儿童精神病学中晚期发育回归的诊断难题:病例系列
Shalu Elizabeth Abraham1, Sakhardande Kasturi Atmaram1, Poornima Khadanga1
1Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India.
BJPsych open
|January 27, 2025
概括
晚期发作的儿童发育回归,没有神经学原因, presents一个诊断挑战. 大多数儿童在一年后表现出持续的缺陷,这突显了需要仔细的长期评估的必要性.
科学领域:
- 儿科神经学 儿科神经学
- 儿童精神病学 儿童精神病学
- 发展心理学 发展心理学
背景情况:
- 没有神经损伤的儿童的发育回归是一个诊断挑战.
- 精神病症状进一步使发育回归的诊断更加复杂.
研究的目的:
- 描述晚期发育回归和精神症状的儿童的临床过程和1年后的结果.
- 为了将这种表现与其他神经发育障碍区分开来.
主要方法:
- 十名儿童 (6-10岁) 的病例系列具有神经类型发育和晚期发病回归 (>6岁).
- 综合性临床评估,实验室测试和神经成像排除了神经病因.
- 一年后的长度随访评估了临床过程和功能.
主要成果:
- 回归时的平均年龄为7.65岁;平均疾病持续时间为10.1个月.
- 症状包括多个领域的回归,情绪障碍和幻觉/重复性行为.
- 在1年的随访中,90%的儿童没有恢复回归前的功能,在言语,语言,社会情感互惠和认知方面存在残余缺陷.
结论:
- 这种表现不同于自闭症谱系障碍和童年开始精神分裂症.
- 诊断的挑战来自症状重叠与儿童解体障碍 (CDD),自闭症和精神分裂症.
- 纵向跟踪对于了解不断变化的现象学,过程和结果至关重要;初步的CDD诊断可能有助于正在进行的病因学搜索.
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