儿童孤独症的心理行为特征及其影响因素

目的观察儿童孤独症的心理行为特征,分析孤独症的影响因素。方法回顾性分析2018年1月～2019年12月本院儿科门诊接诊的63例孤独症患儿临床资料,将其设为孤独症组;另收集同期本院儿科门诊接诊的80例经检查为健康儿童临床资料,将其设为对照组。设计一般情况调查问卷,分析孤独症患儿心理行为特征并探讨儿童孤独症发生的影响因素。结果纳入的63例孤独症患儿中,有25例出现不同程度语言发展迟缓及异常,23例患儿出现社会交往障碍,30例患儿出现兴趣及行为异常,18例患儿出现认知缺陷;将可能的影响因素纳入,经单因素与多项Logistic回归分析发现,母亲职业为专业技术人员、家庭经济较差、母亲孕期患病史、新生儿黄疸、孤独症遗传史均可能是儿童孤独症发病的影响因素(OR 1,P0.05)。结论儿童孤独症普遍存在不良心理行为特征,疾病的发生受多种因素共同影响。     

儿童孤独症80例的脑电图分析

观察儿童孤独症的脑电图变化。对８０例儿童孤独症患儿的临床和脑电图资料进行分析。本组异常脑电图有２３例，其脑电图异常与患儿性别，起病年龄，围产期情况及智商均无显著性差异，但与阳性家庭史及头颅ＣＴ或颅片正常与否有显著差异。结论儿童孤独症的脑器质性与脑功能障碍密切有关。     

儿童孤独症与感觉统合失调的相关分析

目的:探索儿童孤独症与感觉统合失调的关系.方法:对60例符合国际疾病分类第10版(ICD-10)诊断标准的儿童孤独症患儿(患者组)与60名健康儿童(对照组)填写儿童情况调查表,并分别进行感觉统合评定量表(SIS)、克氏孤独症行为量表(CBRS)及并儿童孤独症评定量表(CARS)评定孤独症患儿症状严重程度.结果:患者组伴感觉统合失调的占95.0%,而对照组存在感觉统合失调的仅占3.3%;患者组与对照组的感觉统合评定结果比较,差异具有显著性(P＜0.01);病程长短不同的患儿感觉统合失调严重度不同,差异具有显著性(P＜0.05);智力水平与感觉统合失调显著相关(P＜0.05);多元逐步回归分析结果:是否诊断为儿童孤独症与CBRS总分、本体感、母孕期有无高危因素、既往有重大疾病史、有无窒息史、母亲文化程度有关.结论:儿童孤独症患儿普遍存在感觉统合失调,在对儿童孤独症患儿进行个别化训练的同时应进行感觉统合训练.     

血清抗神经节苷脂M1抗体水平与儿童孤独症严重程度的相关性研究

目的 了解血清抗神经节苷脂M1(GM1)抗体水平的变化及其与儿童孤独症严重程度的关系,为儿童孤独症的病因及治疗提供线索和依据. 方法 病例组选择自2012年6月至8月在广州市小天使康复训练中心进行康复训练的已确诊的孤独症患儿50例,对照组选择同期在广东省妇幼保健院儿童保健科门诊体检正常的儿童50例.采用酶联免疫吸附法(ELISA)检测2组儿童血清抗GM1抗体水平.根据儿童孤独症评定量表(CARS)评定孤独症患儿的疾病严重程度.比较组间及不同疾病严重程度、性别间抗GM1抗体水平并行相关性分析. 结果 根据所测得的抗GM1抗体截断值(156.18 ng/mL)判断,24％(12/50)的孤独症患儿抗GM1抗体阳性,对照组仅4％(2/50)抗GM1抗体阳性,差异有统计学意义(P＜0.05).7.7％(2/26)轻中度孤独症患儿抗GM1抗体阳性,而41.7％(10/24)重度孤独症患儿抗GM1抗体阳性,差异有统计学意义(P＜0.05).孤独症组抗GM1抗体水平[12.79(146.02) ng/mL]高于对照组[11.35(53.80) ng/mL],差异有统计学意义(P＜0.05).女性孤独症患儿抗GM1抗体水平[191.74(216.18) ng/mL]高于男性患儿[11.11(9.51) ng/mL],差异有统计学意义(P＜0.05).相关性分析显示,孤独症患儿血清抗GM1抗体水平与CARS评分呈正相关(r=0.866,P＜0.005). 结论 血清抗神经节苷脂GM1抗体水平可能是孤独症的一项生化标志,与儿童孤独症的严重程度相关.     

