出生季节与儿童孤独症

出生季节与儿童孤独症【英】／ＹｏｒａｒｎＢ…／／ＡｍＪＰｓｙｃｈｉａｔｒｙ，－１９９５；１５２（５）：７９８～８００儿童孤独症是一种发生于儿童期的严重神经精神障碍，在儿童生长发育期多种适应功能受到影响。诊断儿童孤独症主要依据三组症状①人际交往障碍；②...     

40例儿童孤独症的临床症状分析

４０例儿童孤独症的临床症状分析宋青青，纪慈儿童孤独症是发生于儿童早期的严重的神经精神疾病，现就以美国精神病学会《精神障碍诊断和统计手册》第三版修定版（ＤＳＭ一ＩＩＩ－Ｒ）儿童孤独症诊断标准及儿童孤独症定级评分（ＣＡＲＳ）确立诊断的４０例患儿的临床资料...     

利培酮治疗儿童精神疾病的临床初探

对１６例儿童精神疾病患者给予利培酮治疗，以临床总体印象量表等评定疗效及药物不良反应，治疗结果显示：儿童精神分裂症１０例中有效７例，Ｔｏｕｒｅｔｔｅ综合征（ＴＳ）４例有效３例，孤独症２例中有效１例，显效时间为２周，有效日剂量儿童精神分裂症和孤独症为２～３ｍｇ，ＴＳ为１～１．５ｍｇ，５６．３％的患儿出现药物副反应，提示得培酮儿童精神分裂症，ＴＳ和孤独症部分症状有效，对阳性症状的改善更较阴性症状为好。     

儿童青少年时期精神障碍的遗传学研究Ⅱ

儿童和青少年时期除易患成年期精神疾病外，有些精神障碍易在这一年龄段中发生，如脆性X综合征、神经性厌食和神经性贪食、注意缺陷与多动障碍、Tourette’S综合征、儿童孤独症和反社会人格障碍等。本文拟就近年来注意缺陷与多动障碍、Tourette’S综合征、儿童孤独症和反社会人格障碍等的遗传学研究进展概述如下。     

福建省儿童孤独症流行病学调查

目的 了解福建省儿童孤独症的患病及分布情况。方法 抽查福建省不同地区１４岁以下儿童共１０８０２人,采取ＡＢＣ量表筛查、ＣＣＭＤ－２－Ｒ及ＤＳＭ－Ⅲ－Ｒ确定诊断的方法。结果 确诊为儿童孤独症的共３名时患病率为０．２８‰。结论福建省儿童孤独症的患病率在国外的国外报道患病率范围之内应加强对儿童孤独症的研究。     

50例三岁以下孤独症儿童发育商水平的对照研究

目的探讨孤独症儿童的早期发育水平，通过对5个能区的分析，为早期诊断，早期实施有针对性的康复训练提供科学依据。方法采用北京-Gesell婴幼儿发育检查量表对50例符合ICD-10及DSM-Ⅲ-R诊断标准的孤独症儿童和50例非孤独症儿童进行评估。结果早期确诊的典型孤独症儿童在三岁以前与非孤独症儿童发育商比较差异有显著性意义。从各个功能区发育水平看，除0～24个月组大运动项差异无显著性意义外（P〉0．05），其它各项孤独症组与非孤独症组差异均有显著性意义（P〈0．05）。结论孤独症儿童在早期即有发育滞后的表现，可早期诊断，早期治疗。     

短暂性完全性遗忘综合征2例报告

短暂性完全性遗忘综合征２例报告高素琴短暂性完全性遗忘综合征（ＴｒａｎｓｉｅｎｔＧｌｏｂａｌＡｎｍｅｓｉａＳｙｎｄｒｏｍｅ，ＴＧＡＳ），国内报导少见，现将我们收治的２例报道如下：例１，男，４６岁，工人，于１９９２年的某日中午看完电视后，与其妻外出，在途...     

