Zaccaria Valerio, Ardizzone Ignazio, Pisani Francesco, Raballo Andrea, Poletti Michele
Department of Human Neuroscience, Sapienza University of Rome, Italy.
Faculty of Biomedical Sciences, University of Southern Switzerland, Lugano, Switzerland.
Clin Child Psychol Psychiatry. 2025 Jan;30(1):5-19. doi: 10.1177/13591045241285486. Epub 2024 Sep 19.
Multiple complex developmental disorder (MCDD) manifests as early-onset impairment across different domains. Although it could appear as a transitional condition between autism and childhood-onset schizophrenia, interest in MCDD has progressively waned. This study attempts to discern MCDD current relevance to avoid "throwing the baby out with the bathwater" too fast.
All available studies published up to January 2024 were retrieved and evaluated following on the PRISMA guidelines for systematic reviews using the term "multiple complex developmental disorder" or "MCDD", without any filter for study design nor year of publication.
Only 16 studies were included and analyzed. Overall, a variable heterogeneity was observed in terms of country of investigation, study design, and clinical groups. Most of the included studies explored the construct of MCDD in developmental age, comparing MCDD mostly with autistic patients, and observing how the former group had higher levels of paranoia, illusions, and psychotic thoughts, whereas the latter showed more frequently difficulties in social interactions and stereotypical behaviors.
Overall, these results showed how progressive changes in diagnostic criteria over time led MCDD to be abandoned as nosographic construct, leaving perhaps a diagnostic void between autism and psychotic disorders that needs to be further studied. A systematic review on the Multiple Complex Developmental Disorder (MCDD): a forgotten diagnosis between autism and schizophrenia.
多重复杂发育障碍（MCDD）表现为不同领域的早发性损害。尽管它可能表现为自闭症和儿童期精神分裂症之间的一种过渡状态，但对MCDD的关注已逐渐减少。本研究试图厘清MCDD目前的相关性，以免过快地“把孩子和洗澡水一起倒掉”。
检索截至2024年1月发表的所有可用研究，并按照PRISMA系统评价指南进行评估，使用术语“多重复杂发育障碍”或“MCDD”，不设研究设计或发表年份的筛选条件。
仅纳入并分析了16项研究。总体而言，在调查国家、研究设计和临床组方面观察到了不同程度的异质性。大多数纳入研究探讨了发育年龄阶段的MCDD结构，主要将MCDD与自闭症患者进行比较，并观察到前一组有更高水平的偏执、幻觉和精神病性思维，而后者在社交互动和刻板行为方面更常出现困难。
总体而言，这些结果表明，随着时间的推移诊断标准的逐步变化如何导致MCDD作为一种疾病分类结构被摒弃，可能在自闭症和精神障碍之间留下了一个需要进一步研究的诊断空白。关于多重复杂发育障碍（MCDD）的系统评价：自闭症和精神分裂症之间被遗忘的诊断。
