A clinical study on symptoms, development and course of childhood disintegrative disorders

为研究DSM-IV儿童期分裂症（CDD）的临床效度，（男=7.7岁; 7男，3女），11（M=6.5岁; 9名男性，2名女性）患有ICD-9崩解性精神病（DP），诊断为DSM-IV自闭症障碍（AD）（DP-AD），7（M=6.1岁; 5名男性，2名女性）诊断为DSM-IV PDDNOS的DP（DP-PDDNOS）和82（M=5.9岁; 62名男性，20名女性）与AD与言语丧失（ASL）进行了比较，在16，8，和24个变量之前，期间，和回归后。在年龄和性别比无显著性差异的4组中，12个变量经事后比较有显著性差异。在回归前，CDD在1岁左右的分离焦虑方面显著强于ASL，手指指向比DP-PDDNOS和ASL更常见，膀胱控制比DP-AD和ASL更好。ASL使用两个词短语的频率显著低于其他3个词短语，更早失去语言，在正常关系中比CDD和DP-AD更少。CDD组手指指向障碍发生率显著高于ASL组，膀胱控制障碍发生率显著高于DP-AD组和ASL组，而ASL组的恐惧发生率显著低于其他3组。经回归分析，CDD组癫痫和刻板症状的发生率显著高于ASL组，DP-PDDNOS组言语沟通障碍的发生率显著低于ASL组，而IQ<35的儿童的孤独症倾向和发生率在4组间无显著性差异。虽然CDD在回归前发育较好，回归时较清晰，但回归后4年左右，其与ASL的发育和自闭症倾向差异消失，与DP-AD和DP-PDDNOS的差异减小。CDD具有临床有效性。它的发展结果可能与占自闭症人口20%至40%的ASL没有什么不同。

To study clinical validity of DSM-IV childhood disintegrative disorder (CDD), 10CDD children (M=7.7 years ; 7 male, 3 female), 11 (M=6.5 years ; 9 male, 2female) with ICD-9 disintegrative psychosis (DP) diagnosed as DSM-IV autistic disorder (AD)(DP-AD), 7 (M=6.1 years ; 5 male, 2 female) with DP diagnosed as DSM-IV PDDNOS (DP-PDDNOS), and 82 (M=5.9 years ; 62 male, 20 female) with AD with speech loss (ASL) were compared on 16, 8, and 24 variables before, during, and after regression, respectively. Among the 4 groups without significant difference in age and sex ratio, 12 variables showed a significant difference by post hoc comparisons. Before regression, CDD was significantly stronger in separation anxiety around age one than ASL, more common to use finger pointing than DP-PDDNOS and ASL, and better in bladder control than DP-AD and ASL.ASL was significantly less frequent to use a two-word phrase and earlier to lose speech than the other 3, and less common in normal relationship than CDD and DP-AD.During regression, CDD significantly more frequently lost finger pointing than ASL and bladder control than DP-AD and ASL.ASL showed significantly less commonly fearfulness than the other 3. After regression, CDD showed epilepsy and stereotypy significantly more frequently than ASL.DP-PDDNOS showed significantly milder verbal communication disturbance than ASL.The autistic tendency and rate of children with IQ<35 did not differ significantly among the 4 groups. Although CDD was better in development before regression and clearer in regression, its difference in development and autistic tendency from ASL disappeared and its differences from DP-AD and DP-PDDNOS decreased about 4 years after regression. CDD has clinical validity. Its developmental outcome may not be different from that of ASL occupying 20 to 40 % of the autism population.