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共病症状是否能区分自闭症谱系障碍、注意力缺陷多动障碍和非言语性学习障碍?

Do comorbid symptoms discriminate between autism spectrum disorder, ADHD and nonverbal learning disability?

机构信息

Department of Developmental and Social Psychology, University of Padova, Italy.

Department of Developmental and Social Psychology, University of Padova, Italy.

出版信息

Res Dev Disabil. 2022 Jul;126:104242. doi: 10.1016/j.ridd.2022.104242. Epub 2022 May 5.

Abstract

Characterizing the functioning of individuals with neurodevelopmental disorders is crucial to their diagnosis. Research has found that children with different neurodevelopmental disorders, including autism spectrum disorders (ASD), attention deficit and hyperactivity disorder (ADHD), and nonverbal learning disability (NLD), may have comorbid symptoms of anxiety and depression, and problems with pragmatic language. The main aim of the present study was to identify any differences in the above-mentioned comorbid symptoms associated with these clinical profiles. A second aim was to establish how well signs of pragmatic language difficulties could discriminate between the three clinical profiles, in terms of their diagnostic power. For this purpose, 107 participants from 8 to 16 years old with a diagnosis of ASD, ADHD or NLD were compared with a group of typically-developing children. Self-reports on symptoms of anxiety and depression, and parents' reports on social and communication problems were analyzed. Our findings confirmed that symptoms of anxiety and depression, and problems with pragmatic language are associated with different neurodevelopmental disorders, but not in the same way. In terms of diagnostic power, we found that pragmatic language difficulties clearly discriminated children with ASD, ADHD or NLD from typically-developing children. Importantly, pragmatic language difficulties also discriminated adequately between ASD and NLD. Our findings are discussed in terms of the value of considering comorbid symptoms to obtain a more accurate diagnosis of neurodevelopmental disorders.

摘要

对神经发育障碍患者的功能进行特征描述对其诊断至关重要。研究发现,患有不同神经发育障碍的儿童,包括自闭症谱系障碍(ASD)、注意力缺陷多动障碍(ADHD)和非言语学习障碍(NLD),可能会出现焦虑和抑郁的共病症状,以及语用语言问题。本研究的主要目的是确定与这些临床特征相关的上述共病症状是否存在差异。第二个目的是确定语用语言困难的迹象在多大程度上可以根据其诊断能力来区分这三种临床特征。为此,我们比较了 107 名 8 至 16 岁的被诊断为 ASD、ADHD 或 NLD 的患者与一组典型发育的儿童。分析了他们的焦虑和抑郁症状的自我报告,以及父母对社交和沟通问题的报告。我们的研究结果证实,焦虑和抑郁症状以及语用语言问题与不同的神经发育障碍有关,但方式不同。就诊断能力而言,我们发现语用语言困难可以清楚地区分 ASD、ADHD 或 NLD 儿童与典型发育儿童。重要的是,语用语言困难也可以充分地区分 ASD 和 NLD。我们的研究结果从考虑共病症状以获得更准确的神经发育障碍诊断的角度进行了讨论。

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