CAJ | 학술논문

目的了解学龄期儿童孤独障碍共患病的发生情况.方法采用横断面研究,对2011年9-11月在北京大学精神卫生研究所儿科门诊连续就诊的62例年龄6～16周岁、符合《美国精神障碍诊断与统计手册(第4版)》(DSM-Ⅳ)中孤独障碍诊断标准的儿童进行调查和评定.内容包括:一般状况调查及《学龄儿童情感障碍和精神分裂症问卷》(K-SADS-PL)、《儿童总评评定问卷》(C-GAS)、《儿童孤独症评定量表》(CARS)、《中国修订韦氏儿童智力量表》(WISC)的评定(不能进行韦氏测查者进行瑞文标准推理测验、比奈测验或图词测验评定).结果孤独障碍患儿共患病的终生共患率为100％ (62/62),其中:7例(11.3％)患有1种共患病,16例(25.8％)患有2种共患病,11例(17.7％)患有3种共患病,28例(45.2％)患有4种或4种以上共患病.98.4％(61/62)目前存在共患病,其中:11例(17.7％)患有1种共患病,16例(25.8％)患有2种共患病,17例(27.4％)患有3种共患病,17例(27.4％)患有4种或4种以上共患病.各种共患病的终生患病率和现患率分别为:精神发育迟滞53.2％(33/62)、53.2％(33/62)；未特定的精神病性障碍22.6％ (14/62)、21.0％(13/62);情感障碍中抑郁障碍12.9％(8/62)、9.7％(6/62),双相障碍1.6％(1/62)、1.6％ (1/62)；焦虑障碍中广泛性焦虑障碍21.0％ (13/62)、19.4％ (12/62),分离焦虑障碍6.5％ (4/62)、3.2％(2/62),惊恐障碍3.2％(2/62)、0(0/62),强迫障碍45.2％ (28/62)、45.2％ (28/62),恐怖症30.6％(19/62)、29.0％ (18/62)；注意缺陷多动障碍62.9％(39/62)、58.1％(36/62),对立违抗障碍12.9％(8/62)、11.3％ (7/62),品行障碍4.8％ (3/62)、4.8％ (3/62)；抽动障碍14.5％ (9/62)、11.3％(7/62)；遗尿症16.1％(10/62)、4.8％ (3/62),遗粪症9.7％(6/62)、1.6％(1/62).孤独症患儿现患共患病的数目随年龄增长有增多趋势(F =2.745,P=0.051).结论共患病在学龄期儿童孤独障碍患者中非常常见,积极治疗共患病具有重要意义. 目的瞭解學齡期兒童孤獨障礙共患病的髮生情況.方法採用橫斷麵研究,對2011年9-11月在北京大學精神衛生研究所兒科門診連續就診的62例年齡6～16週歲、符閤《美國精神障礙診斷與統計手冊(第4版)》(DSM-Ⅳ)中孤獨障礙診斷標準的兒童進行調查和評定.內容包括:一般狀況調查及《學齡兒童情感障礙和精神分裂癥問捲》(K-SADS-PL)、《兒童總評評定問捲》(C-GAS)、《兒童孤獨癥評定量錶》(CARS)、《中國脩訂韋氏兒童智力量錶》(WISC)的評定(不能進行韋氏測查者進行瑞文標準推理測驗、比奈測驗或圖詞測驗評定).結果孤獨障礙患兒共患病的終生共患率為100％ (62/62),其中:7例(11.3％)患有1種共患病,16例(25.8％)患有2種共患病,11例(17.7％)患有3種共患病,28例(45.2％)患有4種或4種以上共患病.98.4％(61/62)目前存在共患病,其中:11例(17.7％)患有1種共患病,16例(25.8％)患有2種共患病,17例(27.4％)患有3種共患病,17例(27.4％)患有4種或4種以上共患病.各種共患病的終生患病率和現患率分彆為:精神髮育遲滯53.2％(33/62)、53.2％(33/62)；未特定的精神病性障礙22.6％ (14/62)、21.0％(13/62);情感障礙中抑鬱障礙12.9％(8/62)、9.7％(6/62),雙相障礙1.6％(1/62)、1.6％ (1/62)；焦慮障礙中廣汎性焦慮障礙21.0％ (13/62)、19.4％ (12/62),分離焦慮障礙6.5％ (4/62)、3.2％(2/62),驚恐障礙3.2％(2/62)、0(0/62),彊迫障礙45.2％ (28/62)、45.2％ (28/62),恐怖癥30.6％(19/62)、29.0％ (18/62)；註意缺陷多動障礙62.9％(39/62)、58.1％(36/62),對立違抗障礙12.9％(8/62)、11.3％ (7/62),品行障礙4.8％ (3/62)、4.8％ (3/62)；抽動障礙14.5％ (9/62)、11.3％(7/62)；遺尿癥16.1％(10/62)、4.8％ (3/62),遺糞癥9.7％(6/62)、1.6％(1/62).孤獨癥患兒現患共患病的數目隨年齡增長有增多趨勢(F =2.745,P=0.051).結論共患病在學齡期兒童孤獨障礙患者中非常常見,積極治療共患病具有重要意義.
