journal1 ›› 2015, Vol. 23 ›› Issue (3): 257-260.DOI: 10.11852/zgetbjzz2015-23-03-11

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Clinical characteristics of symptom of autism based on DSM criteria and ABC evaluation

LI Gai-zhi,JIANG Wen-qing,DU Ya-song,JIANG Ling-xiao,LIU Wen-wen,YANG Cao-hua   

  1. Shanghai Mental Health Center,Medical School of Shanghai Jiaotong University,Shanghai 200030,China
  • Received:2014-09-18 Online:2015-03-10 Published:2015-03-10
  • Contact: DU Ya-song,E-mail:yasongdu@163.com

以DSM系统和ABC量表角度来看孤独症症状变化

李改智,江文庆,杜亚松,姜凌霄,刘文文,杨曹骅   

  1. 上海交通大学医学院附属精神卫生中心,上海 200030
  • 通讯作者: :杜亚松,E-mail:yasongdu@163.com
  • 作者简介:李改智(1987-),女,山西人,住院医师,在读博士研究生,研究方向为儿童青少年精神病与精神医学。
  • 基金资助:
    国家重点基础研究发展计划(973)(2010CB529602);上海市科委重点项目(11411952401);上海交通大学医工交叉重点项目[多学科交叉项目培育(医工)](YG2013ZD0503);2013年上海市精神卫生中心特色专科建设项目(2013-YJTSZK-04)

Abstract: Objective To know the characteristics of symptoms in autism,and to understand the diagnostic criteria of autism spectrum disorder (ASD) in DSM-Ⅴ. Methods Children with autism were diagnosed using DSM-Ⅳ criteria and assessed by Autism Behavior Checklist (ABC) in Shanghai Mental Health Center.Then the positive rates of each item in DSM-Ⅳ and ABC,and the difference of every item in DSM-Ⅳ between gender/age were analysed. Results 1)Among 466 autistic children,the highest positive rates of qualitative impairment in social interaction,communication,restricted repetitive and stereotyped patterns of behavior,interest and activities,delays or abnormal functioning were 95.3%,84.8%,79.8%,92.9% respectively.There were differences among ages on marked impairment in the use of multiple nonverbal behaviors;marked impairment in the ability to initiate or sustain a conversation with others; stereotyped and repetitive use of language or idiosyncratic language;apparently inflexible adherence to specific,nonfunctional routines or rituals; delays or abnormal functioning in social interaction.There was difference between boys and girls in language as used in social communication,persistent preoccupation with parts of objects.2) 263 of 466 children diagnosed by DSM-Ⅳ children met DSM-Ⅴ part A.3) The positive rates ranged from 34.2%~94% in ABC,there was difference between genders on item 27. Conclusions With DSM-Ⅴ,the diagnosis of ASD may decrease,social communication and language may get better with age,but the behavior may get worse.Gender may be not the primary factor that affect the symptoms.

Key words: autism, DSM-Ⅳ, DSM-Ⅴ, Autism Behavior Checklist

摘要: 目的 了解孤独症患儿的症状特点,进一步理解DSM-Ⅴ的孤独谱系障碍(autism spectrum disorder,ASD)的诊断标准。方法 对经DSM-Ⅳ诊断的466例孤独症患儿进行ABC评估,分析DSM-Ⅳ、ABC各个条目阳性率、不同性别及年龄段的阳性率。结果 1)466例孤独症患儿中,DSM-Ⅳ社交缺陷、言语缺陷、行为、功能延迟中,阳性率最高分别为95.3%,84.8%,79.8%,92.9%。5个条目存在年龄差异,2个条目存在性别差异,男性均高于女性。2)只有263名符合DSM-Ⅴ中社会交流和社会交往缺陷的标准。3)在ABC的57个条目中,阳性率最高的条目是38,占94%,最低的是条目34,占34.2%;男女生在第27条存在差异。结论 使用DSM-Ⅴ之后, ASD 诊断可能会下降,随着年龄增长,患者的社交和言语可能好转,但是行为问题表现更差,性别可能不是影响症状的原因。

关键词: 孤独症, DSM-Ⅳ, DSM-Ⅴ, Autism Behavior Checklist量表

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