Menezes Michelle, Mazurek Micah O
University of Virginia.
Res Autism Spectr Disord. 2021 Apr;82. doi: 10.1016/j.rasd.2021.101740. Epub 2021 Feb 5.
Health-related quality of life (HRQoL) can be used as a measure of the impact of a particular disorder on one's daily functioning. Previous studies have found that comorbid psychiatric disorders in children and adolescents with autism spectrum disorder (ASD) are associated with poorer HRQoL than ASD alone. Less is known about potential associations between specific symptoms of comorbid psychopathology (i.e., emotional and behavioral problems) and domains of functioning or HRQoL in youth with ASD.
Participants were 470 children with ASD 2-14 years old recruited from one of three sites. Hierarchical multiple regressions were conducted with Pediatric Quality of Life Inventory 4.0 (PedsQL; Varni et al., 2001) HRQoL domains of physical functioning, emotional functioning, school functioning, and social functioning as the dependent variables. Covariates were entered at step 1, followed by the independent variables of interest at step 2: irritability, social withdrawal, stereotypic behavior, hyperactivity/noncompliance, and inappropriate speech.
The study found that increased irritability was associated with poorer emotional and physical functioning and that greater social withdrawal was associated with worse social functioning. Furthermore, findings showed that more hyperactivity/noncompliance was associated with worse school functioning.
Results demonstrated that certain emotional and behavioral symptoms are differentially associated with domains of HRQoL. This indicates that comorbid emotional and behavioral problems should be considered when measuring HRQoL in children with ASD. It also suggests that treating comorbid emotional/behavioral problems could improve HRQoL and functioning in certain domains for this population.
健康相关生活质量（HRQoL）可作为衡量特定疾病对个体日常功能影响的指标。先前的研究发现，患有自闭症谱系障碍（ASD）的儿童和青少年中，合并精神疾病与比单纯ASD更差的HRQoL相关。对于合并精神病理学的特定症状（即情绪和行为问题）与ASD青少年的功能领域或HRQoL之间的潜在关联，人们了解较少。
参与者为从三个地点之一招募的470名2至14岁的ASD儿童。以儿童生活质量量表4.0（PedsQL；Varni等人，2001）的身体功能、情绪功能、学校功能和社会功能的HRQoL领域作为因变量进行分层多元回归分析。协变量在第一步纳入，随后在第二步纳入感兴趣的自变量：易怒、社交退缩、刻板行为、多动/不依从和不当言语。
研究发现，易怒程度增加与较差的情绪和身体功能相关，社交退缩程度越高与较差的社会功能相关。此外，研究结果表明，多动/不依从程度越高与较差的学校功能相关。
结果表明，某些情绪和行为症状与HRQoL领域存在不同程度的关联。这表明在测量ASD儿童的HRQoL时应考虑合并的情绪和行为问题。这也表明，治疗合并的情绪/行为问题可能会改善该人群在某些领域的HRQoL和功能。