注意缺陷多动障碍自我意识和家庭环境情况的初步研究

目的评定注意缺陷多动障碍（ＡＤＨＤ）儿童的自我意识和家庭环境，并探讨二者与ＡＤＨＤ儿童的关系。方法应用Ｐｉｅｒｓ－Ｈａｒｒｉｓ儿童自我意识量表和家庭环境量表对７７例ＡＤＨＤ儿童进行评定。结果ＡＤＨＤ儿童自我意识低者占５３％，在行为、智力和学校、合群等方面低于正常儿童，家庭环境在亲密度、文化性等方面低于正常儿童家庭，而矛盾性高于正常家庭（Ｐ＜００１～００５）。结论ＡＤＨＤ儿童自我意识水平偏低，家庭环境较差。因此，对ＡＤＨＤ儿童药物治疗的同时，不可忽视心理治疗     

青少年儿童时期精神障碍的遗传学研究Ⅰ

儿童和青少年期除易患成年期精神疾病外，有些精神障碍易在这一年龄段中发生，如脆性X综合征、神经性厌食和神经性贪食、注意缺陷与多动障碍、Tourette’s综合征、儿童孤独症和反社会人格障碍等，本文拟就近年来脆性X综合征、神经性厌食和神经性贪食的遗传学研究进展概述如下。     

儿童孤独症血浆5-羟色胺的测定

目的 比较孤独症儿童和正常儿童血浆5-羟色胺(5-HT)的浓度,探索5-HT浓度增高和5-HT浓度正常的孤独症儿童各自的临床特点。方法 采用孤独症行为评定量表(ABC)、儿童期孤独症评定量表(CARS)和适应行为评定量表对33例孤独症儿童进行评定,并进行了血浆5-HT检测,以高出正常儿童平均5-HT浓度1.67个标准差的孤独症儿童为5-HT增高组,其他孤独症儿童为5-HT正常组,比较两组孤独症儿童的临床特征。结果 孤独症儿童的ABC得分为72.30±29.91、CARS的得分为41.83±4.05、适应行为评定量表的得分为66.55±12.52。孤独症儿童5-HT浓度为0.77±0.33μmol/L;正常儿童5-HT浓度为0.62±0.18μmol/L,两组经t检验有显著性差异(t=2.23;P=0.03)。5-HT增高的孤独症儿童有9例,5-HT正常的孤独症儿童有24例,两组临床特征比较未发现明显差异。结论 27.3％的孤独症儿童5-HI浓度增高,5-HT增高与5-HT正常的儿童孤独症临床特征相同。孤独症的病因可能是异质性的。     

Specifying PDD-NOS: a comparison of PDD-NOS, Asperger syndrome, and autism

OBJECTIVE: To describe the clinical characteristics of children given a diagnosis of pervasive developmental disorder-not otherwise specified (PDD-NOS) by expert clinicians and to compare these to the clinical characteristics of children given a diagnosis of autism and Asperger syndrome (AS). METHOD: Two hundred sixteen children with autism, 33 with AS, and 21 with PDD-NOS were compared on measures of level of functioning (communication, daily living and social skills, IQ, and age of acquisition of language) and on various symptoms of autism (impaired communication and reciprocal social interaction and a preference for repetitive and stereotyped activities). RESULTS: In terms of level of functioning measures, the PDD-NOS children had scores that were between those of the children with autism and those of the children with AS. In contrast, the PDD-NOS group had fewer autistic symptoms, especially repetitive stereotyped behaviors, than both the autism and AS groups (chi2 = 11.06, p =.004). Children with PDD-NOS could be placed into one of three subgroups: a high-functioning group (24%) who resembled AS but had transient language delay or mild cognitive impairment; a subgroup resembling autism (24%) but who had late age of onset or too severe cognitive delays or were too young to potentially meet the full diagnostic criteria for autism; and a group (52%) not fulfilling the criteria for autism because of fewer stereotyped and repetitive behaviors. CONCLUSIONS: With some revision to current diagnostic criteria, a more homogenous atypical group with significant impairments in social-communication but fewer repetitive behaviors can be differentiated from the more nonspecific PDD-NOS group. This differentiation may lead to better reliability in diagnosis and to further progress in studies of etiology.     

