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...     

抽动障碍的分类诊断和治疗进展

根据ＤＳＭ－Ⅳ和ＣＣＭＤ－２－Ｒ对抽动障碍的分类及诊断标准进行了归纳总结，并根据国外献资料介绍其治疗方面的某些进展。     

孤独症患者T淋巴细胞功能及其亚群的研究

为研究孤独症患者免疫学方面的异常，探索孤独症的病理学机制，对２７例孤独症、１６例精神发育迟滞（ＭＲ）和１８名正常儿童进行了Ｔ淋巴细胞增殖反应及其亚群的测定，应用ｔ检验进行统计学处理。结果显示：孤独症组的ＣＤ４阳性细胞百分数明显低于其它两组（ｔ值分别为２．６４，２．２１；Ｐ平均值＜０．０５），孤独症ＣＤ３阳性细胞也较ＭＲ组显著为低（ｔ＝２．４７４，Ｐ＜０．０２）。在淋巴细胞增殖反应方面，孤独症组也较对照组明显降低（ｔ＝２．１７５，Ｐ＜０．０５）。提示ＣＤ４阳性细胞数下降与孤独症的发病有关，并讨论了孤独症与Ｔ淋巴细胞功能间的联系     

抽动障碍的分类诊断和治疗进展

根据ＤＳＭ－Ⅳ和ＣＣＭＤ－２－Ｒ对抽动障碍的分类及诊断标准进行了归纳总结，并根据国外文献资料介绍其治疗方面的某些进展     

儿童孤独症的家庭矫治

对我院１９９１年以来收治的儿童孤独症患者１３例进行出院后家庭矫治并随访观察。其中男９例，女４例；平均年龄６．４±１．６岁，平均病程３９．２±２３．７月，平均住院２５．８±１６．６天，出院后平均随访４０．３±１２．５月。均符合ＣＣＭＤ－２－Ｒ与ＤＳＭ－...     

胶质瘤多药耐药细胞系C6／adr的建立及其耐药性逆转的研究

目的 研究胶质瘤多药耐药（ＭＤＲ）的发生机理及逆转方法。方法 建立了Ｃ６／ａｄｒ ＭＤＲ细胞系,经ＲＴ－ＰＣＲ及免疫组化染色分别研究了ｍｄｒ－１基因及Ｐ－糖蛋白（Ｐ－ｇｐ）的表达;采用ＭＴＴ药敏试验及ＨＰＬＣＡ测定细胞内阿霉素浓度的方法研究了异搏定、红霉素、潘生丁、Ｐ－ｇｐ单克隆抗体、复方丹参对ＭＤＲ的逆转作用。结果 Ｃ６／ａｄｒ ＭＤＲ细胞系ｍｄｒ－１基因阳性,Ｐ－ｇｐ高度表达。异搏定（２～６μ     

40例精神疾病CCMD－2－R现场测试结果分析

本文对４０例各类精神疾病纳入ＣＣＭＤ－２－Ｒ现场测试病例进行了类别诊断、亚型诊断及附加评定的分析，对应用ＣＣＭＤ－２－Ｒ与ＣＣＭＤ－２－Ｒ两诊断标准之间的一致率进行了比较。     

100例精神分裂症与神经症CCMD－2－R的应用对照

１００例精神分裂症与神经症ＣＣＭＤ－２－Ｒ的应用对照高成阁，陈佩璋ＣＣＭＤ－２－Ｒ在ＣＣＭＤ－２的基础上进行了较大的修订。作者通过精神分裂症和神经症患者各５０例的回顾性观察，对ＣＣＭＤ－２－Ｒ、ＩＣＤ－ｌ０、ＤＳＭ－Ⅲ－Ｒ三种诊断标准进行了比较，谈谈...     

