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Praxis Oct 2014
Topics: Adult; Asperger Syndrome; Child; Child Development Disorders, Pervasive; Cross-Sectional Studies; Diagnosis, Differential; Humans; Intelligence; Social Adjustment; Social Support; Surveys and Questionnaires
PubMed: 25270744
DOI: 10.1024/1661-8157/a001824 -
Journal of Child Psychology and... May 2004Hans Asperger drew attention to individuals who show the core symptoms of autism in the presence of high verbal intelligence. (Review)
Review
BACKGROUND
Hans Asperger drew attention to individuals who show the core symptoms of autism in the presence of high verbal intelligence.
METHODS
A review of the literature explores current issues concerning the diagnosis and nature of Asperger syndrome.
RESULTS
The behavioural and neurophysiological evidence to date suggests that Asperger syndrome is a variant of autism typically occurring in high-functioning individuals, and not a separate disorder. One of the problems of diagnosis is that the typical impairment of social communication may be difficult to identify in early childhood, and can be camouflaged in adulthood by compensatory learning. The range and nature of the social impairments in Asperger syndrome are still in need of investigation, but appear to be less severe than in autism. Experimental evidence suggests that individuals with Asperger syndrome may lack an intuitive theory of mind (mentalising), but may be able to acquire an explicit theory of mind. Brain imaging studies pinpoint a network that links medial prefrontal and temporal cortex as the neural substrate of intuitive mentalising. This network shows reduced activation and poor connectivity in Asperger syndrome. While some individuals with Asperger syndrome have written eloquently about their lives, their ability to talk about their own emotions appears to be impaired (alexithymia). This impairment may be linked to depression and anxiety, which is common in adulthood. Little is as yet known about the often considerable cognitive strengths in Asperger syndrome, or about the difficulties observed in higher-level executive skills.
CONCLUSIONS
Studies are needed that define the developmental course of the disorder and the nature of the strengths and weaknesses in both social and non-social domains. This requires more sensitive assessment instruments than are currently available. Questions about the prevalence of Asperger syndrome, about associated and secondary features, and about optimal education and management, urgently call for such studies.
Topics: Adolescent; Adult; Affective Symptoms; Anxiety; Asperger Syndrome; Child; Child Development; Child, Preschool; Cognition; Depression; Diagnosis, Differential; Humans; Infant; Infant, Newborn; Learning; Mind-Body Relations, Metaphysical; Prefrontal Cortex; Social Behavior; Temporal Lobe
PubMed: 15056300
DOI: 10.1111/j.1469-7610.2004.00262.x -
Deutsches Arzteblatt International Nov 2013As a result of the increased public interest in autism spectrum disorders (ASD), certain core manifestations of ASD--impaired social interaction and communication,... (Review)
Review
BACKGROUND
As a result of the increased public interest in autism spectrum disorders (ASD), certain core manifestations of ASD--impaired social interaction and communication, bizarre interests--are now commonly recognized as being typical of autism, not only in children, but in adults as well. More often than before, general practitioners, neurologists, and psychiatrists find themselves being asked whether a patient is suffering from previously unrecognized Asperger syndrome (AS). The prevalence of ASD is estimated at 1%, and the ratio of diagnosed to undiagnosed cases at about 3:2. Little is known about the diagnostic evaluation of AS in adulthood.
METHOD
We selectively searched the Medline database for pertinent literature, paying special attention to diagnostic manuals and to the guideline of the United Kingdom's National Institute for Health and Care Excellence (NICE).
RESULTS
Centrally important aspects of the diagnosis of AS include an assessment of the patient's ability to assume the emotional perspectives of others, non-verbal modes of expression, repetitive behavior patterns, and childhood social behavioral history. The autism quotient (AQ) is now established as a simple but nonspecific screening test. Up to 70% of all affected adults have comorbid disturbances, most often depression and anxiety disorders. The differential diagnosis includes personality disorders, anxiety disorders, obsessive-compulsive disorder, and attention deficit-hyperactivity disorder. The diagnostic assessment should proceed in stepwise fashion, starting from simple screening in primary care and then moving on to evaluation of the suspected diagnosis by a mental health care specialist, followed by extensive further investigation in an outpatient clinic specifically devoted to patients with autism spectrum disorders.
