Izifo zengqondo ezi-Co-morbidities ku-ASD: Ukugxila kuSchizophrenia

Ngisanda kufunda i-athikili enkulu ngezindaba ze-spectrum ezimayelana nezifo zengqondo kubantu abadala abane-autism (ASD) kanye nokunakekelwa kokushoda kwengqondo (ADHD). I-athikili yezindaba ibifingqa iphepha elisanda kwenziwa ngabaphenyi baseNorway elishicilelwe kwiBiological Psychiatry.

Abaphenyi bafunda amarekhodi abantu abadala baseNorway abangu-1.7 million – abanye betholakala benesifo se-ASD, abanye bene-ADHD, abanye abane-ASD ne-ADHD, kanti abanye bengenayo i-ASD noma i-ADHD. Inhloso bekuwukuqonda kangcono amaphethini we-psychiatric co-morbidities (ukuxilongwa okwenzeka ngokubambisana) kubantu abadala abane-ASD, ADHD, noma bobabili. Ngokuyinhloko, abacwaningi bagxile kulokhu kuxilongwa okubambisanayo okubambisanayo: izinkinga zokukhathazeka, ukucindezeleka okukhulu, i-bipolar disorder, ukuphazamiseka kobuntu, i-schizophrenia, nokuphazamiseka kokusebenzisa izidakamizwa.

Sekukonke, ukuphazamiseka kwengqondo okubambisanayo kwakuphakathi kwezikhathi ezi-2-14 ezivame kakhulu kubantu abadala abane-ADHD kanye / noma i-ASD uma kuqhathaniswa nabantu abadala abangatholakali. Iphethini yokuphazamiseka kokubambisana okwakungafani kakhulu phakathi kwamaqembu. Izinkinga ze-bipolar, ukucindezeleka okukhulu kokucindezeleka, ukuphazamiseka kobuntu, nokuphazamiseka kokusebenzisa izidakamizwa kwakuvame kakhulu kubantu abadala abane-ADHD kunabantu abadala abane-ASD. Kodwa-ke, abantu abadala abane-ASD babesemathubeni amakhulu okuba nesifo sokuphazamiseka kwengqondo kunabantu abadala abane-ADHD. Eqinisweni, abantu abadala abane-ASD babenamathuba aphindwe kayi-14 okuba ne-schizophrenia kunabantu abadala emphakathini jikelele (abantu abadala abane-ADHD babenamathuba acishe aphindwe kane okuba ne-schizophrenia kunabantu abadala emphakathini jikelele).

Nginentshisekelo ngokukhethekile kokutholakele okuhlobene ne-schizophrenia ne-ASD enikezwe umlando walezi zimo ezimbili nokuqonda kwethu kwamanje kokuthi zingagudluka kanjani. Ngokomlando, i-ASD ne-schizophrenia zazithathwa njengesimo esisodwa, kanti igama elithi "autism" lalisetshenziswa ngokushintshana ne-schizophrenia kwaze kwaba ngawo-1970. I-Hindsight ihlale ingu-20/20, ngakho-ke kulula ukulahla imicabango yethu yangaphambilini mayelana nokugqagqana njengoba kungasasebenzi. Kodwa-ke, ucwaningo olufana nalokhu okungenhla luqokomisa iphuzu elibalulekile mayelana ne-ASD kanye ne-schizophrenia ebilokhu yaziwa kakhulu eminyakeni eyishumi eyedlule: lezi zimo ezimbili zibonakala zabelana ngezinto ezithile ezivamile.

Lezi zinto ezijwayelekile ziye zabonwa ngokuziphatha, nangocwaningo lwezofuzo nolwezinzwa.

Ngokuziphatha, zombili lezi zimo zabelana ngobunzima nokuxhumana komphakathi nokuphindisela. Abantu abane-ASD abanobunzima bokuhlanganyela ezingxoxweni zokuphindisela nabanye bavame ukucatshangwa ukuthi "banomthelela ophansi", okuyisici esivame ukubikwa nge-schizophrenia.

Ngokwe-genetics, kunobufakazi bokuqina phakathi iziyaluyalu. U-R esearch uthole ubufakazi bokuthi izingane zisengozini enkulu ye-ASD uma zinomzali one-schizophrenia. Lokho wukuthi, ukuxilongwa kwe-schizophrenia kumzali kwandisa ubungozi be-ASD ezinganeni.

Ucwaningo lweNeuroscience lukhombisile ukuthi womabili la maqembu akhombisa ukungasebenzi kahle kwecortex yangaphambili lapho ebuka ubuso nalapho ehlanganyela kumcabango wemisebenzi yengqondo. Lokhu kugqamisa ukufana phakathi kwalezi zimo ezimbili ukuthi ubuchopho busabela kanjani kuzisusa zenhlalo. Lokhu kuthakazelisa ikakhulukazi ekukhanyeni kokubukwa kokuziphatha ukuthi ukuxhumana nomphakathi kunzima kuwo womabili la maqembu.

Ngokwasemtholampilo, kunzima impela ukuxilonga i-schizophrenia ku-ASD, noma i-ASD ku-schizophrenia. Umtholampilo kumele enze inhlolokhono futhi azame ukuhlukumeza lokho okubizwa ngokuthi yizimpawu ezingezinhle zeschizophrenia (ukuhoxa, ukuthinteka okuyisicaba, inkulumo encishisiwe) ezimpawu zomphakathi ezihambisana ne-ASD.

Lolu hlobo lokuxilongwa lubaluleke kakhulu kubantu abadala abane-ASD abangase babhekane ne-psychosis okokuqala ngqa, futhi abadinga ukwelashwa ngokushesha. Ngeshwa, izimpawu ezikhomba isiqephu sokuqala se-psychotic kwesinye isikhathi azinakwa kubantu abadala abane-ASD uma odokotela nabanakekeli becabanga ukuthi izimpawu ziyingxenye ye-ASD. Sibonile amacala ambalwa afana nalawa emtholampilo, futhi ukubambezeleka kokwelashwa kwabantu abadala abathola izimpawu zokuqala zengqondo kunomthelela omubi emiphumeleni yesikhathi eside.

Kukonke, kusobala ukuthi ukufana nokugqagqana phakathi kwale mibandela emibili akunakushaywa indiva, futhi akufanele kuchithwe njengomqondo ophelelwe yisikhathi. Kunesidingo esithile sezingxoxo ezingcono nezinembile ukuze kutholakale i-schizophrenia ku-ASD, noma i-ASD kulabo abane-schizophrenia, ngoba lokhu kuzosiza ukwenza ngcono imiphumela yabantu abaphila nalezi zimo.

I-Sugranyes G, i-Kyriakopoulos M, i-Corrigall R, i-Taylor E, i-Frangou S (i-2011) i-Autism spectrum disor kanye ne-schizophrenia: ukuhlaziywa kwe-meta-analysis of the neural correlates of cognition social. Ama-PLoS One 6 (10): e25322

Chisholm, K., Lin, A., & Armando, M. (2016). Izinkinga zeschizophrenia spectrum kanye ne-autism spectrum disorder. Ku-Psychiatric Symptoms and Comorbidities ku-Autism Spectrum Disorder (amakhasi 51-66). I-Springer, i-Cham.

ISolberg BS et al. Biol. I-Psychiatry Epub ngaphambi kokuphrinta (2019)