Jiang Zhongliang, Xu Hui, Wang Xianbin, Zhang Wenyan, Zhang Anyi, Yu Liping, Hu Shujin, Yang Kai, Yang Qinghao, Li Yanlin, Cui Yonghua, Li Ying
Department of Psychiatry, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, 56 Nanlishi Road, Beijing, 100101, China.
Big Data Center, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China.
Eur Child Adolesc Psychiatry. 2025 Mar;34(3):1081-1095. doi: 10.1007/s00787-024-02540-5. Epub 2024 Aug 3.
Cognitive Disengagement Syndrome (CDS) is a cluster of behavioral problems that severely affect an individual's functioning. Currently, there is no consensus on the main clinical features of CDS, and further exploration in large samples is needed. Using a cluster-stratified random sampling method, 72,106 children and adolescents were recruited from five provinces in mainland China for this study. Using both the traditional two-factor scoring method and the CBCL DSM-oriented scales, we assessed individual behavioral problems from psychopathological and DSM-oriented perspectives. Network analysis was employed to explore the relationship between CDS and behavioral problems. The various networks were compared by gender and age subgroups. Among 72,106 participants (mean age, 11.49 years; minimum age, 5 years; maximum age, 16 years), there were 36,449 males (50.5%) and 35,657 females (49.5%). From a psychopathological perspective, the motor symptoms node was associated with the sad node and the withdrawn node, while the cognitive symptoms node was linked to the nervous node and the self-conscious node. In terms of gender, males had stronger associations of the motor symptoms node with the sad node and the withdrawn node than females (P = 0.043), and weaker associations of the cognitive symptoms node with the nervous node than females (P = 0.027). In terms of growth stage, the adolescent group had stronger associations of the cognitive symptoms node with the nervous node and the self-conscious node than the child group (P = 0.016, 0.001). From DSM perspective, motor symptoms node were associated with sad node, and cognitive symptoms node were related to can't concentrate node, nervous node, and worthless node. With increasing age, there was an upward trend in the strength of the cognitive and motor symptoms node. CDS is closely linked to psychological and behavioral issues, especially internalizing problems, with differences observed by gender and growth stage. The connection between CDS and the affective, anxiety, and ADH symptoms is particularly pronounced.
认知脱离综合征（CDS）是一组严重影响个体功能的行为问题。目前，关于CDS的主要临床特征尚无共识，需要在大样本中进行进一步探索。本研究采用整群分层随机抽样方法，从中国大陆五个省份招募了72106名儿童和青少年。我们使用传统的双因素评分方法和基于CBCL DSM的量表，从精神病理学和基于DSM的角度评估个体行为问题。采用网络分析方法探讨CDS与行为问题之间的关系。对不同性别和年龄亚组的各种网络进行了比较。在72106名参与者中（平均年龄11.49岁；最小年龄5岁；最大年龄16岁），男性有36449名（50.5%），女性有35657名（49.5%）。从精神病理学角度来看，运动症状节点与悲伤节点和退缩节点相关，而认知症状节点与紧张节点和自我意识节点相关。在性别方面，男性的运动症状节点与悲伤节点和退缩节点的关联比女性更强（P = 0.043），而认知症状节点与紧张节点的关联比女性更弱（P = 0.027）。在生长阶段方面，青少年组的认知症状节点与紧张节点和自我意识节点的关联比儿童组更强（P = 0.016，0.001）。从DSM角度来看，运动症状节点与悲伤节点相关，认知症状节点与注意力不集中节点、紧张节点和无价值节点相关。随着年龄的增长，认知和运动症状节点的强度呈上升趋势。CDS与心理和行为问题密切相关，尤其是内化问题，在性别和生长阶段存在差异。CDS与情感、焦虑和ADH症状之间的联系尤为明显。
