Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy; Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
Handb Clin Neurol. 2020;174:217-238. doi: 10.1016/B978-0-444-64148-9.00016-8.
Studies have consistently reported an increased prevalence of psychiatric comorbidity (PC) in individuals with neurodevelopmental disorders (NDDs) compared with typically developing controls, with high rates of anxiety disorders in autism spectrum disorders and challenging behaviors in children and adolescent with intellectual disability. Psychiatric assessment in this population should include multiple sources of information, derived from multiple contexts and using multiple methods, with accurate detection of contributing and trigger factors. It is important to focus on detecting change from the child's baseline functioning and to use, when possible, ad hoc instruments for assessing PC in the NDD population. Modifications in the setting and assessment procedures should be scheduled based on the child's age, developmental level, and sensory sensitivities. Simultaneously, validated screening instruments, which dimensionally assess the symptomatology of several NDDs and psychiatric disorders, are warranted to not only assist in the identification of PCs in NDDs but also discriminate among different NDDs. Changes from DSM-IV-TR to DSM-5 have had an impact on the diagnosis of several disorders in children and adolescents and, subsequently, on the current diagnostic tools, requiring appropriate and prompt modifications of the available instruments.
研究一致报告称，与正常发育的对照组相比，神经发育障碍 (NDD) 患者的精神共病 (PC) 患病率增加，自闭症谱系障碍患者的焦虑症发病率较高，智力残疾儿童和青少年的行为问题也具有挑战性。对该人群进行的精神科评估应包括多个来源的信息，这些信息来自多个环境并使用多种方法，准确检测促成因素和触发因素。重要的是要关注从孩子的基线功能中检测到的变化，并尽可能使用专门针对 NDD 人群评估 PC 的特定工具。应根据孩子的年龄、发育水平和感官敏感性来安排设置和评估程序的修改。同时，需要验证能够从维度上评估几种 NDD 和精神障碍症状的筛查工具，不仅有助于识别 NDD 中的 PC，还可以区分不同的 NDD。从 DSM-IV-TR 到 DSM-5 的变化对儿童和青少年的几种疾病的诊断产生了影响，进而影响了当前的诊断工具，需要对现有工具进行适当和及时的修改。
