The Term Comorbidity Is of Questionable Value in Reference to Developmental Disorders
The Term Comorbidity Is of Questionable Value in Reference to Developmental Disorders
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术语“共病”对于发育障碍的价值值得怀疑
DOI：
--
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发表时间：
2001
影响因子：
3
通讯作者：
B. Wilson
中科院分区：
文献类型：
--
作者：
B. Kaplan;D. Dewey;S. Crawford;B. Wilson
在过去的十年中，评估儿童和成人发育综合征或疾病重叠的研究数量大幅增加。这种症状的重叠通常被称为合并症，我们在本文中批评这个术语，因为它对独立病因的推定未经证实。本文的前提是现实生活中不存在离散的类别，并且将重叠的类别或症状称为“合并症”是具有误导性的。我们通过提供 179 名学龄儿童的数据来说明我们的观点，这些儿童按照严格的研究标准对七种疾病进行了评估：阅读障碍 (RD)、注意力缺陷/多动障碍 (ADHD)、发育性协调障碍 (DCD)、对立违抗障碍 (ODD)、品行障碍 (CD)、抑郁和焦虑。该样本中有 50% 的人符合至少两项诊断的标准。与患有 RD 的儿童相比，患有 ADHD 的儿童至少患有第二种疾病的风险更高。总体而言，在这个广泛确定的样本中，这些行为、情感和教育缺陷的高重叠率支持了共病概念不充分的观点。我们讨论非典型大脑发育的概念，作为解释发育障碍高重叠率的解释性想法。
Over the last decade, there has been an enormous increase in the number of studies evaluating the overlap of developmental syndromes or disorders in both children and adults. This overlap of symptoms is often referred to as comorbidity, a term we criticize in this article because of its unsubstantiated presumption of independent etiologies. The premise of this article is that discrete categories do not exist in real life, and that it is misleading to refer to overlapping categories or symptoms as "comorbidities." We illustrate our point by presenting data from 179 school-age children evaluated with rigorous research criteria for seven disorders: reading disability (RD), attention-deficit/hyperactivity disorder (ADHD), developmental coordination disorder (DCD), oppositional defiant disorder (ODD), conduct disorder (CD), depression, and anxiety. Fully 50% of this sample met the criteria for at least two diagnoses. The children with ADHD were at higher risk of having at least a second disorder compared to the children with RD. Overall, the high rates of overlap of these behavioral, emotional, and educational deficits in this broadly ascertained sample support the idea that the concept of comorbidity is inadequate. We discuss the concept of atypical brain development as an explanatory idea to interpret the high rate of overlap of developmental disorders.
儿童和青少年的抑郁合并症：经验、理论和方法论问题。
DOI：
10.1176/ajp.150.12.1779
发表时间：
1993
期刊：
The American journal of psychiatry
影响因子：
--
作者：
Angold,A;Costello,EJ
通讯作者：
Costello,EJ
发育性阅读障碍的家庭模式，第二部分：行为表型。
DOI：
10.1002/ajmg.1320600604
发表时间：
1995
期刊：
American journal of medical genetics.
影响因子：
--
作者：
Wolff,PH;Melngailis,I;Obregon,M;Bedrosian,M
通讯作者：
Bedrosian,M