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青年精神科门诊患者的神经发育障碍和共病。

Neurodevelopmental disorders and comorbidity in young adults attending a psychiatric outpatient clinic.

机构信息

Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Sweden; PRIMA Adult psychiatry, Stockholm, Sweden.

Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Sweden; Child Neuropsychiatric Clinic, Queen Silvia Children´s Hospital, Gothenburg, Sweden.

出版信息

Psychiatry Res. 2022 Jul;313:114638. doi: 10.1016/j.psychres.2022.114638. Epub 2022 May 15.

Abstract

"Missed" cases with neurodevelopmental disorders (NDDs) within adult psychiatry services have attracted increasing attention in the last decade. Key questions have been what the prevalence of NDDs (particularly attention-deficit/hyperactivity disorder/ADHD and autism spectrum disorder/ASD) is, and what the clinical and gender characteristics of those with NDD in adult psychiatry are. All first-time attenders at an adult psychiatry clinic serving 18-25 years old were invited to take part in the study regardless of cause of concern. Participation in the study included diagnostic in-depth evaluation performed by experienced adult psychiatrists. Clinical diagnoses (DSM-IV-TR and DSM-5 criteria) were based on all available information (clinical psychiatric interview, clinical observation, and self-rating questionnaires). Almost two thirds (63%) of the study group met criteria for ADHD or ASD. Most of the patients with NDD (particularly the "NDD females") had not been diagnosed in childhood. Twelve percent of the females included had been given an ADHD diagnosis in childhood. In the current study we found that 48% of the females had ADHD. The high male:female NDD ratio reported among children, was not obvious in our NDD group. The results underscore the importance of screening for NDD in adult psychiatric services regardless of referral reason.

摘要

在过去十年中,成人精神病学服务中神经发育障碍(NDD)的“漏诊”病例引起了越来越多的关注。关键问题是 NDD(特别是注意缺陷/多动障碍/ADHD 和自闭症谱系障碍/ASD)的患病率是多少,以及成人精神病学中 NDD 患者的临床和性别特征是什么。所有首次到为 18-25 岁人群服务的成人精神病学诊所就诊的人都被邀请参加这项研究,无论关注的原因是什么。参与研究包括由经验丰富的成人精神病学家进行的深入诊断评估。临床诊断(DSM-IV-TR 和 DSM-5 标准)基于所有可用信息(临床精神病学访谈、临床观察和自我评估问卷)。研究组中近三分之二(63%)符合 ADHD 或 ASD 的标准。大多数患有 NDD 的患者(特别是“NDD 女性”)在儿童时期没有被诊断出。包括的 12%的女性在儿童时期被诊断为 ADHD。在目前的研究中,我们发现 48%的女性患有 ADHD。在儿童中报告的高男性:女性 NDD 比例在我们的 NDD 组中并不明显。研究结果强调了在成人精神病学服务中无论转诊原因如何都要对 NDD 进行筛查的重要性。

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