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Acta Paediatrica (Oslo, Norway : 1992) May 2023Hans Asperger is probably best known for Asperger syndrome. However, he has been accused of knowingly and willingly participating in the National Socialist Child...
AIM
Hans Asperger is probably best known for Asperger syndrome. However, he has been accused of knowingly and willingly participating in the National Socialist Child Euthanasia programme by referring patients to the Am Spiegelgrund children's home in Vienna. This later became notorious for euthanising disabled children. We investigated those allegations.
METHODS
Clinicians and historians examined original documents and transcripts related to Asperger's referrals from the Viennese Therapeutic Pedagogy Unit, and corresponding Am Spiegelgrund admissions, up to 25 March 1943, when he was drafted.
RESULTS
Asperger referred 13 children to Am Spiegelgrund. Eleven survived and apparently received adequate care that allowed them to achieve positive developments, but two girls died. Asperger referred these two girls during June and October 1941, before most of the deaths at Am Spiegelgrund occurred and before its euthanasia programme became public knowledge. Our detailed investigation of the medical records, Unit referral practices and Am Spiegelgrund provided no evidence that Asperger knew about the euthanasia programme at the time of the referrals. One death was probably due to euthanasia, but the other was less clear.
CONCLUSION
There was no evidence that Asperger knew about the euthanasia programme when he referred two patients who died at Am Spiegelgrund.
Topics: Male; Female; Humans; Child; Asperger Syndrome; National Socialism; Disabled Children; Euthanasia; Occupations
PubMed: 36239413
DOI: 10.1111/apa.16571 -
Basic and Clinical Neuroscience 2022Autism is a heterogeneous neurodevelopmental disorder associated with social, cognitive and behavioral impairments. These impairments are often reported along with...
INTRODUCTION
Autism is a heterogeneous neurodevelopmental disorder associated with social, cognitive and behavioral impairments. These impairments are often reported along with alteration of the brain structure such as abnormal changes in the grey matter (GM) density. However, it is not yet clear whether these changes could be used to differentiate various subtypes of autism spectrum disorder (ASD).
METHOD
We compared the regional changes of GM density in ASD, Asperger's Syndrome (AS) individuals and a group of healthy controls (HC). In addition to regional changes itself, the amount of GM density changes in one region as compared to other brain regions was also calculated. We hypothesized that this structural covariance network could differentiate the AS individuals from the ASD and HC groups. Therefore, statistical analysis was performed on the MRI data of 70 male subjects including 26 ASD (age=14-50, IQ=92-132), 16 AS (age=7-58, IQ=93-133) and 28 HC (age=9-39, IQ=95-144).
RESULT
The one-way ANOVA on the GM density of 116 anatomically separated regions showed significant differences among the groups. The pattern of structural covariance network indicated that covariation of GM density between the brain regions is altered in ASD.
CONCLUSION
This changed structural covariance could be considered as a reason for less efficient segregation and integration of information in the brain that could lead to cognitive dysfunctions in autism. We hope these findings could improve our understanding about the pathobiology of autism and may pave the way towards a more effective intervention paradigm.
PubMed: 37323949
DOI: 10.32598/bcn.2021.2262.1 -
Health Economics May 2023Do movies reduce stigma, increasing healthcare product choices offered by firms? We provide causal evidence on this question in the context of Indian pharmaceutical...
Do movies reduce stigma, increasing healthcare product choices offered by firms? We provide causal evidence on this question in the context of Indian pharmaceutical markets. For unpacking these effects, we use an exogenous shock to the market due to the release of a Bollywood blockbuster movie - My Name is Khan (MNIK) where the protagonist, superstar Shahrukh Khan, suffers from Asperger's Syndrome (AS). Using a difference-in-differences design, we find a positive and statistically significant effect of MNIK (between 14% and 22% increase in variety sold and prescribed) on product differentiation and choices in the market for antipsychotic medicines used to clinically treat AS. Results are consistent using alternative controls, a placebo treatment-based test and with a variety of other robustness checks. Our findings document likely for the first-time, supply side responses to edutainment and suggests potential associated welfare effects in healthcare markets characterized by sticky demand. Implications for global health and public policy given worldwide concerns around a mental wellness epidemic with Covid-19 are discussed.
Topics: Humans; Motion Pictures; COVID-19; Drug Industry
PubMed: 36727570
DOI: 10.1002/hec.4653 -
Annali Dell'Istituto Superiore Di Sanita 2022To identify developmental symptoms reported at firsts doctor visits by parents of children later diagnosed with Autism Spectrum Disorder (ASD).
OBJECTIVE
To identify developmental symptoms reported at firsts doctor visits by parents of children later diagnosed with Autism Spectrum Disorder (ASD).
DESIGN
Cohort study.
SETTING
The study was conducted in the Department of Psychiatry Research of "Prof. Dr. Alexandru Obregia" Clinical Psychiatry Hospital from Bucharest between September 2019 and May 2021.
PATIENTS
105 cases: 82 boys and 23 girls, 100 children with autism, and 5 patients with Asperger's syndrome.
