儿童和青少年自闭症谱系障碍及并发症的患病率:系统性文献综述。

Focus (American Psychiatric Publishing) Pub Date : 2024-04-01 Epub Date: 2024-04-10 DOI:10.1176/appi.focus.24022005
Clémence Bougeard, Françoise Picarel-Blanchot, Ramona Schmid, Rosanne Campbell, Jan Buitelaar
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引用次数: 0

摘要

目的:自闭症谱系障碍患者通常伴有躯体疾病和/或精神疾病。DSM-5 允许考虑自闭症谱系障碍以外的其他诊断,这可能会影响合并疾病的患病率,而且在捕捉男女患病率的真实差异方面也存在局限性。我们描述了儿童和青少年中 ASD 的患病率以及经常观察到的并发症(方法:我们在 PubMed 和 Embase 上进行了两项系统性文献综述,时间跨度为 2014-2019 年,重点关注 ASD 的患病率以及根据患病频率和/或严重程度确定的九种相关并发症:注意力缺陷多动障碍(ADHD)、焦虑、抑郁障碍、癫痫、智力障碍(ID)、睡眠障碍、视力/听力障碍/损失和胃肠综合征(GI):结果:共纳入 13 项关于 ASD 患病率的研究和 33 项关于合并疾病患病率的研究。美国 4 岁和 8 岁儿童的 ASD 患病率分别为 1.70% 和 1.85%,而欧洲的患病率介于 0.38% 和 1.55% 之间。此外,目前有证据表明,在过去几年中,全球 ASD 患病率有所上升。合并疾病的患病率存在很大的异质性:多动症(0.00-86.00%)、焦虑症(0.00-82.20%)、抑郁症(0.00-74.80%)、癫痫(2.80-77.50%)、智障(0.00-91.70%)、睡眠障碍(2.08-72.50%)、视力/听力障碍/丧失(0.00-14.90%/0.00-4.90%)和消化道综合征(0.00-67.80%)。这些研究在设计和估计患病率的方法方面存在差异。性别似乎是共病多动症(男性发病率较高)和癫痫/癫痫发作(女性发病率较高)的一个风险因素,而年龄也与多动症和焦虑症有关(直到青春期才会增加):我们的研究结果对儿童和青少年中 ASD 及其并发症的患病率进行了描述性回顾。这些见解对临床医生和自闭症儿童的家长/监护人很有价值。随着时间的推移,自闭症的患病率越来越高,而合并症又给临床表现带来了更多的异质性,这就进一步要求我们采取个性化的治疗和支持方法。清楚地了解自闭症的发病率及其并发症对于提高利益相关者的认识非常重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prevalence of Autism Spectrum Disorder and Co-Morbidities in Children and Adolescents: A Systematic Literature Review.

Objective: Individuals with autism spectrum disorder often present somatic and/or psychiatric co-morbid disorders. The DSM-5 allows for consideration of additional diagnoses besides ASD and may have impacted the prevalence of co-morbidities as well as being limited in capturing the true differences in prevalence observed between males and females. We describe the prevalence of ASD and frequently observed co-morbidities in children and adolescents (<18 years) in the United States and five European countries.

Methods: Two systematic literature reviews were conducted in PubMed and Embase for the period 2014-2019 and focusing on the prevalence of ASD and nine co-morbidities of interest based on their frequency and/or severity: Attention Deficit Hyperactivity Disorder (ADHD), anxiety, depressive disorders, epilepsy, intellectual disability (ID), sleep disorders, sight/hearing impairment/loss, and gastro-intestinal syndromes (GI).

Results: Thirteen studies on prevalence of ASD and 33 on prevalence of co-morbidities were included. Prevalence of ASD was 1.70 and 1.85% in U.S children aged 4 and 8 years respectively, while prevalence in Europe ranged between 0.38 and 1.55%. Additionally, current evidence is supportive of a global increase in ASD prevalence over the past years. Substantial heterogeneity in prevalence of co-morbidities was observed: ADHD (0.00-86.00%), anxiety (0.00-82.20%), depressive disorders (0.00-74.80%), epilepsy (2.80-77.50%), ID (0.00-91.70%), sleep disorders (2.08-72.50%), sight/hearing impairment/loss (0.00-14.90%/0.00-4.90%), and GI syndromes (0.00-67.80%). Studies were heterogeneous in terms of design and method to estimate prevalence. Gender appears to represent a risk factor for co-morbid ADHD (higher in males) and epilepsy/seizure (higher in females) while age is also associated with ADHD and anxiety (increasing until adolescence).

Conclusion: Our results provide a descriptive review of the prevalence of ASD and its co-morbidities in children and adolescents. These insights can be valuable for clinicians and parents/guardians of autistic children. Prevalence of ASD has increased over time while co-morbidities bring additional heterogeneity to the clinical presentation, which further advocates for personalized approaches to treatment and support. Having a clear understanding of the prevalence of ASD and its co-morbidities is important to raise awareness among stakeholders.Appeared originally in Front Psychiatry 2021; 12:744709.

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