Kaba Duygu, Arıcı Canlı Merve
Department of Child and Adolescent Psychiatry, Başkent University Faculty of Medicine, Ankara, Türkiye.
Clinic of Child and Adolescent Psychiatry, Ankara Etlik City Hospital, Ankara, Türkiye.
Psychiatry Clin Psychopharmacol. 2024 Jun 1;34(2):172-178. doi: 10.5152/pcp.2024.24864. eCollection 2024 Jun.
Approximately 30% of autism spectrum disorder (ASD) cases exhibit developmental regression after a period of typical development, leading to what is known as regressive autism. Our understanding of the factors underlying regression, including precise mechanisms, clinical features, and risk factors, remains limited. This study aims to compare children with ASD with language regression (ASD-LR) to those without developmental regression (ASD-NR) in terms of clinical and demographic characteristics and to identify potential predictors.
In this cross-sectional retrospective study, children aged 2-6 diagnosed with ASD-LR were matched for age and gender with children diagnosed with ASD-NR between January 2023 and January 2024. The groups were compared in terms of demographic and clinical characteristics.
The mean age of the ASD-LR group (n = 32) was 52.16 ± 14.56 months, and the ASD-NR group (n = 50) had a mean age of 48.76 ± 13.41 months. Univariate analyses revealed no significant differences in autism severity between groups in clinician ( = .367) and parent evaluations ( = .541). However, in the ASD-LR group, a significant relationship was found between regression, a history of febrile seizures ( = .012), a father's psychiatric background ( = .002), and a family history of psychiatric disorders ( < .001). Family history of psychiatric disorders (OR 7.54, 95% CI 1.10-51.64, = .040) and cesarean delivery (odds ratio 3.90, 95% CI 1.05-14.47, = .042) were identified as independent predictors of language regression.
The results indicate that regression may be associated with both genetic and environmental factors, including a family history of psychiatric disorders, cesarean delivery, and febrile seizure. Future research should focus on explaining these factors and identifying potential preventive measures.
约30%的自闭症谱系障碍(ASD)病例在一段典型发育时期后出现发育倒退,导致所谓的退行性自闭症。我们对导致倒退的因素的理解,包括确切机制、临床特征和风险因素,仍然有限。本研究旨在比较有语言倒退的自闭症谱系障碍儿童(ASD-LR)和无发育倒退的儿童(ASD-NR)在临床和人口统计学特征方面的差异,并确定潜在的预测因素。
在这项横断面回顾性研究中,2023年1月至2024年1月期间,将年龄在2至6岁、被诊断为ASD-LR的儿童与年龄和性别相匹配的被诊断为ASD-NR的儿童进行比较。比较两组的人口统计学和临床特征。
ASD-LR组(n = 32)的平均年龄为52.16 ± 14.56个月,ASD-NR组(n = 50)的平均年龄为48.76 ± 13.41个月。单因素分析显示,临床医生评估(P = 0.367)和家长评估(P = 0.541)中,两组之间的自闭症严重程度无显著差异。然而,在ASD-LR组中,发现倒退、热性惊厥病史(P = 0.012)、父亲的精神病史(P = 0.002)和精神障碍家族史(P < 0.001)之间存在显著关系。精神障碍家族史(OR 7.54,95% CI 1.10 - 51.64,P = 0.040)和剖宫产(比值比3.90,95% CI 1.05 - 14.47,P = 0.042)被确定为语言倒退的独立预测因素。
结果表明,倒退可能与遗传和环境因素都有关,包括精神障碍家族史、剖宫产和热性惊厥。未来的研究应侧重于解释这些因素并确定潜在的预防措施。