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智力结构失衡在自闭症谱系障碍和注意力缺陷多动障碍鉴别中的价值

The value of intellectual structural imbalance in the differentiation of autism spectrum disorder and attention deficit hyperactivity disorder.

作者信息

Zhang Dan-Yang, Wei Qiu-Hong, Hu Bin-Yue, Ai Dan, Zhang Yu, Ding Yuan, Yang Ting, Chen Jie, Chen Li, Wu Yuan, Chen Hong-Yu, Xiang Xue-Li, Mou Qiu-Hong, Li Ting-Yu

机构信息

Children Nutrition Research Center, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing, China.

Department of Primary Child Health Care, Children's Hospital of Chongqing Medical University, Chongqing, China.

出版信息

Front Psychiatry. 2025 Aug 14;16:1610278. doi: 10.3389/fpsyt.2025.1610278. eCollection 2025.

Abstract

BACKGROUND

The study delves into the intricate task of differentiating intellectual structures among children diagnosed with the high-functioning Autism Spectrum Disorder (HF-ASD), Attention Deficit Hyperactivity Disorder (ADHD), or comorbidity (ASD+ADHD), aiming to assist in their clinical differentiation, with the goal of refining clinical diagnoses and developing targeted therapeutic interventions.

METHODS

The study included 200 outpatients aged 6.5-13.0 years (total Intelligence Quotient (IQ) 70-130) at the Children's Hospital of Chongqing Medical University, and categorized into HF-ASD (n=91), ADHD (n=47), and comorbidity ASD+ADHD (n=62) groups. We utilized the Chinese Wechsler Intelligence Scale for Children (C-WISC) as the primary assessment tool, supplemented by additional diagnostic measures. Besides, we used SPSS 25.0 to assess the subtest scores and differences.

RESULTS

The comorbidity group had lower total IQ than the other two groups (). The verbal IQ(VIQ) were lower than the performance IQ(PIQ) in HF-ASD () and comorbidity () groups. They also scored higher on perceptual organization subtests particularly in Block Design and Object Assembly than the ADHD group. The ADHD group showed higher VIQ than PIQ (). The ADHD group's scores for working memory subtests were lower than in the HF-ASD group. The respective peak scores for the HF-ASD and comorbidity groups were in Block Design (45%,43%) and Object Assembly (30%,37%) and valleys in Picture Completion (52%,24%), Information (HF-ASD 24%), and Arithmetic (comorbidity 42%).

CONCLUSION

The peak-valley difference in the ADHD group (2 standard deviations) was smaller than in the HF-ASD and comorbidity groups (3 standard deviations), and this characteristic could help differentiate between HF-ASD, ADHD, and both together.

摘要

背景

本研究深入探讨了一项复杂任务,即区分被诊断为高功能自闭症谱系障碍(HF-ASD)、注意力缺陷多动障碍(ADHD)或共病(ASD+ADHD)的儿童的智力结构,旨在辅助其临床鉴别,以完善临床诊断并制定针对性的治疗干预措施。

方法

本研究纳入了重庆医科大学附属儿童医院200名年龄在6.5至13.0岁之间(总智商(IQ)为70至130)的门诊患者,分为HF-ASD组(n=91)、ADHD组(n=47)和共病ASD+ADHD组(n=62)。我们使用中国韦氏儿童智力量表(C-WISC)作为主要评估工具,并辅以其他诊断措施。此外,我们使用SPSS 25.0评估子测验分数及差异。

结果

共病组的总智商低于其他两组()。HF-ASD组()和共病组()的言语智商(VIQ)低于操作智商(PIQ)。他们在知觉组织子测验上的得分也高于ADHD组,尤其是在积木图案和图形拼凑测验中。ADHD组的VIQ高于PIQ()。ADHD组在工作记忆子测验中的得分低于HF-ASD组。HF-ASD组和共病组各自的峰值分数出现在积木图案(45% , 43%)和图形拼凑(30% , 37%)中,而在图片填充(52% , 24%)、知识(HF-ASD组为24%)和算术(共病组为42%)方面得分较低。

结论

ADHD组的峰谷差异(约2个标准差)小于HF-ASD组和共病组(约3个标准差),这一特征有助于区分HF-ASD、ADHD以及两者共病情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/571b/12391015/2d73ae945f68/fpsyt-16-1610278-g001.jpg

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