Defining the Behavioral Phenotype of Asperger Syndrome

Asperger syndrome (AS) is characterized by social deficits and restricted interests in the absence of mental retardation and language delay. However, it is unclear to what extent the social deficits of AS differ from those of traditional autism. To address this issue, 58 subjects with AS were compared with 39 subjects with autism. Social deficits were classified according to Wing and Gould’s method. Forty-six (79%) subjects with AS were rated as active but odd, while 32 (82%) with autism were described as aloof and passive, while a few subjects showed mixed features. Thus, despite the overlap between AS and autism, subjects with AS showed a distinct pattern of social impairment. Implications of these findings are discussed.     

The 2nd to 4th digit ratio and autism

It has been suggested that autism may arise as the result of exposure to high concentrations of prenatal testosterone. There is evidence that the ratio of the lengths of the 2nd and 4th digit (2D:4D) may be negatively correlated with prenatal testosterone. We measured 2D:4D in 95 families recruited via the National Autistic Society, UK. The sample comprised a total 72 children with autism (62 males, 10 females; age range 2 to 14 years), including 23 children (20 males, three females) with Asperger syndrome (AS), 34 siblings, 88 fathers, 88 mothers and sex- and age-matched control participants. We found that the 2D:4D ratios of children with autism, their siblings, fathers and mothers were lower than population normative values. Children with AS, who share the social and communicative symptoms of autism but have normal or even high IQ, had higher 2D:4D ratios than children with autism but lower ratios than population normative values. There were positive associations between 2D:4D ratios of children with autism and the ratios of their relatives. Children with autism had lower than expected 2D:4D ratios and children with AS higher ratios than expected in relation to their fathers' 2D:4D ratio. It was concluded that 2D:4D ratio may be a possible marker for autism which could implicate prenatal testosterone in its aetiology.     

Current status of research on autism spectrum disorders and offending

An emerging literature on autism spectrum disorders (ASD) and offending has highlighted that these disorders are at times associated with criminal behaviour. Ghaziuddin et al. (1991) reviewed the published literature on this topic from 1944 to 1990 and concluded that there was no clear link between Asperger syndrome (AS) and violent crime. They suggested that people with AS hardly were more likely to commit violent crime than the rest of the population. The present review provides an update on the issues in the earlier review mentioned and presents new issues that have emerged in the past two decades. Currently, there is still no body of evidence to suppose that people with ASD are more prone to commit offences than anyone else. However, a small number of serious crimes can be linked to the core features of ASD. Co-morbid psychiatric disorders are important risk factors for offending in people with ASD. Studies of referred samples have suggested considerable differences in offending among subgroups of people with ASD. Offending has rarely been reported in childhood autism, but is more common in atypical autism (AA) and AS. Literature suggests that people with ASD are potentially overrepresented within the criminal justice system, and that failure to detect ASD among offenders is not uncommon. Insofar as people with AA and AS have offended, it has typically been connected with arson and sexual abuse. But due to lack of valid community based studies of offending relating to people with ASD, these findings must be interpreted with caution.     

Defining the Intellectual Profile of Asperger Syndrome: Comparison with High-Functioning Autism

Asperger syndrome (AS) is a disorder of early childhood characterized by autistic social deficits, subtle communication impairment, and excessive isolated interests. There is no history of language delay or of mental retardation. Despite its increasing popularity as a distinct condition, its diagnostic validity remains uncertain. It is still unclear to what extent AS differs from autism with normal intelligence sometimes referred to as high-functioning autism (HFA). However, some reports have suggested that persons with AS possess a distinct profile on tests of intelligence characterized by a high verbal IQ and a low performance IQ, whereas in most cases with HFA, the pattern is reversed. Since few studies have directly compared AS subjects with HFA controls using unmodified diagnostic criteria and standardized measures of assessment, in this report we compared 22 AS subjects with 12 HFA controls, matched on age, sex and level of intelligence. As a group, subjects with AS showed a higher verbal IQ and higher scores on information and vocabulary subtests than those with HFA. However, scores of several AS and HFA subjects showed a mixed pattern. Implications of these findings are discussed in the context of the validity of Asperger Syndrome.     

