雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

Seishin Igaku Volume 60, Issue 5 （May 2018）

精神医学 60巻5号（2018年5月発行）

Japanese English

研究と報告

愛媛大学病院精神科外来における成人期発達障害に対する診療パスの予備的研究 Clinical Pathway for Adult Neurodevelopmental Disorders at Ehime University Hospital Psychiatric Clinic: A preliminary study 河邉憲太郎 ^1,2 , 越智麻里奈 ^1,2,3 , 松本美希 ¹ , 近藤静香 ⁴ , 伊藤瑠里子 ^1,2 , 芳野歩美 ^1,2 , 妹尾香苗 ⁵ , 堀内史枝 ^1,2 , 上野修一 ¹ Kentaro Kawabe ^1,2 , Marina Ochi ^1,2,3 , Miki Matsumoto ¹ , Shizuka Kondo ⁴ , Ruriko Ito ^1,2 , Ayumi Yoshino ^1,2 , Kanae Seo ⁵ , Fumie Horiuchi ^1,2 , Shu-ichi Ueno ¹ ¹愛媛大学大学院医学系研究科分子・機能領域精神神経科学講座 ²愛媛大学医学部附属病院子どものこころセンター ³堀江病院 ⁴松山赤十字病院 ⁵倉敷中央病院小児科 ¹Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Ehime, Japan ²Center for Child Health, Behavior and Development, Ehime Univercity Hospital ³Horie Hospital ⁴Matsuyama Res Cross Hospital ⁵Department of Pediatrics, Kurashiki Central Hospital キーワード： Attention-deficit/hyperactivity disorder , Autism spectrum disorder , Intellectual disability , Outpatient Keyword: Attention-deficit/hyperactivity disorder , Autism spectrum disorder , Intellectual disability , Outpatient pp.545-557

発行日 2018年5月15日 Published Date 2018/5/15

DOI https://doi.org/10.11477/mf.1405205600

PDF(1507KB)

有料閲覧

Abstract 文献概要
1ページ目 Look Inside
参考文献 Reference

抄録　本研究は愛媛大学病院精神科外来において，成人期発達障害における発達障害の特徴を，診療パスの内容により検討することを目的とした。対象は2013〜16年に当院を初診し，発達障害の精査を希望した18歳以上の患者104名(男性57，女性47)である。診療パスは生育歴の聴取や主訴の問診票と，AQ-J，ASRS，CAARS，BDI-Ⅱ，SFS，SRSなどの質問紙とWAIS-Ⅲで構成されている。対象者のうちASD29例，ADHD18例，精神疾患に該当しない18例の3群を比較した。結果，ASD群はADHD群と比較して有意に男性，精神症状の主訴が多く，SFSが低値，WAIS-ⅢのVIQが高値であった。ADHD群は不注意の主訴，既婚者の割合，ASRSが有意に高かった。診療パスは精神症状や社会機能の把握に一定の有用性があった。本研究は予備的研究であり，診療パスにはさらなる検討が必要である。

　The aim of this study was to examine the clinical features of neurodevelopmental disorders in adulthood using the clinical pathway at the psychiatric clinic of Ehime University Hospital. The study participants were 104 patients(57 men, 47 women)older than 18 years, who had visited the Ehime University Hospital seeking diagnosis for neurodevelopmental disorders during 2013-2016. The clinical pathway for adult neurodevelopmental disorders involves interviews regarding the developmental history and patient's chief complaint, self-completed questionnaires including Autistic Spectrum Quotient Japanese Version, Adult ADHD Self-Report Scale(ASRS), Conners' Adult ADHD Rating Scales, Beck Depression Inventory-Ⅱ, Social Functioning Scale(SFS), the parent-reported Social Responsiveness Scale, and psychological and cognitive tests including Wechsler Adult Intelligence Scale-Ⅲ(WAIS-Ⅲ). The study population included 29 subjects diagnosed with autistic spectrum disorder(ASD)and 18 with ADHD；18 subjects were without psychiatric disorders. We conducted multiple comparison analyses with the data of groups diagnosed with ASD only, with ADHD only, and without psychiatric disorders. The results indicated significantly higher numbers of affected males, and more chief complaints related to psychiatric symptoms in the ASD group. The SFS scores were significantly lower, with higher scores of Verbal Intelligence Quotient(VIQ)in WAIS-Ⅲ in the ASD group. There were significantly more chief complaints related to inattention and a higher number of married persons. Moreover, ASRS scores were significantly higher. in the ADHD group. The clinical pathway for neurodevelopmental disorders in adulthood may be useful in understanding the mental and social functioning of patients. This study provided preliminary findings. Further detailed study of the clinical pathway is required.