Van der Gaag R J, Buitelaar J, Van den Ban E, Bezemer M, Njio L, Van Engeland H
Department of Child and Adolescent Psychiatry, University of Utrecht, The Netherlands.
J Am Acad Child Adolesc Psychiatry. 1995 Aug;34(8):1096-106. doi: 10.1097/00004583-199508000-00021.
The primary aim of the study was to ascertain the usefulness and the validity of the set of criteria proposed to define a subgroup within the DSM-III-R category of pervasive developmental disorder-not otherwise specified under the name of multiple complex developmental disorder (MCDD).
A multivariate analysis (cluster and principal-components analysis) was performed on the characteristics, reliably extracted from the charts of 105 children with MCDD, 32 with autistic disorder, 51 with externalizing disorders, and 56 with internalizing disorders, all with an IQ greater than 70, fully assessed in our department between 1984 and 1991.
The main finding was a strong correspondence between the classification of the cases by DSM-III-R categories and the subdivision by means of a multivariate cluster analysis. The cluster analysis did not discriminate between children with emotional and disruptive disorders. Furthermore, children with MCDD and autistic disorder were significantly different both on symptom factors ("psychotic thinking/anxiety," "aggression," "deficient interaction/communication," "stereotyped and rigid behavior," and "suspiciousness/odd interaction") and on factors that reflected developmental and environmental background variables.
The results of this study add to the nosology of autistic spectrum disorders and lend additional support to the need for a separate subcategory of MCDD within DSM-V. Further corroboration of these results in independent (multicenter) samples will be required.
本研究的主要目的是确定所提出的一套标准的实用性和有效性,该标准用于在《精神疾病诊断与统计手册》第三版修订版(DSM-III-R)中未另作说明的广泛性发育障碍类别内,以多重复杂发育障碍(MCDD)之名定义一个亚组。
对从105例MCDD儿童、32例自闭症谱系障碍儿童、51例外化性障碍儿童和56例内化性障碍儿童的病历中可靠提取的特征进行多变量分析(聚类分析和主成分分析),所有儿童智商均高于70,于1984年至1991年在我们科室进行了全面评估。
主要发现是DSM-III-R类别对病例的分类与通过多变量聚类分析进行的细分之间存在强烈对应关系。聚类分析未区分有情绪和破坏性行为障碍的儿童。此外,MCDD儿童和自闭症谱系障碍儿童在症状因素(“精神病性思维/焦虑”、“攻击行为”、“互动/沟通缺陷”、“刻板和僵化行为”以及“猜疑/怪异互动”)以及反映发育和环境背景变量的因素方面均存在显著差异。
本研究结果丰富了自闭症谱系障碍的分类学,并为在《精神疾病诊断与统计手册》第五版(DSM-V)中设立MCDD单独亚类的必要性提供了更多支持。需要在独立(多中心)样本中进一步证实这些结果。