The Autism-Spectrum Quotient (AQ)—Adolescent Version

The Autism Spectrum Quotient (AQ) quantifies autistic traits in adults. This paper adapted the AQ for children (age 9.8–15.4 years). Three groups of participants were assessed: Group 1: n=52 adolescents with Asperger Syndrome (AS) or high-functioning autism (HFA); Group 2: n=79 adolescents with classic autism; and Group 3, n=50 controls. The adolescents with AS/HFA did not differ significantly from the adolescents with autism but both clinical groups scored higher than controls. Approximately 90% of the adolescents with AS/HFA and autism scored 30+, vs. none of the controls. Among the controls, boys scored higher than girls. The AQ can rapidly quantify where an adolescent is situated on the continuum from autism to normality.     

Quantitative Assessment of Neuromotor Function in Adolescents with High Functioning Autism and Asperger Syndrome

Background: Motor impairment in children with Asperger Syndrome (AS) or High functioning autism (HFA) has been reported previously. This study presents results of a quantitative assessment of neuromotor skills in 14–22 year old HFA/AS. Methods: 16 HFA/AS and 16 IQ-matched controls were assessed by the Zurich Neuromotor Assessment (ZNA). Results: The HFA/AS group showed strongest impairments of dynamic balance skills and diadochokinesis. Motor abilities were associated with degree of social withdrawal in the full sample and severity of current autistic symptoms in the HFA/AS group. Conclusion: Similar motor patterns as in younger children were found in the older adolescents. The association of autistic symptoms with motor performance points towards an essential role of motor impairment in autism spectrum disorders.     

Insomnia is a frequent finding in adults with Asperger syndrome

Background  

Asperger syndrome (AS) is a neurodevelopmental disorder belonging to autism spectrum disorders with prevalence rate of 0,35% in school-age children. It has been most extensively studied in childhood while there is scarcity of reports concerning adulthood of AS subjects despite the lifelong nature of this syndrome. In children with Asperger syndrome the initiation and continuity of sleep is disturbed because of the neuropsychiatric deficits inherent of AS. It is probable that sleep difficulties are present in adulthood as well. Our hypothesis was that adults with AS suffer from difficulty in initiating and maintaining sleep and nonrestorative sleep (insomnia).     

儿童孤独症血浆5-羟色胺水平的对照研究

目的：通过检测血浆5—羟色胺(5—HT)水平，初步探讨儿童孤独症的生化病理机制。方法：采用放射免疫方法定量检测54例儿童孤独症患儿(病例组)及26名健康儿童(对照组)的血浆5—HT水平，并作比较。结果：病例组的血浆5—HT水平显著高于对照组，但与疾病的严重程度无明显相关。结论：提示高5—HT可能是儿童孤独症生物学标志。     

The amygdala theory of autism

Brothers (Brothers L. Concepts in Neuroscience 1990;1:27-51) proposed a network of neural regions that comprise the "social brain", which includes the amygdala. Since the childhood psychiatric condition of autism involves deficits in "social intelligence", it is plausible that autism may be caused by an amygdala abnormality. In this paper we review the evidence for a social function of the amygdala. This includes reference to the Kluver-Bucy syndrome (which Hetzler and Griffin suggested may serve as an animal model of autism). We then review evidence for an amygdala deficit in people with autism, who are well known to have deficits in social behaviour. This includes a detailed summary of our recent functional magnetic resonance imaging (fMRI) study involving judging from the expressions of another person's eyes what that other person might be thinking or feeling. In this study, patients with autism or AS did not activate the amygdala when making mentalistic inferences from the eyes, whilst people without autism did show amygdala activity. The amygdala is therefore proposed to be one of several neural regions that are abnormal in autism. We conclude that the amygdala theory of autism contains promise and suggest some new lines of research.