High-functioning pervasive developmental disorders presenting in school non-attendees in adolescence – Comparison with adjustment disorders and clinical consideration of HFPDD – *
[Purpose] High-Functioning Pervasive Developmental Disorders（HFPDD）have not been recognized in some adolescents with school non-attendance. The purpose of this study was to differentiate adolescents with school non-attendance who have HFPDD from those with adjustment disorders and to consider the clinical development of HFPDD. [Subject] Among 116 patients（46 male, 70 female）referred to the Department of Psychiatry at Kawasaki Medical School Hospital with the problem of school non-attendance between June 2005 and May2007. 27 patients（14 male, 13 female）were diagnosed as having HFPDD and 26 patients（9 male, 17 female）as having adjustment disorders according to the DSM-Ⅳ-TR. [Method] The patients were asked about their mental states by a psychiatrist, and their mothers were asked about the children's developmental history. The patients were then evaluated using the Autism-Spectrum Quotient Japanese Version（AQ-J）, while the mothers were given the Autism Spectrum Screening Questionnaire（ASSQ-R）. [Result] 1）It was confirmed that the AQ-J and the ASSQ-R were useful in distinguishing between adjustment disorders and HFPDD. 2）Among the patients with HFPDD, AQ-J-positive and AQ-J-negative groups showed no significant differences in the scores for“Attention switching”and“Attention to detail”of the AQ-J and they both showed high scores. However, the AQ-J-negative group with HFPDD showed significantly higher scores for“Attention switching”and“Attention to detail”than the adjustment disorders' group. 3）Later, after 15 HFPDD patients had completed treatment, they started going to school again. Five patients were able to attend school again by finding an aim for their attendance, while four patients were able to attend again by changing schools. [Discussion] 1）Both the ASSQ-R and the AQ-J are useful in distinguishing between HFPDD and adjustment disorders. 2）Patients with HFPDD are said to basically have disturbances of personal relationships. However, even if total AQ-J scores are low, the possibility of HFPDD should not be ruled out if the scores for“attention switching”and“attention to detail”are high. 3）The disturbances of“attention switching”and“attention to detail”may contribute to school non-attendance. It was concluded that effective treatment for adolescents with HFPDD presenting with school non-attendance is to come to a precise understanding of their disturbances in“attention switching”and“attention to detail”and then to suggest changes in their environment and viewpoints. (Accepted on October，2007)
