实施《国际疾病分类》第 11 次修订版中关于并发自闭症谱系障碍的智力发育障碍行为指标。

IF 2.1 2区 医学 Q1 EDUCATION, SPECIAL
K. R. Lemay, C. S. Kogan, T. Rebello, J. W. Keeley, R. Bhargava, S. Buono, S. Cooray, P. Ginige, M. T. Kishore, J. V. S. Kommu, M. Recupero, A. Roy, P. Sharan, G. M. Reed
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引用次数: 0

摘要

背景:世界卫生组织《国际疾病分类》第 11 版(ICD-11)对精神、行为和神经发育障碍的分类包括神经发育障碍分组中的一整套行为指标(BIs)。在没有或无法对智力功能和适应行为进行标准化测量的情况下,行为指标可用于评估智力发育障碍的严重程度。这项国际性研究考察了智力发育障碍和自闭症谱系障碍(ASD)中智力障碍和适应行为严重程度的标准化测量方法,并将其与标准化测量方法进行了比较。此外,还评估了 ICD-11 的临床实用性及其在国际临床环境中应用的忠实性:共有 116 名儿童和青少年(5-18 岁)被疑似或确诊为智力发育障碍,他们来自四个地方[意大利(n = 18)、斯里兰卡(n = 19)和印度的两个地方(n = 79)]。我们进行了主成分分析,以评估 ICD-11 指南在合并严重程度等级方面的应用:结果:使用生物统计学指标进行的评估显示,被归类为轻度严重程度的患者比例较高,而标准化测量结果显示,被归类为重度严重程度的患者比例较高。此外,BIs 和标准化测量结果均显示,与无 ASD 的患者相比,合并 ASD 的患者往往有更严重的障碍。总体而言,虽然在对同时患有智力发育障碍和 ASD 的个体应用指南时需要更多的时间和考虑,但 BIs 被认为在临床上是有用的。主成分分析显示,一个主成分代表了智力发育障碍的整体严重程度:结论:在国际临床环境中,ICD-11 BIs 可按预期用于神经发育障碍患者的各种表现。使用 BIs 所得出的诊断结果与使用标准化测量方法得出的诊断结果相似。在没有适当的智力和适应行为标准化测量方法或这些方法不可行的情况下,《国际功能、残疾和健康分类》有望提高严重程度评估的可靠性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Implementation of the International Classification of Diseases 11th revision behavioural indicators for disorders of intellectual development with co-occurring autism spectrum disorder

Background

The classification of mental, behavioural and neurodevelopmental disorders in the World Health Organization's International Classification of Diseases 11th revision (ICD-11) includes a comprehensive set of behavioural indicators (BIs) within the neurodevelopmental disorders grouping. BIs can be used to assess the severity of disorders of intellectual development in situations in which standardised measures of intellectual functioning and adaptive behaviours are not available or feasible. This international study examines the implementation characteristics of the BIs and compares them to standardised measures for assessing the severity of intellectual impairment and adaptive behaviours in disorders of intellectual development and autism spectrum disorder (ASD). The clinical utility of the ICD-11 and the fidelity of its application in international clinical settings were also assessed.

Methods

A total of 116 children and adolescents (5–18 years old) with a suspected or established diagnosis of disorders of intellectual development were included across four sites [Italy (n = 18), Sri Lanka (n = 19) and two sites in India (n = 79)]. A principal component analysis was conducted to evaluate the application of the ICD-11 guidance for combining severity levels.

Results

Assessment using the BIs showed a higher proportion of individuals classified with mild severity, whereas the standardised measures indicated a higher proportion of severe ratings. Additionally, individuals with co-occurring ASD tended to have more severe impairments compared with those without ASD, as indicated by both BIs and standardised measures. Overall, the BIs were considered clinically useful, although more time and consideration were required when applying the guidelines for individuals with a co-occurring disorder of intellectual development and ASD. The principal component analysis revealed one principal component representing overall disorders of intellectual development severity levels.

Conclusions

The ICD-11 BIs can be implemented as intended in international clinical settings for a broad range of presentations of individuals with neurodevelopmental disorders. Use of the BIs results in similar severity diagnoses to those made using standardised measures. The BIs are expected to improve the reliability of severity assessments in settings where appropriate standardised measures for intellectual and adaptive behaviours are not available or feasible.

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来源期刊
CiteScore
5.60
自引率
5.60%
发文量
81
期刊介绍: The Journal of Intellectual Disability Research is devoted exclusively to the scientific study of intellectual disability and publishes papers reporting original observations in this field. The subject matter is broad and includes, but is not restricted to, findings from biological, educational, genetic, medical, psychiatric, psychological and sociological studies, and ethical, philosophical, and legal contributions that increase knowledge on the treatment and prevention of intellectual disability and of associated impairments and disabilities, and/or inform public policy and practice. Expert reviews on themes in which recent research has produced notable advances will be included. Such reviews will normally be by invitation.
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