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

为探讨DSM-IV儿童解体障碍(CDD)的临床效度，将10例CDD儿童(男=7.7岁；男7例，女3例)，11例(男=6.5岁；男9例，女2例)ICD-9解体精神病(DP)诊断为DSM-IV自闭症(DP-AD)，7例(男=6.1岁；男5例，女2例)诊断为DSM-IV PDDNOS(DP-PDDNOS)，82例(M=5.9岁)；对62例男性、20例女性AD伴言语损失(ASL)患者在回归前、中、后分别进行16、8、24个变量的比较。在年龄和性别比无显著差异的4组中，12个变量经后组比较显示有显著差异。回归前，CDD在1岁左右的分离性焦虑症中明显高于ASL，在膀胱控制方面明显好于DP-AD和ASL，在膀胱控制方面明显好于DP-AD和ASL。在正常关系中，ASL在正常关系中比CDD和DP-AD更不常见。在回归过程中，CDD比ASL更频繁地失去手指，膀胱控制比DP-AD和ASL更常见。回归后，ASL比其他3个人更少使用两个单词的短语和更早失语。CDD表现为癫痫和刻板印象明显高于ASL，DP-PDDNOS表现为言语交流障碍明显轻于ASL。35在4组间差异无统计学意义。虽然CDD在回归前发育较好，回归较清晰，但回归后4年左右，CDD与ASL在发育和孤独症倾向上的差异消失，与DP-AD和DP-PDDNOS的差异缩小。CDD具有临床有效性。它的发育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.