常州市儿童孤独症的流行病学调查

目的；了解常州市儿童孤独症的患病率。方法：抽查市区5个街道2－6岁儿童3978人，采用Clancy行为量表进行筛查，以CCMD－2－R儿童孤独症诊断标准、儿童期孤独症评定量表（CARS量表）及儿童心理教育评定量表（PEP量表）进行诊断。结果：确诊为儿童孤独症者7人，时点患病率为17．89／万。结论：常州市儿童孤独症的患病率较高，且绝大多数无任何康复措施，故培养基层儿童精神科医师及建立基层特殊康复机构十分重要。     

利培酮与利他林治疗儿童注意缺陷障碍的对照研究

儿童注意缺陷障碍（ＡＤＨＤ）的发病原因是多因素的，其发病机理目前仍争论很多。我们采用前瞻性单盲对照研究方法观察利培酮与利他林治疗ＡＤＨＤ的疗效与副反应。资料一般资料：两组共３３例，均为１９９７年７月至９月门诊病人，症状符合ＣＣＭＤ－Ⅱ－Ｒ标准；排除精...     

Non-expert clinicians' detection of autistic traits among attenders of a youth mental health service

Aims: The aims of this study were to determine the point prevalence of autism spectrum disorders and to estimate the prevalence of autistic traits in a youth mental health service. Methods: Following three educational sessions on autism spectrum disorders, treating clinicians were interviewed to determine whether the clients on their caseloads had (i) a confirmed prior diagnosis of autism spectrum disorder; (ii) were felt to exhibit autistic traits; or (iii) were not felt to exhibit autistic traits. Results: Information on autism spectrum disorder status was obtained for 476 patients. Of the included patients, 3.4% (n = 16) had a confirmed diagnosis of autism spectrum disorder and 7.8% (n = 37) were reported by treating clinicians to exhibit autistic traits. Conclusions: The rate of autism spectrum disorder was higher in this population than that in community samples with twice as many again being identified as having autistic traits by their treating clinicians. This has implications for correct diagnosis and appropriate management in these settings.     

Prevalence of autism in children born to Somali parents living in Sweden: a brief report

In a geographical area of Stockholm, with a relatively large Somali immigrant population, parents as well as teachers in special schools and staff at habilitation centres have raised concerns over whether children with a Somali background are over-represented in the total group of children with autism. The aim of the study was, therefore, to investigate the prevalence of autism in children with parents from Somalia, living in Stockholm county, and to compare the prevalence in children of Somali background with that in the non-Somali group. We reviewed the records of 17 children (13 males, four females), born between 1988 and 1998 (age range 7-17y) and with a Somali background, who had a diagnosis of autistic disorder or pervasive developmental disorder not otherwise specified (PDDNOS) and were registered at either of the two autism habilitation centres for school-aged children. The prevalence of autistic disorder or PDDNOS was found to be three to four times higher than in the non-Somali group (0.7% vs 0.19%). All children also had learning disability.* Our findings warrant further investigations of possible aetiological factors behind the increased prevalence of autistic disorders in children of Somali origin found in this area in Sweden.     

Autism in visually impaired individuals

The aim of the present study was to assess the prevalence and associated risk factors of autism in a sample of visually impaired children and adolescents. A total of 257 blind children and adolescents (age range: 7-18 years) were examined for autism using a three-stage process. The first stage estimated probable cases of autistic disorder based on the Autism Behavior Checklist and the second stage by direct observation of the subjects in different settings. In the third stage, subjects with the probable diagnosis of autistic disorder were asked to undergo psychiatric examination. A final diagnosis of autistic disorder (based on the criteria in DSM-IV) was given after interviewing the caregivers and clinical observation. Thirty of 257 subjects met the criteria for autistic disorder. Comparison of the characteristics of the two groups (autistic and non-autistic) with chi2-squared and independent sample t-tests revealed a statistically significant difference in terms of severity of blindness (P = 0.015), cerebral palsy (P = 0.02) and intellectual level (P = 0.001). The results of the present study suggest that subjects with blindness plus autism have greater neurological impairment (as suggested by the presence of lower intellectual level and cerebral palsy), and more severe visual impairment than the subjects with blindness only.     

