歯科心身症患者の神経発達特性と症状の関連を明らかに ーAQ・ASRSによる患者層別化で個別支援の可能性を示唆ー

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2026-10-02 東京科学大学

東京科学大学の研究チームは、歯科心身症患者756人を対象に、自閉スペクトラム症(ASD)関連特性を評価するAQと、ADHD関連特性を評価するASRSを用いて患者を4群に層別化し、神経発達特性と症状負担の関連を調べた。両質問票が陰性だった患者が645人(85.3%)と大多数を占めた一方、いずれか、または両方が陽性の群では、抑うつ症状、中枢性感作関連症状、身体症状の負担が大きく、両方陽性の群で最も高かった。ただし両方陽性群は15人と少なく、因果関係も示されていないため慎重な解釈が必要である。質問票陽性者は診療録上のASD・ADHD診断者より多く、一部では関連特性が十分認識されていない可能性も示唆された。本研究は、診断そのものではなく患者層別化の補助情報として神経発達特性を活用し、説明方法、治療計画、自己管理支援などを個別化する可能性を示した。

歯科心身症患者の神経発達特性と症状の関連を明らかに ーAQ・ASRSによる患者層別化で個別支援の可能性を示唆ー
図1. 本研究の概略

<関連情報>

医学的に説明のつかない口腔症状における神経発達特性のサブグループ:後向き観察研究 Neurodevelopmental Trait Subgroups in Medically Unexplained Oral Symptoms: A Retrospective Observational Study

Qinyi Chen, Takayuki Suga, Trang Thi Huyen Tu, Satoshi Kasahara, Akira Toyofuku
International Dental Journal  Available online: 22 September 2026
DOI:https://doi.org/10.1016/j.identj.2026.111160

Abstract

Introduction and aims
Medically unexplained oral symptoms (MUOS) are heterogeneous conditions with prominent subjective complaints despite limited objective findings. We examined whether autism spectrum disorder (ASD)- and attention-deficit/hyperactivity disorder (ADHD)-related traits characterize exploratory MUOS subgroups.

Methods
In this retrospective exploratory study, 756 MUOS patients seen from April 2023 to March 2025 were classified using the Autism-Spectrum Quotient (AQ) and Adult ADHD Self-Report Scale (ASRS). Depressive symptoms, central sensitization, somatic symptom burden, and MUOS diagnoses were compared, and regression tested associations of AQ and 18-item ASRS total scores with Self-Rating Depression Scale (SDS) and Central Sensitization Inventory (CSI) scores.

Results
Of 756 patients, 645 (85.3%) were AQ−/ASRS−, 67 (8.9%) AQ−/ASRS+, 29 (3.8%) AQ+/ASRS−, and 15 (2.0%) AQ+/ASRS+. AQ and ASRS positivity overlapped significantly (odds ratio 4.98, 95% confidence interval 2.54-9.75; P < .001), and continuous scores were moderately correlated (rho = 0.39). SDS, CSI, and Somatic Symptom Scale-8 (SSS-8) scores differed across groups (all P < .001). The AQ+/ASRS+ subgroup had the highest observed values, but its estimates were imprecise because it included only 15 patients. Higher AQ and ASRS total scores were independently associated with higher SDS and CSI in pooled multiple-imputation models.

Conclusion
AQ/ASRS screen-positive traits were associated with greater depressive symptoms, central sensitization, and somatic symptom burden. These measured associations may have implications for management complexity, although management complexity itself was not assessed. AQ/ASRS screening may support exploratory phenotyping but cannot establish ASD or ADHD diagnoses or serve as a definitive clinical decision tool. Prospective validation is required before clinical implementation.

Clinical relevance
Brief AQ/ASRS screening may help characterize MUOS patients with higher psychosomatic burden and possible under-recognized neurodevelopmental traits. Any implications for management complexity or screening-informed referral and care are exploratory because these outcomes were not evaluated; positive screens should be interpreted as trait indicators rather than diagnoses.

医療・健康
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