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Seishin Igaku Volume 63, Issue 10 （October 2021）

精神医学 63巻10号（2021年10月発行）

Japanese English

研究と報告

成人発達障害専門外来における診断名および自己記入式評価尺度の検討 DSM-5 Classifications and Clinical Characteristics of Outpatient at the Specialty Clinic for Adult Neurodeveropmental Disorders 中村善文 ¹ , 太田晴久 ^1,2 , 西尾崇志 ¹ , 土岐幸生 ¹ , 石部穣 ¹ , 林若穂 ¹ , 傅佳慧 ² , 加藤進昌 ² , 岩波明 ¹ Yoshifumi Nakamura ¹ , Haruhisa Ohta ^1,2 , Takashi Nishio ¹ , Sachio Toki ¹ , Yutaka Ishibe ¹ , Wakaho Hayashi ¹ , Jiahui Fu ² , Nobumasa Kato ² , Akira Iwanami ¹ ¹昭和大学医学部精神医学講座 ²昭和大学発達障害医療研究所 ¹Department of Psychiatry, School of Medicine, Showa University, Tokyo, Japan ²Medical Institute of Developmental Disabilities Research, Showa University キーワード：自閉スペクトラム症 , autism spectrum disorder , 注意欠如・多動症 , attention-deficit hyperactivity disorders , 診断 , diagnosis , 自閉症スペクトラム指数 , Autism-Spectrum Quotient , 成人ADHD自己報告スケール , Adult ADHD Self-Report Scale Keyword: 自閉スペクトラム症 , autism spectrum disorder , 注意欠如・多動症 , attention-deficit hyperactivity disorders , 診断 , diagnosis , 自閉症スペクトラム指数 , Autism-Spectrum Quotient , 成人ADHD自己報告スケール , Adult ADHD Self-Report Scale pp.1555-1567

発行日 2021年10月15日 Published Date 2021/10/15

DOI https://doi.org/10.11477/mf.1405206473

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抄録　近年，成人期の神経発達障害は注目を集めているが，適切な診断や併存の評価は難しい。本研究は，昭和大学附属烏山病院の成人期発達障害専門外来を受診した3,845名の診療録を後方視的に調査し，最終診断や患者背景，前医での診断名，および評価尺度の妥当性について検討した。自閉スペクトラム症(ASD)，注意欠如・多動症(ADHD)，限局性学習症のいずれかの最終診断がついた者は45%であった。Autism-Spectrum Quotient(AQ)とAdult ADHD Self-Report Scale(ASRS)の特異度は低く，女性は男性より高値を示し，ASDにおいてはAQと年齢が正相関していた。この結果から，専門外来受診者の半数は神経発達障害以外の診断となり，AQやASRSは年齢や性別の影響を受けるため，使用には慎重な解釈が必要であると考えられた。

　While neurodevelopmental disorders, including autism spectrum disorder(ASD), attention-deficit/hyperactivity disorder(ADHD), and specific learning disorder(SLD), are garnering much attention in clinical and research settings in recent years, their diagnoses in adulthood remain challenging. In the present study, we examined the final diagnoses and clinical characteristics of adults who visited our specialty clinic for adult neurodevelopmental disorders. The specificity and sensitivity of the Autism-Spectrum Quotient(AQ)and Adult ADHD Self-Report Scale(ASRS)were also evaluated for those who received the final diagnosis of ASD and ADHD respectively. Retrospective chart reviews were conducted on 3845 outpatients of Showa University Karasuyama Hospital Specialty Clinic for Adult Neurodevelopmental Disorders between April 2008 and March 2017. Sociodemographic and clinical characteristics, final diagnoses, AQ and ASRS scores were collected. Forty-five percent of the participants received the final diagnosis of either ADHD, or/and ASD, or/and SLD. The specificities of the AQ for ASD and ASRS for ADHD were both low. Females scored higher on the AQ and ASRS than males did. The AQ scores showed a positive correlation with age in those with ASD diagnosis. The results showed that a large proportion of adults who visited the specialty clinic for adult neurodevelopmental disorders had other mental disorders, and the AQ and ASRS scores need careful interpretations as they may be affected by age and gender.