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...     

正常儿童与孤独症患儿事件相关电位P300 对照研究

目的探讨孤独症患儿的事件相关电位P300的特点.方法使用美国Nicolet Spirit脑电生理仪记录37例孤独症患儿和30名正常健康儿童的P300特点.结果(1)与正常儿童比较,孤独症患儿P300波形变异较大.(2)在靶潜伏期P3上,孤独症患儿延迟于正常儿童,差异有极显著性(P＜0.01).(3)在靶波幅P3和非靶波幅P2上,孤独症患儿波幅又降低于正常儿童(P＜0.01和P＜0.05).结论P300对临床辅助诊断孤独症有参考价值.     

结构化教育结合地板时光在孤独症患儿中的治疗效果分析

目的观察结构化教育结合地板时光疗法对孤独症儿童的治疗效果。方法选取在我院接受治疗的孤独症患儿80例,对这80例患儿采取结构化教育结合地板时光的疗法进行9个月的治疗。采用孤独症儿童行为检查量表(ABC)、儿童孤独症及相关发育障碍心理教育评定量表(C-PEP)和孤独症治疗评估表(ATEC)在治疗前和治疗后对患儿进行评估。结果治疗后孤独症患儿ABC量表各个因子得分及总分均显著低于治疗前(P0.05),治疗后孤独症患儿ATEC量表各个维度及总分均显著低于治疗前(P0.05),治疗后孤独症患儿C-PEP量表各因子及总分均显著高于治疗前(P0.05)。结论结构化教育结合地板时光在孤独症患儿中治疗有效,能改善患儿症状,值得推广应用。     

父母生育年龄及围生期因素与孤独症的关系

目的:探讨父母生育年龄及围生期因素对孤独症发病的影响。方法:对符合美国精神障碍诊断与统计手册第4版(DSM-IV)诊断标准的371例孤独症患儿(孤独症组)及采用分层随机抽样法收集的上海市幼儿园及中小学747名学生(正常对照组)父母生育年龄、该儿童的围生期情况进行统计分析。结果:父亲生育年龄在孤独症组较正常对照组高(χ2=46.672,P=0.000),差异具有统计学意义;孤独症组剖宫产率(χ2=15.480,P=0.000)、新生儿黄疸(χ2=17.395,P=0.000)发生率高于正常对照组,差异具有统计学意义。结论:父亲生育年龄较高可能子女罹患孤独症的风险高;剖宫产、新生儿黄疸可能是孤独症发病的危险性因素。     

孤独症患儿的脑干听觉反应

目的研究孤独症患儿与正常儿童在脑干听觉反应(ABR)检测中的不同特点.方法应用美国Nicolet Spirit脑诱发电位仪,对37例孤独症患儿和30例健康儿童的ABB作了检测.结果孤独症患儿波形不规则,ABRⅢ波和V波尤甚.与正常儿童组相比,孤独症组ABRⅢ波和V波绝对潜伏期延迟(P＜0.01),ABRⅢ波波幅同时降低,差异达极显著性(P＜0.01).结论 初步认为ABR是反映孤独症患儿感知功能的一种脑电生理检测工具.     

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。     

Perinatal risk factors for schizophrenia: How specific are they?

The association between exposure to perinatal risk factors and increased vulnerability for schizophrenia is now documented by a large body of epidemiologic studies. However, the diagnostic specificity of this association may be questioned, because subjects with a history of exposure to early environmental risk factors are at an increased risk for other psychiatric disorders with childhood or adult onset, such as autism, anorexia nervosa, or affective disorders. Because a given risk factor may be associated with several adverse health outcomes, these findings do not preclude the existence of a causal relationship between perinatal risk factors and schizophrenia. This lack of diagnostic specificity suggests that the clinical expression of the vulnerability induced by early risk factors depends on gene-environment interactions or interaction between this prenatally determined vulnerability and exposure to later environmental risk factors.     