목적 료해학령기인동고독장애공환병적발생정황.방법 채용횡단면연구,대2011년9-11월재북경대학정신위생연구소인과문진련속취진적62례년령6～16주세、부합《미국정신장애진단여통계수책(제4판)》(DSM-Ⅳ)중고독장애진단표준적인동진행조사화평정.내용포괄:일반상황조사급《학령인동정감장애화정신분렬증문권》(K-SADS-PL)、《인동총평평정문권》(C-GAS)、《인동고독증평정량표》(CARS)、《중국수정위씨인동지역량표》(WISC)적평정(불능진행위씨측사자진행서문표준추리측험、비내측험혹도사측험평정).결과 고독장애환인공환병적종생공환솔위100％ (62/62),기중:7례(11.3％)환유1충공환병,16례(25.8％)환유2충공환병,11례(17.7％)환유3충공환병,28례(45.2％)환유4충혹4충이상공환병.98.4％(61/62)목전존재공환병,기중:11례(17.7％)환유1충공환병,16례(25.8％)환유2충공환병,17례(27.4％)환유3충공환병,17례(27.4％)환유4충혹4충이상공환병.각충공환병적종생환병솔화현환솔분별위:정신발육지체53.2％(33/62)、53.2％(33/62)；미특정적정신병성장애22.6％ (14/62)、21.0％(13/62);정감장애중억욱장애12.9％(8/62)、9.7％(6/62),쌍상장애1.6％(1/62)、1.6％ (1/62)；초필장애중엄범성초필장애21.0％ (13/62)、19.4％ (12/62),분리초필장애6.5％ (4/62)、3.2％(2/62),량공장애3.2％(2/62)、0(0/62),강박장애45.2％ (28/62)、45.2％ (28/62),공포증30.6％(19/62)、29.0％ (18/62)；주의결함다동장애62.9％(39/62)、58.1％(36/62),대립위항장애12.9％(8/62)、11.3％ (7/62),품행장애4.8％ (3/62)、4.8％ (3/62)；추동장애14.5％ (9/62)、11.3％(7/62)；유뇨증16.1％(10/62)、4.8％ (3/62),유분증9.7％(6/62)、1.6％(1/62).고독증환인현환공환병적수목수년령증장유증다추세(F =2.745,P=0.051).결론 공환병재학령기인동고독장애환자중비상상견,적겁치료공환병구유중요의의.
Objective To investigate the occurrence of comorbidity in school-aged children with autism disorder.Methods Sixty-two outpatients in Peking University Institute of Mental Health,aged 6 to 16 years old,meeting the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition (DSM-Ⅳ) criteria for autism were included in this cross-sectional study from September 2011 to November 2011.They were assessed with the self-made general condition questionnaire,Kiddie-Sade-Present and Lifetime Version (K-SADS-PL),Child-Global Assessment Scale (C-GAS),Childhood Autism Rating Scale (CARS),Chinese Wechsler Intelligence Scale for Children(WISC) (Raven's Standard Progressive Matrices (SPM),Stanford-Binet Intelligence Scale and Peabody picture vocabulary test (PPVT) were performed for patients who could not perform WISC test).Results The lifetime prevalence of comorbidity was 100％ (62/62),in which 7 (11.3％) with 1 comorbidity,16 (25.8％) with 2 comorbidities,11 (17.7％) with 3 comorbidities,and 28 (45.2％) with 4 or more comorbidities.There were 61 (98.4％) children with current comorbidities,11 (17.7％) with 1 comorbidity,16 (25.8％) with 2 comorbidities,17 (27.4％) with 3 comorbidities,17 (27.4％) with 4 or more comorbidities.The lifetime prevalence and current prevalence of comorbidities were:mental retardation 53.2％ (33/62) and 53.2％ (33/62),psychotic disorder not otherwise specified 22.6％ (14/62) and 21.0％ (13/62),depression disorder 12.9％ (8/62) and 9.7％ (6/62),bipolar disorder 1.6％ (1/62) and 1.6％ (1/62),generalized anxiety disorder 21.0％ (13/62)and 19.4％ (12/62),separation anxiety disorder 6.5 ％ (4/62)and 3.2％ (2/62),panic disorder 3.2％ (2/62) and 0 (0/62),obsessive-compulsive disorder 45.2％ (28/62) and 45.2％ (28/62),phobia 30.6％ (19/62)and 29.0％ (18/62),attention deficit hyperactivity disorder (ADHD) 62.9％ (39/62) and 58.1％ (36/62),inattentive type12.9％ (8/62) and 11.3％ (7/62),hyperactive/impulsive type 21.0％ (13/62) and 17.7 ％ (11/62),combined type 29.0％ (18/62) and 29.0％ (18/62),oppositional defiant disorder 12.9％ (8/62) and 11.3％ (7/62),conduct disorder 4.8％ (3/62) and 4.8％ (3/62),Tic disorder 14.5％ (9/62) and 11.3％ (7/62),enuresis 16.1％ (10/62)and 4.8％ (3/62),encopresis 9.7％ (6/62) and 1.6％ (1/62).A increasing trend of number of current comorbidity with the increasing of age were found in children with autism (F =2.745,P =0.051).Conclusion Comorbidities in school-aged children with autism disorder are very common.It is very important to pay attention to comorbidity of autism disorder.