CONCLUSION
The diagnostic assessment of autism in adults requires knowledge of the core and accompanying manifestations of autism and of their differential diagnoses. More research is needed for the development of further screening tests and the precise determination of diagnosis rates, differential diagnoses, nd comorbidities.
Topics: Asperger Syndrome; Diagnosis, Differential; Humans; Medical History Taking; Neuropsychological Tests; Psychometrics
PubMed: 24290364
DOI: 10.3238/arztebl.2013.0755 -
British Medical Bulletin 2009We conducted a systematic review of the current literature for this review, but as there are many gaps in the research literature, we have supplemented this by our own... (Review)
Review
SOURCES OF DATA
We conducted a systematic review of the current literature for this review, but as there are many gaps in the research literature, we have supplemented this by our own clinical experience.
AREAS OF AGREEMENT
There is a general agreement that Asperger syndrome (AS) is one of the autistic spectrum disorders, that it is a developmental disorder which is either present at birth or develops shortly after and that there is a strong hereditary component.
AREAS OF CONTROVERSY
The fundamental impairment of AS is in the social arena, but what causes this is disputed. We propose that it is a disorder of non-verbal communication. Another important area of controversy is the extent to which AS may remit.
GROWING POINTS
Many people with AS develop secondary psychiatric disorders in adolescence and adulthood, some of which may be linked genetically, notably bipolar disorder [DeLong R, Nohria C (1994) Psychiatric family history and neurological disease in autistic spectrum disorders. Dev Med Child Neurol, 36, 441-448] or be explicable by some other association, but many patients and carers attribute their anxiety and low mood to bullying. The prevalence, treatment and prevention of co-morbid mental health problems are rapidly developing areas of interest. Some people with AS are known to commit offences, and when they commit they are more likely to be violent offences against strangers. How much of a risk that is presented by people with AS, and how to assess this risk, is another growing area of concern.
AREAS TIMELY FOR DEVELOPING RESEARCH
The social impairments of people with AS include deficits in empathy, self-awareness and executive function. Many of these are quintessentially human characteristics, and the study of people with AS provides opportunities for using neuroimaging to compare people with AS and controls and identify which areas of the brain are concerned with these 'higher functions'. The study of AS, like that of other fronto-striatal disorders, is also throwing light on the role of networks in the brain and on how networks are formed during embryogenesis.
Topics: Asperger Syndrome; Community Mental Health Services; Crime; Humans; Interpersonal Relations; Prevalence; Psychiatric Status Rating Scales; Remission Induction
PubMed: 19240041
DOI: 10.1093/bmb/ldp006 -
Zeitschrift Fur Kinder- Und... Feb 2001Asperger's Syndrome is a pervasive developmental disorder that manifest itself at pre-school age. It is characterized by qualitative impairments of social interaction,... (Review)
Review
Asperger's Syndrome is a pervasive developmental disorder that manifest itself at pre-school age. It is characterized by qualitative impairments of social interaction, deficits in empathy, motor disturbances, and restricted repetitive and stereotyped patterns of behavior, interests and activities. A genetic etiology is assumed in context with brain dysfunctions and neuropsychological deficits which are all focused upon nonverbal learning, even though the general intellectual level is within the normal range. Treatment must take into account the individual aspects of each case and is based mainly on behavior therapy, group training of social skills, vocational training and adaptation, and if necessary, on medication. Medical treatment is indicated in the presence of special symptoms such as hyperactivity, aggressive behavior, sleep disorders, or depression.
Topics: Adult; Asperger Syndrome; Autistic Disorder; Behavior Therapy; Brain; Child; Comorbidity; Diagnosis, Differential; Genetic Predisposition to Disease; Humans; Incidence
PubMed: 11234553
DOI: 10.1024//1422-4917.29.1.59 -
Irish Journal of Psychological Medicine Dec 2018Internet technology offers psychiatrists new opportunities for remote interaction with patients. It also raises issues regarding therapeutic effectiveness, safety,...
