Hours Camille, Recasens Christophe, Baleyte Jean-Marc
Service universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Centre hospitalier Intercomunal de Créteil, Créteil, France.
Front Psychiatry. 2022 Feb 28;13:837424. doi: 10.3389/fpsyt.2022.837424. eCollection 2022.
According to the scientific literature, 50 to 70% of individuals with autism spectrum disorder (ASD) also present with comorbid attention deficit hyperactivity disorder (ADHD). From a clinical perspective, this high rate of comorbidity is intriguing. What is the real significance of this dual diagnosis? Is ADHD in fact always present in such cases? Might the attentional impairment reported among our ASD patients actually be a distinct trait of their ASD-namely, impaired joint attention-rather than an ADHD attention deficit? Could their agitation be the consequence of this joint attention impairment or related to a physical restlessness etiologically very different from the agitation typical of ADHD? The neurobiological reality of ASD-ADHD comorbidity is a subject of debate, and amphetamine-based treatment can have paradoxical or undesirable effects in the ASD population. Consequently, does a dual diagnosis, notwithstanding its currency in the literature, prevent us from shedding sufficient light on major physiopathologic questions raised by the clinical picture of ASD?
根据科学文献，50%至70%的自闭症谱系障碍（ASD）患者还伴有共病注意缺陷多动障碍（ADHD）。从临床角度来看，这种高共病率很有意思。这种双重诊断的真正意义是什么？在这些病例中ADHD是否实际上一直存在？我们的ASD患者中报告的注意力损害实际上可能是他们ASD的一种独特特征，即联合注意受损，而不是ADHD的注意缺陷吗？他们的多动可能是这种联合注意受损的结果，还是与一种在病因上与ADHD典型多动非常不同的身体不安有关？ASD与ADHD共病的神经生物学现实是一个有争议的话题，基于苯丙胺的治疗在ASD人群中可能会产生矛盾或不良影响。因此，尽管双重诊断在文献中很常见，但它是否会妨碍我们充分阐明ASD临床表现所引发的主要病理生理问题呢？
