DSM-V在早期筛查孤独症谱系障碍患儿中的应用分析  

Analysis on application of DSM-V in early screening of autism spectrum disorder children

作　　者：王艳娟[1] 王文荣[1] 

机构地区：[1]江苏省连云港市妇幼保健院儿童心理卫生科,222006

出　　处：《中国妇幼保健》2015年第13期2011-2014,共4页Maternal and Child Health Care of China

基　　金：江苏省连云港市"科教兴卫工程"青年科技项目〔Q1210〕

摘　　要：目的:通过应用《美国精神疾病诊断与统计手册》第5版(DSM-V)作为诊断标准进行孤独症谱系障碍(ASD)的早期筛查,了解疾病在低年龄幼儿的患病情况以及新诊断标准在儿童保健医生进行疾病早期筛查工作中应用探讨。方法:应用分层整群抽样法,抽取新浦区6个街道及东海县15个乡镇的幼儿2 090例,应用原版幼儿孤独症筛查问卷(CHAT)-23结合克氏孤独症行为量表(CABRS)进行筛查,阳性者进一步检查,仍为可疑者由该院精神科副主任以上医师依据DSM-V确诊。结果:最终确诊为ASD 24例,总患病率为11.48‰。24例患儿都完成了神经心理发育测评,其中5例幼儿发育商正常,其余19例发育商落后,其中发育商轻度落后12例,中度3例,重度4例。除大运动外,其他方面两组患儿都表现出不同程度的落后。结论:依据最新诊断标准DSM-V,连云港市ASD患病率与美国最近报道结果接近,高于国内其他地区的多数报道,提示在儿童系统保健中应用新标准易于儿童保健医生早期识别ASD。Objective： To conduct early screening of autism spectrum disorder （ASD） using DSM-V （5th edition） as diagnostic criteria, understand the prevalence of ASD among young children, and explore the application of new diagnostic criteria in early screening of ASD. Methods： Stratified cluster sampling method was used to select 2 090 young children from 6 communities in Xinpu District and 15 villages and towns in Donghai county, CHAT-23 and CABRS were used for early screening, the positive children received further examination, then the children suspected of ASD were diagnosed definitely according to DSM-V by associate chief physicians or chief physicians in Department of Psychiatry in the hospital. Results： Finally, 24 children were diagnosed as ASD definitely, the total prevalence rate was 11.48%e. All the 24 children completed neuropsychological development assessment, the development quotients （DQs） of 5 children were normal; DQs of 19 children were low, 12 children with mild low-DQ, 3 children with moderate low-DQ, and 4 children with severe low-DQ were includ- ed. Excepting large motor, other indexes fell behind in varying degrees. Conclusion： According to the latest diagnostic criteria of DSM-V, the prevalence rate of ASD in Lianyungang is close to that reported in USA, while it is higher than those reported in other regions in China. The study indicates that the new diagnostic criteria is appropriate for child health care doctors to diagnose ASD early during child systematic health care.

关 键 词：孤独症谱系障碍 早期筛查 DSM-V 

分 类 号：R714.5[医药卫生—妇产科学]