Begleitsymptomatik bei tief greifenden Entwicklungsstörungen
II. Genetische Syndrome und neurologische Begleiterscheinungen
Abstract
Fragestellung: Kinder und Jugendliche mit tief greifenden Entwicklungsstörungen zeigen neben der Kernsymptomatik eine Vielzahl assoziierter Erkrankungen i. S. von genetischen Syndromen oder neurologischen Erkrankungen, die für die Behandlung und den Verlauf der Störung von Bedeutung sind. In der vorliegenden Arbeit wird die Art und Häufigkeit dieser somatischen Begleiterscheinungen in Relation zur Intelligenz der Patienten analysiert. Methodik: Die Stichprobe besteht aus 601 Patienten, bei denen zwischen 1997 und 2007 in der Abteilung für Entwicklungsstörungen des Heckscher-Klinikums die Diagnose einer tief greifenden Entwicklungsstörung gestellt wurde. Neben genetischen Syndromen wurden auch neurologische Störungen erfasst. Ergebnisse: 373 (62 %) der Patienten hatten eine, 121 (20 %) zwei Diagnosen auf der Achse IV des multiaxialen Klassifikationsschemas. Genetische Störungen wurden bei insgesamt 6 % (N = 37) der Stichprobe festgestellt. Die häufigsten neurologischen Diagnosen waren Bewegungsstörungen (N = 214; 35.6 %) und Epilepsien (N = 98; 16.3 %). Patienten mit einer Intelligenzminderung zeigen häufiger somatische Begleiterscheinungen als Patienten ohne Intelligenzminderung. Schlussfolgerungen: Tief greifende Entwicklungsstörungen sind komplexe Störungsbilder, die überzufällig häufig einhergehen mit neurologischen Störungen und einem breiten Spektrum an genetischen Syndromen. Kinder mit autistischen Störungen und einer Intelligenzminderung zeigen mehr Begleiterkrankungen und sind in der psychosozialen Anpassung deutlicher beeinträchtigt als Kinder mit autistischen Störungen ohne Intelligenzminderung.
Objective: Children with a pervasive developmental disorder show in addition to core symptoms a variety of genetic syndromes as well as neurological problems, which are relevant for the treatment and the course of the disorder. The objective of our study is to analyse the nature and the frequency of these co-morbid somatic disorders in relation to the level of intellectual functioning of the patients. Method: The sample consists of 601 patients with a pervasive developmental disorder diagnosed at the Department of Developmental Disorders at the Heckscher-Klinikum between 1997 and 2007. In addition to genetic syndromes, we also recorded a variety of neurological disorders. Results: 373 of the patients (62%) had at least one additional diagnosis and 121 (20%) had at least two additional diagnoses on Axis IV of the multi-axial classification scheme. Genetic syndromes were found in 6% of the patients (N = 37). Movement disorders (N = 214; 35.6%) and epilepsy (N = 98; 16.3%) were the most frequent neurological disorders. Children with mental retardation showed significantly more somatic diagnoses than children without mental retardation. Conclusions: Children with pervasive developmental disorders show a wide variety of co-morbid somatic problems, which are relevant for the treatment and the course of the disorder. Children with autism and mental retardation show more co-morbid conditions and are more impaired in their psychosocial adaptation than children with autism without mental retardation.
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