Johnson C R, Handen B L, Lubetsky M J, Sacco K A
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, PA 15213, USA.
Res Dev Disabil. 1995 May-Jun;16(3):221-31. doi: 10.1016/0891-4222(95)00010-k.
We contrasted a sample of children and adolescents with affective disorders and mental retardation with a comparison group on behavioral symptoms, associated diagnoses, and psychopharmacologic treatment. Fifty consecutive patients with both impaired intellectual functioning and at least one affective disorder admitted to a psychiatric inpatient unit for children and adolescents with developmental disabilities and psychiatric disorders were matched to a group of 50 inpatients without depression. Behavioral symptoms such as suicidal ideation or gestures, crying, irritability, sleep problems, agitation, mood lability, and social withdrawal/isolation occurred significantly more often in the affective group than in the comparison group. Aggression, however, was the most frequent behavior concern for both groups, whereas disruption/destruction was identified significantly more often in the comparison group. Regarding Axis I diagnoses, the comparison group was more often identified with externalizing disorders (ADHD, ODD), though there was a high rate of comorbidity in the affective disorder group. The behavioral symptoms used to diagnosis normally developing children and adolescents appear to be applied in making affective disorders diagnoses in this sample of children and adolescents with mental retardation.
我们将一组患有情感障碍和智力迟钝的儿童及青少年样本与一个对照组在行为症状、相关诊断及心理药物治疗方面进行了对比。连续五十名智力功能受损且患有至少一种情感障碍的患者被收治到一家为患有发育障碍和精神疾病的儿童及青少年设立的精神科住院部,他们与五十名无抑郁症状的住院患者组成对照组进行匹配。情感障碍组出现自杀意念或行为、哭泣、易怒、睡眠问题、激动、情绪不稳定以及社交退缩/孤立等行为症状的频率显著高于对照组。然而,攻击行为是两组最常见的行为问题,而破坏行为在对照组中被识别出的频率明显更高。关于轴I诊断,对照组更常被诊断为外化性障碍(注意力缺陷多动障碍、对立违抗障碍),尽管情感障碍组的共病率也很高。用于诊断正常发育儿童及青少年的行为症状似乎也适用于对这组患有智力迟钝的儿童及青少年进行情感障碍诊断。