A genome-wide search for alleles and haplotypes associated with autism and related pervasive developmental disorders on the Faroe Islands

The involvement of genetic factors in the etiology of autism has been clearly established. We undertook a genome-wide search for regions containing susceptibility genes for autism in 12 subjects with childhood autism and related pervasive developmental disorders (PDDs) and 44 controls from the relatively isolated population of the Faroe Islands. In total, 601 microsatellite markers distributed throughout the human genome with an average distance of 5.80 cM were genotyped, including 502 markers in the initial scan. The Faroese population structure and genetic relatedness of cases and controls were also evaluated. Based on a combined approach, including an assumption-free test as implemented in CLUMP, Fisher's exact test for specific alleles and haplotypes, and IBD(0) probability calculations, we found association between autism and microsatellite markers in regions on 2q, 3p, 6q, 15q, 16p, and 18q. The most significant finding was on 3p25.3 (P(T1)=0.00003 and P(T4)=0.00007), which was also supported by other genetic studies. Furthermore, no evidence of population substructure was found, and a higher degree of relatedness among cases could not be detected, decreasing the risk of inflated P-values. Our data suggest that markers in these regions are in linkage disequilibrium with genes involved in the etiology of autism, and we hypothesize susceptibility genes for autism and related PDDs to be localized within these regions.     

Autism Spectrum Disorder in a Term Birth Neonatal Intensive Care Unit Population

BackgroundNonspecific perinatal risk factors have been revealed to be associated with the development of autism spectrum disorder. However, term at-risk infants, as a distinct population, are underrepresented in the literature. This study examines the incidence and neonatal risk factors for autism spectrum disorder in term neonatal intensive care unit survivors.MethodsWe performed a retrospective analysis from a single university-practice database of neonates admitted to the neonatal intensive care unit and followed by a single pediatric neurologist. Term infants (≥37 weeks), born between 1991 and 2011, with at least 2 years (or 1 year if found to be neurologically normal) of follow-up were included. Principle outcomes were autism spectrum disorder, cerebral palsy, global developmental delay, and epilepsy.ResultsOne hundred eighty infants were included from a database of 564 neonates. Twelve (6.6%) developed autism spectrum disorder, 53 (29.4%) cerebral palsy, 77 (42.7%) global developmental delay, and 47 (26.1%) epilepsy. Seventy-one (39.4%) developed no adverse outcomes. Nine patients with autism spectrum disorder (75%) were diagnosed with at least one other adverse outcome. No neonatal or perinatal variables were evident to be significantly associated with later autism spectrum disorder.ConclusionsIn term neonatal intensive care unit survivors, autism spectrum disorder occurs at a greater frequency than in the general population and often develops alongside comorbid conditions. This highlights the importance of screening term neonatal intensive care unit survivors for autism spectrum disorder, particularly when comorbidities are present.     

The antecedents of psychoses: a case-control study of selected risk factors

Winter birth, urban birth and/or childhood residence, and perinatal complications have each been identified as environmental risk factors for the later development of schizophrenia, schizoaffective disorder, and bipolar disorder. A preliminary case-control study also identified cat exposure in childhood as a possible risk factor. To assess selected environmental events, including childhood exposure to pets, as possible risk factors for these diseases, a case-control telephone survey was carried out by the University of Maryland Survey Research Center for 264 mothers of cases and 528 mothers of matched controls. The cases were randomly selected mothers who were members of the National Alliance for the Mentally Ill, and whose children had been diagnosed with schizophrenia, schizoaffective disorder, or bipolar disorder. The controls were mothers randomly selected from the same telephone exchanges. For five of the 19 major variables, there were statistically significant differences between cases and controls: fever during pregnancy, complications during delivery, city or suburban residence at birth, cat ownership between birth and age 13, and breast-feeding. In a multivariate logistic regression including these five variables, each variable made a significant contribution. The finding of perinatal complications, urban/suburban residence at birth, and cat ownership in childhood as risk factors for the later development of psychoses confirmed previous studies. Previous research on breast-feeding as a risk factor has yielded contradictory results. Additional research is needed to ascertain how such environmental risk factors interact with genetic risk factors. Understanding these could lead to better treatments and possible prevention strategies.     

Autism and epilepsy: a retrospective follow-up study

So-called "idiopathic" autism, which exhibited no major complications before diagnosis is well-known as one of the risk factors for epilepsy. This retrospective follow-up study aimed to clarify the characteristics of epilepsy in the autism; onset of seizure, seizure types, EEG findings and epilepsy outcome and the differences as a group between the autism with epilepsy and those without epilepsy. One hundred thirty individuals with autistic disorder or atypical autism diagnosed in childhood were followed up over 10 years and were evaluated almost every year up to 18-35 years of age. Their medical records related to perinatal conditions, IQ, social maturity scores and several factors of epilepsy were reviewed in October 2005. Thirty-three of the follow-up group (25%) exhibited epileptic seizures. The onset of epilepsy was distributed from 8 to 26 years of age. Two types of seizure were observed; partial seizure with secondarily generalized seizure and generalized seizure. Twenty of the epileptics (61%) showed the partial seizure. Although 18% of the non-epileptic group exhibited epileptic discharges on EEG, 68% of the epileptic group revealed epileptiform EEG findings before the onset of epilepsy. No differences were observed concerning the sex ratio, autistic disorder/atypical autism and past history of febrile seizures between the epileptic and non-epileptic groups. Lower IQ, lower social maturity score and higher frequency of prescribed psychotropics were observed in the epileptic group compared to the non-epileptics. Idiopathic autism was confirmed as the high risk factor for epilepsy. Epileptiform EEG findings predict subsequent onset of epileptic seizures in adolescence. Epilepsy is one of negative factors on cognitive, adaptive and behavioral/emotional outcomes for individuals with autism.     