INTERVENTION
ASD was diagnosed according to the DSM-5 criteria, ADOS-1 (Autism Diagnostic Observation Schedule, 1st Edition) and/or ADI-R (Autism Diagnostic Interview-Revised) tests scores; features reported by the parents for which they presented to the doctor for a diagnosis were taken into consideration.
MAIN OUTCOME MEASURES
The age at first presentation to the doctor; the most common early signs reported by the parents of children with ASD.
RESULTS
The age at first presentation to the doctor in our group was between 9 months and 14 years. The most common early signs reported by parents were: delayed language development, deficits in understanding verbal instructions/indications, and hyperactivity and aggressivity. In the case of patients with Asperger's syndrome, the reported features were hyperactivity and aggressivity, learning difficulties, and social interaction problems. Regression and delay in language development occurred more often in boys than in girls.
CONCLUSIONS
Parents, as well as family doctors or paediatricians, should pay great attention to the children's behaviour, alongside their cognitive and language development. Early detection is essential for early intervention and our results can be used to develop training programs for parents and paediatricians for early recognition of ASD.
Topics: Autism Spectrum Disorder; Child; Cohort Studies; Diagnostic and Statistical Manual of Mental Disorders; Female; Humans; Infant; Male; Parents
PubMed: 36128967
DOI: 10.4415/ANN_22_03_07 -
Sleep Science (Sao Paulo, Brazil) 2021Sleep spindles are an element of the sleep microstructure observed on the EEG during the NREM sleep phase. Sleep spindles are associated to sleep stability functions as...
Sleep spindles are an element of the sleep microstructure observed on the EEG during the NREM sleep phase. Sleep spindles are associated to sleep stability functions as well as memory consolidation and optimization of different cognitive processes. On the other hand, Asperger's syndrome (AS) is a generalized developmental disorder in which cognitive and sleep disturbances have been described. In this study we analyzed different characteristics of sleep spindles in a group of children with AS and compared them with sleep spindles of a group of children with typical development paired by age; both groups ranged from 6 to 12 years of age and were all male. We observed a statistically significant decrease in sleep spindles intrinsic frequency in different brain regions in the AS group in relation to the typical development group. This finding could be due to immaturity in brain regions related to the integration of sleep spindles; and this immaturity could be related with cognitive aspects in these patients.
PubMed: 35186197
DOI: 10.5935/1984-0063.20200059 -
PloS One 2019We examined the emotional and psychophysiological underpinnings of social interaction in the context of autism spectrum disorder, more specifically, involving... (Comparative Study)
Comparative Study
We examined the emotional and psychophysiological underpinnings of social interaction in the context of autism spectrum disorder, more specifically, involving participants diagnosed with Asperger syndrome (AS). We recorded participants' autonomic nervous system (ANS) activation (electrodermal activity, heart rate, and heart rate variability) and facial muscle activation during conversations in two different types of male dyads: (1) ten dyads where one participant has been diagnosed with AS (AS/NT dyads) and (2) nine dyads where both participants are neurotypical (NT/NT dyads). Afterwards, three independent raters assessed continuously each participant's affiliative and dominant behaviors during the first and last 10 minutes of the conversations. The relationship between the assessed data and ANS responses was examined. We found that, in the NT/NT dyads, a high level of affiliation displayed by the conversational partner calms down the participant when they are actively dominating the interaction. In contrast, when the participants themselves expressed affiliation, their psychophysiological responses indicated increase in arousal, which suggests that the giving of affiliation is physiologically "hard work." The affiliation-related ANS responses were similar in those NT participants whose conversational partner had AS, while some differences in facial muscle activation did occur in comparison to NT/NT dyads. In the AS participants, in contrast, a high level of affiliation provided by the conversational partner was associated with increase in arousal, suggesting heightened alertness and stress. As for their own affiliative behavior, the AS participants exhibited similar indicators of alertness and stress as the NT participants, but only when their own level of dominance was low. Our results increase understanding of how individuals with AS experience social interaction at the physiological level, and how this experience differs from that in NT individuals. Moreover, our results confirm and further specify our earlier results, where we proposed that affiliation involves the type of "sharing of the burden" that also reverberates in the participants' bodies.
Topics: Adult; Asperger Syndrome; Autonomic Nervous System; Case-Control Studies; Facial Muscles; Female; Finland; Humans; Interpersonal Relations; Male; Video Recording; Young Adult
PubMed: 31532809
DOI: 10.1371/journal.pone.0222084 -
Journal of Psychiatric Research May 2024In the last decades, growing caseness for Autism Spectrum Disorder (ASD) has been observed, owing to the diagnostic accretion of low-impairment forms, over and above... (Review)
Review
In the last decades, growing caseness for Autism Spectrum Disorder (ASD) has been observed, owing to the diagnostic accretion of low-impairment forms, over and above other possible causes. Unrecognized ASD is likely to be mislabeled as a psychotic disorder (PD), as people in the spectrum may show 'pseudopsychotic' symptoms, resembling both negative and positive symptoms. On the other hand, PDs are likely to be overlooked when they arise in people with ASD, due to the 'diagnostic overshadowing' of new-onset conditions by lifelong core autistic symptoms. The three available metanalyses on the occurrence of psychosis in adults with ASD convergently reported a rate of PDs that is at least ten times higher than in the general population. Therefore, the lack of literature addressing risk factors, outcomes, and treatment options for psychosis in the context of ASD is utterly concerning. The present review aims to summarize up-to-date knowledge of PDs with comorbid ASD in terms of clinical features, course, and treatment.
