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孤独症谱系障碍儿童合并紧张症症状的临床特征

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目的 通过减弱行为问卷(ABQ)及与之相关的功能和情绪行为问卷,调查孤独症谱系障碍(ASD)儿童合并紧张症症状的表现和相关临床特征。方法 选择 2021 年 11 月至 2023 年 12 月在中山大学附属第三医院或其他三甲医院已明确诊断ASD的儿童,招募其家长或长期照顾者进行问卷调查。根据ABQ问卷结果将ASD儿童分为ABQ筛查阳性组与阴性组,并采用席汉失能量表、重复行为量表(修订版)、儿童简化情绪量表和斯宾塞儿童焦虑量表评估儿童的功能损害及相关的情绪行为表现。结果 回收有效问卷 441 份。ABQ问卷筛查阳性组ASD儿童共 166 名,其ABQ问卷的前 6 个核心症状条目、运动症状、情感改变、行为改变总得分均高于阴性组(P<0。001)。ABQ筛查阳性组ASD儿童中 6 种核心症状均普遍出现,其中"需要提示来完成动作"的出现者比例最高,其次是"不动、卡住、动作缓慢、一旦开始就不能停止动作",有 50%以上的儿童出现这些症状。ABQ筛查阳性组ASD儿童在学习/工作、社交生活、家庭生活/家庭责任等方面功能损失时间、效率低下时间、失能程度"中度"及以上者比例均高于阴性组(P均<0。001);ABQ筛查阳性组ASD儿童的刻板行为、自我伤害行为、强迫行为、单调/仪式行为的得分(P均<0。001)和儿童简化情绪量表得分(P<0。001)及焦虑量表得分(P均<0。01)高于阴性组。结论 紧张症症状在ASD儿童中并不少见。合并有紧张症症状的ASD儿童情绪和行为问题更多,功能损害更严重,需要早期识别、早期干预。
Clinical characteristics of catatonic symptoms in children with autism spectrum disorder
Objective To investigate the presentations and related clinical characteristics of catatonic symptoms in children with autism spectrum disorder(ASD)by using the Attenuated Behavior Questionnaire(ABQ)and related functional and emotional behavior questionnaires.Methods Children who were diagnosed with ASD in the Third Affiliated Hospital of Sun Yat-sen University or other tertiary hospitals from November 2021 to December 2023 were selected.Reports from parents or long-term caregivers of children with ASD were collected through an online questionnaire.Children with ASD were divided into the ABQ screening positive and negative groups using ABQ questionnaire.Sheehan Disability Scale,Repetitive Behavior Scale-Revised,Children's Simplified Emotion Scale and Spence children's Anxiety Scale were used to assess children's functional impairment and related emotional behavior.Results Four hundred and forty-one valid questionnaires were collected.166 children with ASD were screened positive by using the ABQ.The total scores of the first six core symptoms,motor symptoms,emotional changes and behavior changes in the ABQ questionnaire of ASD children in the positive group were significantly higher than those in the negative group(all P<0.001).All six core motor symptoms were commonly reported in the positive group,with"requiring prompts to complete actions"being the most reported,followed by"immobility,getting stuck,slowness in movement,and problems stopping actions once started".Over 50%of the children in the positive screening group exhibited these symptoms.The days of functional loss and inefficiency in study/work,social life,family life/family responsibilities,and the proportion of"moderate"or above degree of disability of ASD children in the ABQ-positive group were higher than those in the negative group,and the differences were statistically significant(all P<0.001).The scores of stereotypical behaviors,self-injurious behavior,compulsive behavior,sameness/ritual behavior(all P<0.001),simplified emotion scale(P<0.001)and anxiety scale(both P<0.01)in the ABQ-positive group were significantly higher than those in the ABQ-negative group,and the differences were statistically significant.Conclusions Catatonic symptoms are not uncommon in children with ASD.ASD children complicated with such symptoms tend to exhibit more emotional and behavioral problems,as well as more severe functional impairment,underscoring the need for early identification and intervention.

Attenuated behaviorAutism spectrum disorderCatatoniaChildren

李咏梅、贺洁琼、邢艺沛、刘兴华、朱绘霖、邓红珠、邹小兵

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中山大学附属第三医院儿童发育行为中心,广东 广州 510630

减弱行为 孤独症谱系障碍 紧张症 儿童

2024

新医学
中山大学

新医学

CSTPCD
影响因子:0.8
ISSN:0253-9802
年,卷(期):2024.55(12)