PDF(Pubmed)
Abstract：
Objective: This study aims to delineate the characteristics of severe self-injurious behaviors (SIB) in a cohort of children with autism and unspecified intellectual developmental disorder (UIDD) (intellectual disability) and examine potential risk factors for developing SIB. Methods: A retrospective chart review studied characteristics of severe SIB in 30 children with autism spectrum disorder (ASD) and UIDD referred to a tertiary care center. Characteristics examined include genetic syndromes, brain MRI abnormalities, verbal ability, adaptive functioning, SIB frequency and severity, age of onset, number of psychopharmacological agents, irritability, hyperactivity, stereotypy, psychiatric and physical comorbidities, among others. Descriptive and bivariate analysis were applied to explore potential relationships between factors. Results: Children with severe SIB exhibit this behaviour with high frequency, inflicting moderate to severe injury. Most children in the study sample are non-verbal and have ASD (93.3%; n = 28) with psychiatric (96.7%; n = 29) and physical (90%; n = 27) comorbidities. Overall SIB improvement using the Clinical Global Impression, Improvement Score (CGI-I) was 3.0 (minimally improved). A minority were much or very much improved following appropriate intervention. Conclusions: The severity of SIB is much higher in this sample than previously noted in the literature. Severe SIB is associated with ADHD, early onset mood disorders, tics, avoidant restrictive food intake disorder and Obsessive-Compulsive Disorder.
摘要：
目的：本研究旨在描述自闭症和未指定智力发育障碍（UIDD）（智力残疾）儿童中严重的自我伤害行为（SIB）的特征，并研究发展SIB的潜在危险因素。方法：回顾性图表回顾研究了转诊到三级护理中心的30名自闭症谱系障碍（ASD）和UIDD儿童的严重SIB特征。检查的特征包括遗传综合征，脑部MRI异常，言语能力,适应性功能，SIB频率和严重性，发病年龄,精神药物的数量，烦躁，多动症,刻板印象，精神病和身体合并症，在其他人中。描述性和双变量分析用于探索因素之间的潜在关系。结果：患有严重SIB的儿童表现出这种行为的频率很高，造成中度至重度伤害。研究样本中的大多数儿童是非语言的，患有ASD（93.3％；n=28），精神病（96.7％；n=29）和身体（90％；n=27）合并症。使用临床总体印象的总体SIB改善，改善评分（CGI-I）为3.0（最低改善）。经过适当的干预，少数人得到了很大或很大的改善。结论：该样本中SIB的严重程度远高于文献中先前提到的。严重的SIB与多动症有关，早发情绪障碍,Tics,避免限制性食物摄入障碍和强迫症。
