group (11%, OR = 3.2). The frequencies of motor and language impairments were not statistically different between participants in the DMDD group and in the NMD group. The high rate of motor and written language disorders found in DMDD patients may partly account for their academic difficulties. Such finding, if confirmed, supports systematic screening of motor and written language impairments in youths with chronic irritability and suggests remediation potential.
患有严重和持续性烦躁的青少年尤其容易出现学业失败和学习困难。本研究旨在确定患有破坏性情绪失调障碍 (DMDD) 的住院青少年与患有其他精神障碍的患者相比，是否存在更多的运动和/或语言障碍。对 2017 年 1 月至 2018 年 12 月期间在两个青少年住院病房连续入院的所有病例进行了回顾性图表审查（N=191）。所有患者均接受了多学科临床和发育评估。对于受试者的一个亚测试，还使用了额外的标准化测试来记录运动和语言障碍。在这份临床图表中，我们将 53 名患有 DMDD 的青少年（平均年龄 13.6±1.5，最小 12，最大 16，70%为男性）与患有重度抑郁症（MDD，n=64，平均年龄 15.3±1.6，52%为男性）和非心境障碍（NMD，n=61，平均年龄 14.4±1.55，59%为男性）的患者进行了比较。在患有 DMDD 的住院患者中，71%存在相关的运动和/或语言障碍，其中约三分之二的病例为混合形式。与患有 MDD 的青少年相比，患有 DMDD 的参与者更有可能患有相关的发育协调障碍（67%对 22%，OR=4.7）和书面语言障碍（35%对 10%，OR=4.6）。虽然患有 DMDD 的住院患者中有 31%存在相关的沟通/口语语言障碍，但这一比率与 MDD 组观察到的比率无统计学差异（11%，OR=3.2）。DMDD 组和 NMD 组患者的运动和语言障碍频率无统计学差异。在 DMDD 患者中发现的高频率的运动和书面语言障碍可能部分解释了他们的学习困难。如果这一发现得到证实，将支持对慢性烦躁的青少年进行运动和书面语言障碍的系统筛查，并提示可能存在矫正的潜力。
