Disintegrative Psychosis in Childhood

Evans-Jones, L G; Rosenbloom, Lewis

doi:10.1111/j.1469-8749.1978.tb15247.x

Cited by 62 publications

(6 citation statements)

References 10 publications

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“…Medical problems before the onset of developmental symptoms were present in a minority of participants in the CDD and ASD groups, although more commonly in CDD. A few reports have speculated that stressful events such as physical illness, birth of siblings, or change of caregiver could trigger regression in both regressive ASD and CDD. While these factors seem non‐specific, with no evidence of a causal role, further research on the influence of the environment on CDD is required.…”

Section: Discussionmentioning

confidence: 99%

Childhood disintegrative disorder and autism spectrum disorder: a systematic review

Mehra

Sil

Hedderly

et al. 2018

Develop Med Child Neuro

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Aim In an attempt to clarify the debate surrounding the diagnostic validity of childhood disintegrative disorder (CDD), we systematically reviewed its characteristics and compared it with autism spectrum disorder (ASD). Method Four databases were searched (PubMed, PsycINFO, Embase, and Web of Science). Included articles had participants with CDD, as defined by symptoms present in the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision and the International Classification of Diseases, 10th Revision. Comparison groups were those with ASD and ASD with regression. Case studies were excluded. Results Twenty articles, comprising 96 participants with CDD (80 males, 16 females), were included. Most studies were cross‐sectional. The prevalence of CDD was 1.1 to 9.2 per 100 000, with a mean age at regression of 3 years 2 months (SD 1y 1mo), with a range of 2 years to 7 years. In addition to core CDD symptoms, most had intellectual impairment, anxiety, challenging behaviours, and regressed in toileting skills. Participants with CDD and ASD shared core diagnostic and extra‐diagnostic features. However, participants with CDD seemed to have more severe symptoms and a different symptom profile, including apparently typical development before regression, faster regression, more affective symptoms, and more global developmental deficit. Possible genetic and autoimmune neurobiological mechanisms were identified. Interpretation There is limited high‐quality evidence describing the aetiology and outcomes of CDD. However, given the qualitative and prognostic differences between ASD and CDD, we recommend that future diagnostic criteria should distinguish late‐onset regression.

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Section: Discussionmentioning

confidence: 99%

Childhood disintegrative disorder and autism spectrum disorder: a systematic review

Mehra

Sil

Hedderly

et al. 2018

Develop Med Child Neuro

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“…Of the two variables before SL, one is the number of obstetric risk factors ≥ 3 (above the mean of 2.4 in the 98 children in whom the risk factors were counted) from the possible total of 30 items (e.g., maternal physical diseases, threatened abortion, medication during pregnancy, cord complications, premature rupture of the membrane, cesarean section, asphyxia and severe icterus). The other is a psychosocial event before SL, which is frequently reported in cases of CDD [6,8,21] and its synonyms, Dementia infantilis [1], Heller's syndrome [33] and disintegrative psychosis [34,35]. The one variable during SL is fearfulness during regression, which is fairly frequently reported in cases of CDD [8,11,14,36] and its synonyms [1,[33][34][35].…”

Section: Methodsmentioning

confidence: 99%

How different is early-onset childhood disintegrative disorder from autistic disorder with speech loss?

Kitamura¹,

Inoue²

2013

OJPsych

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To examine the difference between early-onset (< age 3) childhood disintegrative disorder (CDD) and autistic disorder with speech loss (ADSL), 8 children with early-onset CDD (mean age = 7.6 years, SD = 3.8; 6 males) were compared with 92 age and gender-ratio comparable children with ADSL (mean age = 6.8 years, SD = 4.1; 70 males) on 24 variables not directly related to the key features of CDD (regression after normal development for at least the first 2 years after birth). Compared with the ADSL group, the early-onset CDD group had a tendency to have a higher rate of a psychosocial event before speech loss (SL) (early-onset CDD, 75.0% vs ADSL, 37.0%, p = 0.057; effect size (phi) = 0.211, p < 0.05); a significantly higher rate of fearfulness during SL (62.5% vs 4.3%, p = 0.000; phi = 0.551, p < 0.05); and a tendency to have a higher rate of epilepsy (25.0% vs 3.3%, p = 0.050; phi = 0.271, p < 0.05), a tendency to have a lower rate of the Childhood Autism Rating Scale-Tokyo Version (CARS-TV) total score ≥ 30 (75.0% vs 95.7%, p = 0.072; phi = 0.236, p < 0.05), and a significantly lower rate of CARS-TV item 2 (imitation) score ≥ 2 (50.0% vs 82.6%, p = 0.049; phi = 0.221, p < 0.05) on the first visit. The two groups did not exhibit any significant difference in the other 19 variables. The findings of no significant difference in the great majority and a significant difference in the small minority of the 24 variables between the two groups support integrating CDD into regressive autism spectrum disorder and studying CDD as its prototypical form.

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“…At the other extreme, there are cases of disintegrative disorder in which there has been a substantial period of apparently normal development followed by a widespread loss of skills not only in language and play but in other functions as well. The syndrome has been known for a long while 3674–76, and there is every reason to accept the reality of the loss that occurs in these cases. It might well be meaningful if the evidence showed a substantial increase in the frequency of what had hitherto been a rather uncommon variety of ASD.…”

Section: The Alleged Links Between Asd and Use Of The Mmr Vaccinementioning

confidence: 99%

Incidence of autism spectrum disorders: Changes over time and their meaning*

Rutter

2005

Acta Paediatrica

214

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Aim: Several reviews have noted a huge increase in the rate of diagnosed autism spectrum disorders. The main aims of this paper are: 1) to use published empirical findings to consider whether the rise reflects a true increase in incidence, as distinct from the consequences of better ascertainment and a broadening of the diagnostic concept; and 2) to consider how epidemiological data may be used to test hypotheses about possible causal influences, using MMR and thimerosal as examples. Methods: Search of the literature for studies with a large epidemiological base population, systematic standardized screening, a focus on an age group for which diagnostic assessments are reliable and valid, and diagnosis by trained professionals using high‐quality research assessments. Also, search of a broader literature to consider the evidence from all epidemiological studies with respect to the hypothesized causal effect of MMR and thimerosal on autism spectrum disorders. Results: The true incidence of autism spectrum disorders is likely to be within the range of 30–60 cases per 10 000, a huge increase over the original estimate 40 years ago of 4 per 10 000. The increase is largely a consequence of improved ascertainment and a considerable broadening of the diagnostic concept. However, a true risk due to some, as yet to be identified, environmental risk factor cannot be ruled out. There is no support for the hypothesis for a role of either MMR or thimerosal in causation, but the evidence on the latter is more limited. Conclusion: Progress in testing environmental risk hypotheses will require the integration of epidemiological and biological studies.

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Disintegrative Psychosis in Childhood

Cited by 62 publications

References 10 publications

Childhood disintegrative disorder and autism spectrum disorder: a systematic review

Childhood disintegrative disorder and autism spectrum disorder: a systematic review

How different is early-onset childhood disintegrative disorder from autistic disorder with speech loss?

Incidence of autism spectrum disorders: Changes over time and their meaning*

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