BMJ子刊:神经发育障碍与青春期典型发育、性别和行为之前的关系

2022-08-29 liangying MedSci原创

青春期对于患有和未患有NDD的青少年来说都是一个重要的里程碑,也是一个进行预期指导的重要机会。对于女性来说,尤其是NDDs患者,应监测情感障碍。

一般情况下,父母和临床医生都认为青春期是心理健康和行为恶化的时期,尤其是患有神经发育障碍(NDD)的儿童和青少年。令人惊讶的是,支持这一观念的证据很少,而这些信息对于为患有NDD的青少年及其家庭提供前瞻性指导以及帮助临床医生评估和管理青春期的情绪和行为问题至关重要。

患有自闭症障碍(ASD)注意缺陷/多动障碍(ADHD)强迫症(OCD)NDDs的青少年在青春期可能面临心理健康问题和干扰行为的额外风险。每一种疾病都存在着性别差异,这表明在发育早期接触性类固醇可能起到了促进作用——通过激素水平导致神经发育的差异。

本研究的目的是评估青春期阶段与各种NDD内部和外部行为之间的关系,并解释其中的性别差异。

这是一项来自安大略省神经发育障碍网络的横断面研究,包括患有各种NDD和正常发育(TD)对照的儿童/青年。护理人员完成了儿童行为检查表(CBCL)。参与者被分为三个青春期阶段:青春期前期(Tanner 1期)、青春期早期(Tanner 2-3期)和青春期晚期(Tanner 4-5期)。控制性别和诊断,评估青春期与CBCL评分之间的关联。

最后的分析包括1043名参与者(男性=733;70.3%)。青春期状态、性别和诊断之间的三方交互作用对于内化或外化行为并不显著。诊断与内化行为(p<0.0001)和外化行为(p<0.001)的CBCL得分显著相关,TD儿童的得分低于NDD组。与青春期前女性相比,青春期后期女性表现出更高水平的内化行为(p=0.001),男性则无差异。与青春期前男性相比,青春期早期男性表现出较低的外化行为水平(p=0.01),与青春期前女性相比,青春期早期的女性有更高的水平(p=0.051)。

多变量线性回归*CBCL外部化行为、预测得分和得分差异

总之,与TD同龄人相比,本研究分析未能发现患有NDD的儿童/青年内在和外在行为的独特模式。与TD同龄人相比,NDDs儿童的行为水平更高,且出现了重要的性别差异,女性在青春期后期表现出明显更高的内化行为水平。青春期对于患有和未患有NDD的青少年来说都是一个重要的里程碑,也是一个进行预期指导的重要机会。对于女性来说,尤其是NDDs患者,应监测情感障碍。

参考文献:Penner MDupuis AArnold P, et al. Pubertal stage, sex and behaviour in neurodevelopmental disorders versus typical development: a cross-sectional study.

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    2023-07-04 gaoxiaoe
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