A study of intellectual abilities in high-functioning people with autism

This research extends previous research regarding the intellectual functioning of autistic individuals on standardized measures of intelligence (Wechsler Adult Intelligence Scale-Revised and the Wechsler Intelligence Scale for Children-Revised). In Study I 33 individuals with autism who closely fit the DSM-III criteria were studied. Clear evidence was found that differentiates these individuals' verbal intellectual processes from their visual-motor intellectual abilities. Principal components analysis was used to examine the interrelationship among the various intellectual abilities which such tests of intelligence measure. In Study II the intellectual abilities of a group of autistic 8-to 12-year-olds were compared to age-matched groups of children with receptive developmental language disorder, dysthymic disorder, or oppositional disorder. The intellectual abilities of autistic children were significantly different from the other groups of children.Research supported by NIMH grant 1-R01-MH36840, by NINCDS grant 5-R01-NS19855 awarded to E. Courchesne, and by Children's Hospital Research Center, San Diego. Valuable assistance has also been provided by the San Diego Regional Center, San Diego Unified School District, and Allen S. Kaufman.     

Autism in immigrants: children born in Sweden to mothers born in Uganda

Three boys diagnosed as suffering from autistic disorder were born in Sweden to mothers born in Uganda. Two were related but the third boy was unrelated to the others. The prevalence for autistic disorder in Goteborg children born to mothers who were born in Uganda was 15% which is almost 200 times higher than in the general population of children. The possible reason for the high autism rate in this particular ethnic subgroup is discussed.     

Hippocampus and amygdala volumes in parents of children with autistic disorder

OBJECTIVE: Structural and functional abnormalities in the medial temporal lobe, particularly the hippocampus and amygdala, have been described in people with autism. The authors hypothesized that parents of children with a diagnosis of autistic disorder would show similar changes in these structures. METHOD: Magnetic resonance imaging scans were performed in 17 biological parents of children with a diagnosis of DSM-IV autistic disorder. The scans were compared with scans from 15 adults with autistic disorder and 17 age-matched comparison subjects with no personal or familial history of autism. The volumes of the hippocampus, amygdala, and total brain were measured in all participants. RESULTS: The volume of the left hippocampus was larger in both the parents of children with autistic disorder and the adults with autistic disorder, relative to the comparison subjects. The hippocampus was significantly larger in the adults with autistic disorder than in the parents of children with autistic disorder. The left amygdala was smaller in the adults with autistic disorder, relative to the other two groups. No differences in total brain volume were observed between the three groups. CONCLUSIONS: The finding of larger hippocampal volume in autism is suggestive of abnormal early neurodevelopmental processes but is partly consistent with only one prior study and contradicts the findings of several others. The finding of larger hippocampal volume for the parental group suggests a potential genetic basis for hippocampal abnormalities in autism.     

Autistic traits in the general population: a twin study

BACKGROUND: Recent research has indicated that autism is not a discrete disorder and that family members of autistic probands have an increased likelihood of exhibiting autistic symptoms with a wide range of severity, often below the threshold for a diagnosis of an autism spectrum disorder. OBJECTIVE: To examine the distribution and genetic structure of autistic traits in the general population using a newly established quantitative measure of autistic traits, the Social Responsiveness Scale (formerly known as the Social Reciprocity Scale). METHODS: The sample consisted of 788 pairs of twins aged 7 to 15 years, randomly selected from the pool of participants in a large epidemiologic study (the Missouri Twin Study). One parent of each pair of twins completed the Social Responsiveness Scale on each child. The data were subjected to structural equation modeling. RESULTS: Autistic traits as measured by the Social Responsiveness Scale were continuously distributed and moderately to highly heritable. Levels of severity of autistic traits at or above the previously published mean for patients with pervasive developmental disorder not otherwise specified were found in 1.4% of boys and 0.3% of girls. Structural equation modeling revealed no evidence for the existence of sex-specific genetic influences, and suggested specific mechanisms by which females may be relatively protected from vulnerability to autistic traits. CONCLUSIONS: These data indicate that the social deficits characteristic of autism spectrum disorders are common. Given the continuous distribution of these traits, it may be arbitrary where cutoffs are made between research designations of being "affected" vs "unaffected" with a pervasive developmental disorder. The genes influencing autistic traits appear to be the same for boys and girls. Lower prevalence (and severity) of autistic traits in girls may be the result of increased sensitivity to early environmental influences that operate to promote social competency.     