Topics: Adult; Humans; Autism Spectrum Disorder; Psychotic Disorders; Imagination
PubMed: 38593694
DOI: 10.1016/j.jpsychires.2024.03.043 -
Autism Research : Official Journal of... Mar 2021Individuals with autism spectrum disorder are often diagnosed with at least one or more accompanying disorders. Most studies reported prevalence of the psychiatric...
Individuals with autism spectrum disorder are often diagnosed with at least one or more accompanying disorders. Most studies reported prevalence of the psychiatric comorbidities among these individuals; however, the incidence of developing comorbidities is unclear. This study used Taiwan's claims database and aimed to investigate the incidence of developing major psychiatric comorbidities in individuals with autism spectrum disorder and whether the incidence was moderated by gender, autism-spectrum disorder subtypes, and autism-associated neurodevelopmental conditions. A total of 3,837 individuals with autism spectrum disorder (2,929 autistic disorder, 447 Asperger syndrome, 461 pervasive developmental disorder-not otherwise specified) and 38,370 comparison subjects, who were matched by age and gender, were included. The incidences of schizophrenia spectrum, bipolar, and major depressive disorders was examined. The results showed that the incidences of schizophrenia spectrum (9.7 per 1,000 person-year), bipolar disorder (7.0 per 1,000 person-year), and major depressive disorder (3.2 per 1,000 person-year) were significantly higher than the comparison group across all three subtypes of autism-spectrum disorder. Individuals with pervasive developmental disorder-not otherwise specified had higher risk for major depressive disorder than autistic disorder. Females with Asperger syndrome had significant higher risk for schizophrenia spectrum than males. The comorbidity rate dramatically dropped when the autism-associated neurodevelopmental conditions were taken into account. Our findings suggested that the incidences of major psychiatric comorbidities were higher in autism spectrum disorder and influenced by autism subtypes, gender, and autism-associated neurodevelopmental conditions. LAY SUMMARY: We examined whether people with autism spectrum disorder (ASD) have higher incidence of schizophrenia, bipolar disorders, and major depression using a large claims database. The results showed the incidences of these mental illness among individual with ASD were significantly higher than those without ASD. In addition, the incidences were influenced by autism subtypes, gender, and comorbid neurodevelopmental conditions.
Topics: Autism Spectrum Disorder; Comorbidity; Depressive Disorder, Major; Female; Humans; Male; Mood Disorders; Schizophrenia
PubMed: 33615712
DOI: 10.1002/aur.2451 -
Revista de Psiquiatria Y Salud Mental 2020
PubMed: 31248755
DOI: 10.1016/j.rpsm.2019.05.002 -
Psychiatric Services (Washington, D.C.) Nov 2020This study aimed to analyze the pathways to obtaining a diagnosis of autism spectrum disorder (ASD) within the Mexican health system.
OBJECTIVE
This study aimed to analyze the pathways to obtaining a diagnosis of autism spectrum disorder (ASD) within the Mexican health system.
METHODS
Parents of children with ASD (N=186) were approached at specialized health centers and interviewed about the sequence of professionals they contacted that led to a diagnosis. The authors established the pathway to diagnosis, time of first parental concerns, time of first consultation, age of the child at diagnosis, and other measures. A Sankey plot was used to illustrate the complexity of the pathway to diagnosis. Diagnostic delays among children with autism were compared with delays among subsamples of children with Asperger's syndrome. Regression analysis was used to evaluate the effect of socioeconomic and clinical variables on diagnostic delays.
RESULTS
The median diagnostic delay was 27 months (interquartile range [IQR] 8-36), and three professional contacts (IQR 3-6) were needed to achieve a diagnosis. Patients switched between primary and tertiary care even in later stages of the pathway. Patients with Asperger's syndrome had longer delays than patients with autism, and girls and older patients took more time to receive a diagnosis. Parental concerns regarding language, developmental issues, and perceived developmental regression resulted in shorter diagnostic delays.
CONCLUSIONS
Pathways to diagnosis of ASD are long and involve multiple contacts, with patients alternating between primary and specialized care. This pattern reflects failures in the diagnostic protocols and referral systems of clinical centers in Mexico, and such issues may be experienced in countries with similarly overwhelmed health care systems.
Topics: Autism Spectrum Disorder; Child; Delayed Diagnosis; Female; Humans; Mexico; Parents; Referral and Consultation
PubMed: 32746716
DOI: 10.1176/appi.ps.201900518