Aggression and psychiatric comorbidity in children with hypothalamic hamartomas and their unaffected siblings.
Aggression and psychiatric comorbidity in children with hypothalamic hamartomas and their unaffected siblings.
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下丘脑错构瘤儿童及其未受影响的兄弟姐妹的攻击性和精神共病。
DOI：
10.1097/00004583-200106000-00015
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发表时间：
2001
影响因子：
13.3
通讯作者：
Zametkin,AJ
中科院分区：
文献类型：
--
作者：
Weissenberger,AA;Dell,ML;Liow,K;Theodore,W;Frattali,CM;Hernandez,D;Zametkin,AJ
目的评估患有下丘脑错构瘤和弹力性惊厥的儿童样本中的攻击性和精神共病，并评估研究对象的兄弟姐妹的精神病学诊断。方法有脑弹力性惊厥和下丘脑错构瘤临床病史的儿童(n=12，年龄3-14岁)经视频脑电图和头部磁共振成像确诊。进行结构化访谈，包括儿童和青少年诊断性访谈-修订的父母形式(DICA-R-P)，广泛认知能力测试和Vitiello攻击性量表。对每个受试者的父母和年龄最接近的兄弟姐妹进行了DICA-R-P访谈，这些兄弟姐妹没有癫痫发作和下丘脑错构瘤。结果患有弹力性惊厥和下丘脑错构瘤的儿童合并精神疾病的比例显著增加，包括对立违抗障碍(83.3%)和注意力缺陷/多动障碍(75%)。他们还表现出较高的行为障碍(33.3%)、言语障碍/学习障碍(33.3%)以及焦虑和情绪障碍(16.7%)。注意到显著的攻击率，58%的癫痫患者符合情感攻击亚型的标准，30.5%的患者具有捕食性攻击亚型。情绪性攻击明显更常见(p<；0.05)。未受影响的兄弟姐妹在半结构父母访谈中表现出较低的精神病理发生率，并通过Vitiello攻击性量表测量没有攻击性。结论患有下丘脑错构瘤和弹力性癫痫的儿童有较高的精神共病和攻击性。父母报告说，健康的兄弟姐妹精神病理和攻击性的发生率非常低。
OBJECTIVETo assess aggression and psychiatric comorbidity in a sample of children with hypothalamic hamartomas and gelastic seizures and to assess psychiatric diagnoses in siblings of study subjects.METHODChildren with a clinical history of gelastic seizures and hypothalamic hamartomas (n = 12; age range 3–14 years) had diagnoses confirmed by video-EEG and head magnetic resonance imaging. Structured interviews were administered, including the Diagnostic Interview for Children and Adolescents-Revised Parent Form (DICA-R-P), the Test of Broad Cognitive Abilities, and the Vitiello Aggression Scale. Parents were interviewed with the DICA-R-P about each subject and a sibling closest in age without seizures and hypothalamic hamartomas. Patients were seen from 1998 to 2000.RESULTSChildren with gelastic seizures and hypothalamic hamartomas displayed a statistically significant increase in comorbid psychiatric conditions, including oppositional defiant disorder (83.3%) and attention-deficit/hyperactivity disorder (75%). They also exhibited high rates of conduct disorder (33.3%), speech retardation/learning impairment (33.3%), and anxiety and mood disorders (16.7%). Significant rates of aggression were noted, with 58% of the seizure patients meeting criteria for the affective subtype of aggression and 30.5% having the predatory aggression subtype. Affective aggression was significantly more common (p < .05). Unaffected siblings demonstrated low rates of psychiatric pathology on semistructured parental interview and no aggression as measured by the Vitiello Aggression Scale.CONCLUSIONSChildren with hypothalamic hamartomas and gelastic seizures had high rates of psychiatric comorbidity and aggression. Parents reported that healthy siblings had very low rates of psychiatric pathology and aggression.
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