Psychiatric disorders in individuals with pervasive developmental disorder

Pervasive developmental disorders (PDD) refer to the group of heterogeneous conditions that make up a continuum or spectrum of autistic disorders and share a core triad of impairments consisting of qualitative disturbances in social interaction and verbal and nonverbal communication and imagination. It has long been believed that the prevalence of autism was 2-4 per 10,000 children. However, studies using broader definitions of autistic disorder have suggested that the prevalence of autism spectrum disorder may be as high as 90 per 10,000 and that a greater proportion of individuals with PDD have intellectual levels above 70. Clinicians and researchers have commented on the apparent increase in prevalence of the disorder and have offered a number of explanations, including better recognition and diagnosis of the autism spectrum of disorders and a real increase in the disturbance. It is being increasingly recognized that individuals with PDD are at risk for a wide array of psychiatric disturbances, including affective disorder, anxiety disorders, schizophrenia-like psychosis, aggression, antisocial behavior, and Tourette's disorder (TD). Evidence indicates that PDD is significantly related to the comorbid psychiatric disorders and TD. Because PDD is not rare, individuals with autism spectrum disorder may represent significant subgroups of severely emotionally disturbed patients referred for psychiatric treatment. Because of lack of awareness that the clinical manifestations of PDD are heterogeneous and often mild and that comorbid psychiatric disturbances may obscure the symptoms of the developmental disorder, the diagnosis of PDD may be missed. Implications for practicing clinicians are discussed.     

Autistic social impairment in the siblings of children with pervasive developmental disorders

OBJECTIVE: Sibling recurrence risk in autism has been estimated to be approximately 10%. This study investigated subsyndromal autistic impairments among siblings of probands with pervasive developmental disorders. METHOD: The authors used the Social Responsiveness Scale to obtain quantitative assessments of autistic social impairment in three groups of proband-sibling pairs: 1) autistic children from multiple-incidence families and their closest in age nonautistic brothers (N=49 pairs); 2) children with any pervasive developmental disorder, including autism, and their closest-in-age brothers (N=100 pairs), and 3) children with psychopathology unrelated to autism and their closest-in-age brothers (N=45 pairs). RESULTS: Sibling Social Responsiveness Scale scores were continuously distributed and substantially elevated for both the autistic and pervasive developmental disorder groups. Highest scores (i.e., greatest impairment) were seen among siblings of autistic probands from multiple-incidence families, followed by siblings of probands with any pervasive developmental disorder, then siblings of probands with psychopathology unrelated to autism. CONCLUSIONS: Taken together with previous findings, these results support the notion that genetic susceptibility factors responsible for common, subsyndromal social impairments may be related to the causes of categorically defined pervasive developmental disorders.     

Fragile X positivity in Chinese children with autistic spectrum disorder.

Chromosome analysis was performed in 105 Chinese children (96 boys, 9 girls) with autistic spectrum disorder to assess fragile X positivity. Seventy percent of these autistic children were mentally retarded. None of the children in the infantile autism group (N = 75) had fragile X positivity. Two boys in the autistic condition group (N = 30) had clinical features and chromosomal positivity for fragile X syndrome. The low (2%) prevalence rate of fragile X positivity in children with different degrees of expressivity of autistic features may be related to other factors rather than to pure autistic characteristics per se.