Psychiatric Co-morbidities muASD: Inotarisa paSchizophrenia

Ini nguva pfupi yadarika ndakaverenga chinyorwa chakakura pamasekete nhau nezvepfungwa dzezvepfungwa mune vanhu vakuru vane autism (ASD) uye kucherechedzwa kwekushomeka kwehutano hwehutachiona (ADHD). Chinyorwa chenhau chaipfupikisa bepa richangoburwa nevaongorori veNorway rakaburitswa muBiological Psychiatry.

Vanotsvaga vakaongorora zvinyorwa zvemamiriyoni 1.7 vakuru veNorway- vamwe vane chirwere cheASD, vamwe vane ADHD, vamwe vane ASD neADHD, uye vamwe vasina ASD kana ADHD. Chinangwa chaive chekunzwisisa zvirinani mapatani ezvepfungwa co-morbidities (kubatana-kunoitika kuongororwa) kune vanhu vakuru vane ASD, ADHD, kana zvese zviri zviviri. Kunyanya, vaongorori vakatarisa pane zvinotevera co-morbid diagnoses: kusagadzikana kwekushushikana, kushushikana kukuru kwekushushikana, bipolar kusagadzikana, kusagadzikana kwehunhu, schizophrenia, uye kusagadzikana kwekushandisa zvinodhaka.

Pakazara, kusangana-kwekushushikana kwepfungwa kusagadzikana kwaive pakati pe2-14 nguva dzakajairika kune vanhu vakuru vane ADHD uye / kana ASD zvichienzaniswa nevakuru vasina kana kuongororwa. Iyo pateni yeiyo co-morbid kusagadzikana yaive yakanyanya kusiyana pakati pemapoka. Bipolar kusagadzikana, kushushikana kukuru kwekushungurudzika, kusagadzikana kwehunhu, uye kusagadzikana kwekushandisa zvinodhaka zvaiwanzoitika kune vanhu vakuru vane ADHD kupfuura kune vakuru vane ASD. Zvisinei, vanhu vakuru vane ASD vainyanya kuva nechichichiphrenia kupfuura vanhu vakuru vane ADHD. Muchokwadi, vakuru vane ASD vaive nekanenge ka14 mukana wekuti vave nechichichiphrenia kupfuura vanhu vakuru muhuwandu hwevanhu (vakuru vane ADHD vaive nekanenge ka4 mukana wekuve nechichichiphrenia kupfuura vanhu vakuru muhuwandu hwevanhu).

Ini ndinonyanya kufarira zviwanikwa zvine chekuita neschizophrenia uye ASD yakapihwa nhoroondo yemamiriro maviri aya uye kunzwisisa kwedu kwazvino kuti vangangopindirana sei. Nhoroondo yekare, ASD uye schizophrenia zvaionekwa sechinhu chimwe chete, uye izwi rekuti "autism" raishandiswa zvakasiyana neschizophrenia kusvika kuma1970. Hindsight inogara iri 20/20, saka zviri nyore kuti tibvise zvataifunga kare pamusoro peiyi inopindirana sezvo isisiri kukosha. Nekudaro, zvidzidzo zvakaita senge iri pamusoro zvinoratidza pfungwa yakakosha nezveASD uye schizophrenia iyo yave ichinyanya kuzivikanwa pamusoro pemakore gumi apfuura: aya mamiriro maviri anoita kunge anogovera zvimwe zvakafanana zvinhu.

Izvi zvakajairika zvave zvichionekwa zvine hunhu, uye nemajini uye neuroscience kutsvagisa.

Maitiro, mamiriro ese ari maviri anogovera matambudziko nekudyidzana kwevanhu uye kudzokerana. Vanhu vane ASD vanoomerwa nekuita hurukuro nevamwe vachiwanzofungidzirwa sevane "flat touch", chinova chinhu chinowanzotaurwa nezvechichichiphrenia.

Panyaya ye genetics, pane humbowo hwehunhu pakati kusagadzikana. R esearch yawana humbowo hwekuti vana vari panjodzi huru yeASD kana vaine mubereki ane schizophrenia. Ndokunge, kuongororwa kweschizophrenia mumubereki kunowedzera njodzi yeASD muvana.

Ongororo yeNeuroscience yakaratidza kuti mapoka ese ari maviri anoratidza kusagadzikana kweiyo prefrontal cortex kana ichiona zviso uye kana ichiita fungidziro yemabasa epfungwa. Izvi zvinoratidzira fanano pakati pemamiriro maviri aya maratidziro anoita huropi kumagariro. Izvi zvinonyanya kunakidza muchiedza chehunhu hwekucherechedza kuti kudyidzana munharaunda kwakaomera mapato ese ari maviri.

Kiriniki, zvakaoma chaizvo kuongorora schizophrenia muASD, kana ASD muschizophrenia. Chiremba anofanirwa kuita kubvunzurudzwa uye kuyedza kubvarura izvo zvinonzi zvisina kunaka zviratidzo zvechichichiphrenia (kubvisa, kubata kwakadzika, kudzikisira kutaura) kubva kuzviratidzo zvehukama zvine hukama neASD.

Rudzi urwu rwekuongororwa rwakanyanya kukosha kune vechidiki vechidiki vane ASD vanogona kunge vachirwara nepfungwa kekutanga, uye ndiani anoda kurapwa nekukurumidza. Nehurombo, zviratidzo izvo zvinoratidza kwekutanga psychotic episode dzimwe nguva zvinofuratirwa kune vechidiki vechidiki vane ASD kana varapi uye vanochengeta vachifunga kuti zviratidzo chikamu cheASD. Isu takaona mashoma mashoma akadai seakiriniki, uye kunonoka kurapwa kwevakuru vechidiki vari kusangana nezviratidzo zvekutanga zve psychosis kune zvakashata pamhedzisiro yenguva refu.

Pakazara, zviri pachena kuti kufanana uye kupindirana pakati pemamiriro maviri aya hakugone kufuratirwa, uye hakufanirwe kudzingwa seyechinyakare zano. Iko kune kudikanwa kwakati kweiri nani uye yakajeka bvunzurudzo kuitira kuti uongorore schizophrenia muASD, kana ASD mune avo vane schizophrenia, sezvo izvi zvichizobatsira kuvandudza mhedzisiro kune vanhu vanorarama nemamiriro aya.

Sugranyes G, Kyriakopoulos M, Corrigall R, Taylor E, Frangou S (2011) Autism spectrum disor-disers uye schizophrenia: meta-ongororo yeiyo neural correlates yenzvimbo yekuziva. PLoS Imwe 6 (10): e25322

Chisholm, K., Lin, A., & Armando, M. (2016). Schizophrenia spectrum kusagadzikana uye autism spectrum kusagadzikana. MuPsychiatric Zviratidzo uye Comorbidities mu Autism Spectrum Disorder (map. 51-66). Chinobhururuka, Cham.

Solberg BS et al. Biol. Psychiatry Epub pamberi pekudhinda (2019)