Department of Health Sciences, University West, Trollhättan, Sweden.
Department of Biology, Faculty of Sciences, Abdelmalek Essaadi University, Tetouan, Morocco.
BMC Psychiatry. 2020 Dec 17;20(1):595. doi: 10.1186/s12888-020-03003-2.
Conduct disorder (CD), a serious behavioral and emotional disorder in childhood and adolescence, characterized by disruptive behavior and breaking societal rules. Studies have explored the overlap of CD with neurodevelopmental problems (NDP). The somatic health of children with NDP has been investigated; however, the prevalence of these problems in children with CD has not been sufficiently studied. Holistic assessment of children with CD is required for establishing effective treatment strategies.
(1) Define the prevalence of selected neurological problems (migraine and epilepsy) and gastrointestinal problems (celiac disease, lactose intolerance, diarrhea, and constipation) in a population of twins aged 9 or 12; (2) Compare the prevalence of somatic problems in three subpopulations: (a) children without CD or NDP, (b) children with CD, and (c) children with both CD and NDP; (3) Select twin pairs where at least one child screened positive for CD but not NDP (proband) and map both children's neurological and gastrointestinal problems.
Telephone interviews with parents of 20,302 twins in a cross-sectional, nationwide, ongoing study. According to their scores on the Autism-Tics, AD/HD, and Comorbidities inventory, screen-positive children were selected and divided into two groups: (1) children with CD Only, (2) children with CD and at least one NDP.
Children with CD had an increased prevalence of each neurological and gastrointestinal problem (except celiac disease), and the prevalence of somatic problems was further increased among children with comorbid CD and NDP. The presence of CD (without NDP) increased the odds of constipation for girls and the odds of epilepsy for boys. Girls with CD generally had more coexisting gastrointestinal problems than boys with CD. Female co-twins of probands with CD were strongly affected by gastrointestinal problems. Concordance analyses suggested genetic background factors in neurological and gastrointestinal problems, but no common etiology with CD could be concluded.
Co-occurring NDP could explain most of the increased prevalence of somatic problems in CD. Our results raise a new perspective on CD in children and adolescents; their CD seems to be linked to a number of other health problems, ranging from neurodevelopmental and psychiatric disorders to somatic complaints.
品行障碍（CD）是儿童和青少年中一种严重的行为和情绪障碍，其特征是行为破坏和违反社会规则。研究已经探讨了 CD 与神经发育问题（NDP）的重叠。已经研究了 NDP 儿童的身体健康；然而，CD 儿童中这些问题的患病率尚未得到充分研究。需要对 CD 儿童进行全面评估，以制定有效的治疗策略。
（1）确定 9 或 12 岁双胞胎人群中选定的神经问题（偏头痛和癫痫）和胃肠道问题（乳糜泻、乳糖不耐受、腹泻和便秘）的患病率；（2）比较三个亚组的躯体问题患病率：（a）无 CD 或 NDP 的儿童，（b）CD 儿童，和（c）CD 和 NDP 均有的儿童；（3）选择至少一个孩子 CD 筛查阳性但 NDP 筛查阴性的双胞胎对（先证者），并绘制两个孩子的神经和胃肠道问题图谱。
在一项全国范围内的横断面、正在进行的研究中，对 20302 对双胞胎的父母进行电话访谈。根据他们在自闭症-抽搐、AD/HD 和共病清单上的得分，筛选阳性儿童并分为两组：（1）仅 CD 儿童，（2）CD 和至少一种 NDP 儿童。
CD 儿童的每种神经和胃肠道问题的患病率均增加（乳糜泻除外），而 CD 和 NDP 共病儿童的躯体问题患病率进一步增加。CD（无 NDP）的存在增加了女孩便秘的几率，男孩癫痫的几率。患有 CD 的女孩比患有 CD 的男孩通常有更多并存的胃肠道问题。CD 先证者的女性同卵双胞胎受胃肠道问题的影响较大。一致性分析表明神经和胃肠道问题存在遗传背景因素，但不能得出与 CD 有共同病因的结论。
共病 NDP 可以解释 CD 中躯体问题患病率增加的大部分原因。我们的研究结果为儿童和青少年 CD 提供了一个新视角；他们的 CD 似乎与许多其他健康问题有关，从神经发育和精神障碍到躯体投诉。