Prenatal and Perinatal Risk Factors for Autism in China

We conducted a case–control study using 190 Han children with and without autism to investigate prenatal and perinatal risk factors for autism in China. Cases were recruited through public special education schools and controls from regular public schools in the same region (Tianjin), with frequency matching on sex and birth year. Unadjusted analyses identified seven prenatal and seven perinatal risk factors significantly associated with autism. In the adjusted analysis, nine risk factors showed significant association with autism: maternal second-hand smoke exposure, maternal chronic or acute medical conditions unrelated to pregnancy, maternal unhappy emotional state, gestational complications, edema, abnormal gestational age (<35 or >42 weeks), nuchal cord, gravidity >1, and advanced paternal age at delivery (>30 year-old).     

Neuroglobin Protects Rats from Sepsis-Associated Encephalopathy via a PI3K/Akt/Bax-Dependent Mechanism

The pathogenesis of autism spectrum disorders (ASD) is not completely understood, but there is evidence of associations with altered immune responses. The aim of this study was to determine the serum levels of various cytokines in children with ASD and in healthy controls, in order to determine their role in ASD and its diagnostic subgroups. Sixty-five ASD patients were enrolled from an epidemiological survey in Norway, of which 30 were diagnosed with childhood autism, 16 with Asperger syndrome, 12 with atypical autism, 1 with Rett syndrome, and 6 with another ASD diagnosis. The serum levels of 12 cytokines were measured in all of the patients and in 30 healthy children. The cytokine levels did not differ significantly between the ASD group and the healthy controls. However, the interleukin-8 (IL-8) level was significantly higher (6.82 vs 4.58 pg/ml, p?=?0.017) while that of IL-10 was significantly lower (2.24 vs 6.49 pg/ml, p?=?0.009) in patients with childhood autism than in controls. Furthermore, the IL-8 level was significantly higher in childhood autism than in Asperger syndrome (6.82 vs 4.05 pg/ml, p?=?0.013). Our study shows that the cytokine profile of children diagnosed with ASD, regardless of the subdiagnosis, does not differ from healthy controls. However, differentiation into different diagnostic subgroups reveals significantly different levels of IL-8 and IL-10. This indicates that different mechanisms may underlie the different ASD subdiagnoses. Future research into the pathophysiological mechanisms of ASD should pay more attention to the different subdiagnoses of ASD.     

Maternal Exposure to Childhood Abuse is Associated with Mate Selection: Implications for Autism in Offspring

Maternal experience of childhood abuse has been associated with offspring autism. To explore whether familial tendency towards autistic traits—presumably related to genetic predisposition—accounts for this association, we examined whether women who experienced childhood abuse were more likely to select mates with high levels of autistic traits, and whether parental autistic traits accounted for the association of maternal abuse and offspring autism in 209 autism cases and 833 controls. Maternal childhood abuse was strongly associated with high paternal autistic traits (severe abuse, OR = 3.98, 95% CI = 1.26, 8.31). Maternal and paternal autistic traits accounted for 21% of the association between maternal abuse and offspring autism. These results provide evidence that childhood abuse affects mate selection, with implications for offspring health.     

Children with Autism: Quality of Life and Parental Concerns

Past research has shown that children with autism and their families have compromised quality of life (QOL) in several domains. This study examined QOL and parental concerns in children with autism during early childhood, childhood, and adolescence compared to children with Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder (ADD/ADHD) and to typical controls from a US national sample. Families with children diagnosed with autism reported more profound QOL effects than families of children with ADD/ADHD or unaffected controls. Children with autism were significantly less likely to attend religious services, more likely to miss school, and less likely to participate in organized activities. Parental concerns over learning difficulty, being bullied, stress-coping, and achievement were overwhelming in the autism group relative to the comparison groups.