论文部分内容阅读
目的了解学龄期高功能与低功能孤独症儿童共患病的发生情况。方法采用横断面研究,对2011年9月至2011年11月北京大学精神卫生研究所门诊连续就诊、能够配合检查的62例孤独症儿童,年龄6~16岁、符合美国精神障碍诊断与统计手册第4版(DSM-IV)中孤独症诊断标准的儿童进行调查和评定。内容包括:一般状况调查、中国修订韦氏儿童智力量表(WISC)评定(不能进行韦氏测查者进行瑞文标准推理测验、比奈测验或图片词汇测验评定)、学龄儿童情感障碍和精神分裂症问卷(K-SADS-PL)评定、儿童总评问卷(C-GAS)评定、儿童孤独症评定量表(CARS)评定。结果高功能孤独症组(IQ≥70)共患病终生共患率100%(29/29),目前共患率为96.5%(28/29)。低功能孤独症组(IQ<70)共患病终生共患率及目前共患率均为100%(33/33)。高功能孤独症组终生及目前共患情感障碍、焦虑障碍、广泛焦虑障碍、注意缺陷多动障碍、对立违抗障碍、抽动障碍的比例高于低功能孤独症组(P均<0.05)。高功能孤独症组精神科用药史、目前上学比例高于低功能孤独症组,自幼发育落后比例低于低功能孤独症组(P均<0.05)。高功能孤独症组CARS得分低于低功能孤独症组,C-GAS得分高于低功能孤独症组(P均<0.05)。结论共患病在学龄期高功能及低功能孤独症儿童中均非常常见。高功能孤独症患儿较低功能孤独症患儿具有更多的情绪行为障碍、较轻的孤独症症状、更多的精神科用药史,总体功能优于低功能孤独症患儿
Objective To understand the incidence of co-morbidities between children with high-functioning and low-functioning autism in school age. Methods A cross-sectional study was conducted on 62 consecutive cases of autistic children aged 6 to 16 years with outpatient visits at the Institute of Mental Health, Peking University, from September 2011 to November 2011, in line with the American Handbook of Mental Disorders Diagnosis and Statistics Fourth Edition (DSM-IV) autistic diagnosis of children in the survey and assessment. The contents include: General Status Survey, WISC (WISC) Assessment of China (Weasser’s inability to conduct Ruvin’s standard inference test, Beine’s test or picture vocabulary test evaluation), school-age children’s affective disorder and schizophrenia K-SADS-PL, C-GAS and CARS. Results The prevalence of co-morbidities was 100% (29/29) in high-function autism group (IQ≥70). The current co-occurrence rate was 96.5% (28/29). The prevalence of co-morbidities in patients with low-functioning autism (IQ <70) and their current comorbidity rates were 100% (33/33). The prevalence of co-affected affective disorder, anxiety disorder, generalized anxiety disorder, attention deficit hyperactivity disorder, oppositional defiant disorder and tic disorder in high-function autism group were higher than those in low-function autism group (all P <0.05). The history of psychiatric medication in high-function autism group is higher than that in low-function autism group at present, and the proportion of children with autistic development and backwardness is lower than that of low-function autism group (all P <0.05). CARS score in high-function autism group was lower than that in low-function autism group, C-GAS score was higher than that in low-function autism group (all P <0.05). Conclusions Co-morbidity is very common in both school-aged children with high-functioning and low-functioning autism. Children with high-functioning autism had more emotional behavioral disorders, less autistic symptoms, more psychiatric medication history, and better general function than children with low-functioning autism