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蒙特利尔研究人员:最新研究显示自闭症被过度诊断
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《环球邮报》日前发表的一篇文章称,蒙特利尔研究人员在发表一份最新研究报告后警告称,由于自闭症被过度诊断,在未来五到十年里,被诊断罹患自闭症的患者和未患病者将变得几乎没有区别。
 
8月21日发表于《美国医学会杂志精神病学》(JAMA Psychiatry)杂志上的一份最新荟萃分析研究报告对自1966年以来的11项重大研究结果进行分析后发现,被诊断罹患自闭症的患者与一般人群的差异越来越小。
 
该研究报告的作者之一、Riviere-des-Prairies医院的心理健康科室的研究精神病学家劳伦特•默特朗(Laurent Mottron)称,一些被诊断罹患自闭症的患者与普通人群的差异很快就会缩小至零。


 
默特朗在接受采访时称,研究人员目前所检测的自闭症患者和普通人群之间的差异实际上已经越来越小,如果这种趋势继续持续下去,在未来五到十年里这种差异将会降至最小。
 
默特朗称,问题在于这种差异已经降至使得相关诊断变得几乎毫无意义的程度。
 
在此次研究中,默特朗和其他四位研究人员对之前进行的11项重大研究结果进行了荟萃分析,对被诊断罹患自闭症的患者和未患病者进行了比较。默特朗称,此次分析包括来自27,723个个人的数据,实际上是针对自闭症患者大脑的全球性研究。
 
分析发现,在定义自闭症的七个主要特征中,被诊断罹患自闭症的患者和未患病者在五个特征方面的差异随着时间的推移变得越来越小,其中包括情绪识别、心智理论、计划编制和大脑体积。


 
相比之下,研究人员在对精神分裂症的流行现象进行研究时,并未发现这种趋势,在过去二十年里,精神分裂症的发病率一直比较稳定。
 
自闭症又称孤独症,被归类为一种由于神经系统失调导致的发育障碍,其病征包括不正常的社交能力、沟通能力、兴趣和行为模式。自闭症的病因仍然未知,很多研究人员怀疑自闭症是由基因控制,再由环境因素触发。在全球范围内,近年来被诊断罹患自闭症的人数急剧增加,美国的自闭症患病率已经从1966年的不到总人口的0.5%,升至占到在总人口的逾2%。在魁北克省,自闭症患病率亦接近2%。
 
该份研究报告的作者称,他们在经过研究后认为自闭症患病人数急剧增加可能要归因于几个因素,其中包括患病人数确实有所增加,公众意识提高,被确诊的患者可以获得更多支持,确诊门槛下调,更多人使用“问卷”诊断,以及更加倾向于对智商正常的人进行诊断。
 
研究人员还指出,人们对自闭症的理解已经从有限的临床现象定义发展为通过一系列不确定的类似现象去进行定义。他们警告称,这种模糊的定义可能会导致针对这种疾病的研究变得更加困难。


 
默特朗表示,该项研究突显出自闭症存在严重的过度诊断问题,他将此归咎于学校、医生和家长等方面。默特朗甚至称,自闭症的诊断符合一些学校和家长的最佳利益,他们因此可以有资格获得额外的帮助和资助,否则他们可能什么都得不到。
 
默特朗称,目前,被诊断罹患自闭症的儿童可以在学校里获得特殊的服务,与其他疾病相比,被确诊罹患自闭症的儿童有更多机会获得各种各样的额外帮助,但现在这却变得很荒谬,因为被诊断罹患自闭症的儿童未必真的需要这些服务。
 
默特朗称,自闭症的诊断标准已经变得越来越琐碎,比如孩子缺少朋友,厌恶理发或在衣服上贴标签都会被怀疑是否患上了自闭症。


 
默特朗承认自闭症的情况很复杂,因为轻微型闭症确实存在。但他同时指出,出现某些自闭症特征和罹患自闭症有所不同,但是,这些特征的出现是帮助医疗专业人士跳过简单的症状问询,作出疾病诊断的基础。
 
默特朗称,可能出现的误诊会带来多方面的问题,包括有可能导致儿童接受错误的治疗。
 
默特朗说,有些人被诊断罹患自闭症往往不是因为他们真的出现了问题,而是因为他们的一些表现与常人不同。
 
默特朗还称,针对自闭症的专业服务成本十分高昂,如果有太多孩子被诊断罹患自闭症,就会导致资源过于分散,而这意味着那些最需要专业服务的患者无法获得足够的帮助。

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