McDougle C J, Kresch L E, Goodman W K, Naylor S T, Volkmar F R, Cohen D J, Price L H
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
Am J Psychiatry. 1995 May;152(5):772-7. doi: 10.1176/ajp.152.5.772.
The purpose of this study was to investigate the types of repetitive thoughts and behavior demonstrated by adults with autistic disorder and compare them with those of age- and sex-matched adults with obsessive-compulsive disorder.
Fifty consecutive patients admitted to the Yale Adult Pervasive Developmental Disorders (Autism) Clinic with a primary diagnosis of autistic disorder (DSM-III-R and DSM-IV) completed the symptom checklist of the Yale-Brown Obsessive Compulsive Scale. Types of current obsessions and compulsions were evaluated. The comparison group consisted of 50 age- and sex-matched adults with obsessive-compulsive disorder (without tics) (DSM-III-R and DSM-IV).
Direct discriminant function analysis showed that the patients with autistic disorder could be distinguished from those with obsessive-compulsive disorder on the basis of the types of current repetitive thoughts and behavior that they demonstrated. Compared to the obsessive-compulsive group, the autistic patients were significantly less likely to experience thoughts with aggressive, contamination, sexual, religious, symmetry, and somatic content. Repetitive ordering; hoarding; telling or asking (trend); touching, tapping, or rubbing; and self-damaging or self-mutilating behavior occurred significantly more frequently in the autistic patients, whereas cleaning, checking, and counting behavior was less common in the autistic group than in the patients with obsessive-compulsive disorder. In addition, a specific subset of seven obsessive-compulsive variables from the Yale-Brown Obsessive Compulsive Scale symptom checklist was identified that reliably predicted membership in the autistic group.
These results suggest that the repetitive thoughts and behavior characteristics of autism differ significantly from the obsessive-compulsive symptoms displayed by patients with obsessive-compulsive disorder. Future studies are warranted to assess the treatment response and neurobiological underpinnings of repetitive thoughts and behavior in patients with autism and obsessive-compulsive disorder.
本研究旨在调查自闭症谱系障碍成人所表现出的重复思维和行为类型，并将其与年龄和性别匹配的强迫症成人进行比较。
连续50名被收入耶鲁成人广泛性发育障碍（自闭症）诊所、初步诊断为自闭症谱系障碍（DSM-III-R和DSM-IV）的患者完成了耶鲁-布朗强迫症量表症状清单。评估当前的强迫观念和强迫行为类型。对照组由50名年龄和性别匹配的强迫症（无抽动）成人（DSM-III-R和DSM-IV）组成。
直接判别函数分析表明，根据自闭症谱系障碍患者所表现出的当前重复思维和行为类型，可以将其与强迫症患者区分开来。与强迫症组相比，自闭症患者出现带有攻击、污染、性、宗教、对称和躯体内容的思维的可能性显著更低。重复排序、囤积、讲述或询问（有趋势）、触摸、轻拍或摩擦以及自我伤害或自残行为在自闭症患者中发生的频率显著更高，而清洁、检查和计数行为在自闭症组中比在强迫症患者中更不常见。此外，还确定了耶鲁-布朗强迫症量表症状清单中的七个强迫症变量的一个特定子集，该子集能够可靠地预测自闭症组的成员身份。
这些结果表明，自闭症的重复思维和行为特征与强迫症患者所表现出的强迫症状有显著差异。未来有必要进行研究，以评估自闭症和强迫症患者重复思维和行为的治疗反应及神经生物学基础。
