Fucà Elisa, Cirillo Flavia, Celestini Laura, Alfieri Paolo, Valentini Diletta, Costanzo Floriana, Vicari Stefano
Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Pediatric Unit, Pediatric Emergency Department (DEA), Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Front Psychiatry. 2023 Jan 16;13:1062201. doi: 10.3389/fpsyt.2022.1062201. eCollection 2022.
Children and adolescents with intellectual disability (ID) exhibit higher rates of oppositional defiant disorder (ODD) than typically developing (TD) peers. However, studies focusing on the investigation of ODD prevalence in youth with Down syndrome (DS) are still limited.
The current study aimed to investigate the prevalence of ODD clinical and subclinical symptoms in a group of 101 youth with DS (63 boys, 38 girls) ranging in age from 6 to 18 years. Moreover, the prevalence of ODD symptoms, as detected by means of three parent-report questionnaires, was compared with that detected by a semi-structured psychopathological interview, namely, the Schedule for Affective Disorders and Schizophrenia for School Aged Children Present and Lifetime (K-SADS) Version Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5).
We found that 17% of participants met diagnostic criteria for ODD on the K-SADS, whereas 24% exhibited subclinical symptoms. Results also suggest good specificity of Swanson, Nolan, and Pelham-IV Rating Scale (SNAP-IV), Conners' Parent Rating Scales Long Version (CPRS) and Child Behavior Checklist (CBCL) in detecting ODD symptoms. The investigation of the agreement in the prevalence rates of clinical and subclinical symptoms of ODD between K-SADS and the parent-report questionnaires indicated CPRS as the parent-report questionnaire with the best agreement with K-SADS.
This study provides support for the use of parent-report questionnaires to assess ODD symptoms in children and adolescents with DS by evaluating their levels of agreement with a semi-structured psychopathological interview. In particular, our results suggest that CPRS could be considered a suitable screening tool for ODD clinical and subclinical symptoms in youth with DS.
与发育正常的同龄人相比，智障儿童和青少年出现对立违抗性障碍（ODD）的比例更高。然而，针对唐氏综合征（DS）青少年中ODD患病率的研究仍然有限。
本研究旨在调查101名年龄在6至18岁之间的DS青少年（63名男孩，38名女孩）中ODD临床症状和亚临床症状的患病率。此外，通过三份家长报告问卷检测出的ODD症状患病率，与通过半结构化精神病理学访谈（即《学龄儿童情感障碍和精神分裂症量表（目前和终生）》（K-SADS）第五版《精神障碍诊断与统计手册》（DSM-5））检测出的患病率进行了比较。
我们发现，17%的参与者在K-SADS上符合ODD的诊断标准，而24%表现出亚临床症状。结果还表明，斯旺森、诺兰和佩勒姆第四版评定量表（SNAP-IV）、康纳斯家长评定量表长版（CPRS）和儿童行为清单（CBCL）在检测ODD症状方面具有良好的特异性。对K-SADS与家长报告问卷之间ODD临床症状和亚临床症状患病率一致性的调查表明，CPRS是与K-SADS一致性最好的家长报告问卷。
本研究通过评估家长报告问卷与半结构化精神病理学访谈的一致性水平，为使用家长报告问卷评估DS儿童和青少年的ODD症状提供了支持。特别是，我们的结果表明，CPRS可被视为DS青少年ODD临床症状和亚临床症状的合适筛查工具。