BACKGROUND
Internet technology offers psychiatrists new opportunities for remote interaction with patients. It also raises issues regarding therapeutic effectiveness, safety, technical problems and possibilities for overcoming them, and matters related to specific mental health problems such as autism. The case presented concerns an adolescent male with severe social impairment and isolation as manifestations of Aspergers syndrome.
METHODS
The patient was accepted contact with psychiatric services through telepsychiatry, which enabled initial assessment and the development of a therapeutic relationship.
RESULTS
In due course the patient was able to attend the clinic in person. He became somewhat reconciled to his family. With appropriate adaptations he was able to resume his education and career.
CONCLUSIONS
Telepsychiatry shows promise in engaging with patients with autism spectrum disorders. As experience accrues, there is some evidence that it is safe and effective. Adaptations to traditional clinical psychotherapy may be required.
Topics: Adolescent; Asperger Syndrome; Humans; Male; Physician-Patient Relations; Psychiatry; Telemedicine
PubMed: 30501669
DOI: 10.1017/ipm.2017.19 -
La Revue Du Praticien Mar 2021
Topics: Asperger Syndrome; Humans
PubMed: 34161021
DOI: No ID Found -
Crisis 2007
Topics: Adult; Asperger Syndrome; Depression; Female; Humans; Male; Suicide, Attempted
PubMed: 17555026
DOI: 10.1027/0227-5910.28.1.1 -
Presse Medicale (Paris, France : 1983) Sep 2008Patients with Asperger syndrome are often diagnosed late or are wrongly considered to have schizophrenia. Misdiagnosing Asperger syndrome creates serious problems by... (Review)
Review
Patients with Asperger syndrome are often diagnosed late or are wrongly considered to have schizophrenia. Misdiagnosing Asperger syndrome creates serious problems by preventing effective therapy. Several clinical signs described in Asperger syndrome could also be considered as clinical signs of schizophrenia, including impaired social interactions, disabilities in communication, restricted interests, and delusions of persecution. A number of clinical features may facilitate the differential diagnosis: younger age at onset, family history of pervasive developmental disorder, recurring conversations on the same topic, pragmatic aspects of language use, oddities of intonation and pitch, lack of imagination, and incomprehension of social rules are more characteristic of Asperger syndrome. Accurate distinction between Asperger syndrome and schizophrenia would make it possible to offer more treatment appropriate to the patient's functioning.
Topics: Asperger Syndrome; Diagnosis, Differential; Female; Humans; Male; Schizophrenia
PubMed: 18417316
DOI: 10.1016/j.lpm.2008.01.020 -
Psychiatria Danubina Jun 2013Because adult ADHD is often accompanied by psychiatric comorbidities, the diagnostic process should include a thorough investigation for comorbid disorders.... (Comparative Study)
Comparative Study
BACKGROUND
Because adult ADHD is often accompanied by psychiatric comorbidities, the diagnostic process should include a thorough investigation for comorbid disorders. Asperger-Syndrome is rarely reported in adult ADHD and commonly little attention is paid to this possible comorbidity.
SUBJECTS AND METHODS
We investigated 53 adult ADHD-patients which visited our out patient clinic for first ADHD-diagnosis (17 females, 36 males; range of age: 18-56 years) for the frequency of a comorbid Asperger-Syndrome. Diagnosis of this autism-spectrum disorder was confirmed by applying the appropriate DSM-IV-criteria. Additionally we tested the power of the two screening-instruments "Autism-spectrum quotient" (AQ) and "Empathy quotient" (EQ) by Baron-Cohen for screening Asperger-Syndrome in adult ADHD.
RESULTS
Eight ADHD-patients were diagnosed with a comorbid Asperger-Syndrome (15.1%). The difference in AQ- and EQ-scores between pure ADHD-patients and comorbid patients was analysed, showing significantly higher scores in AQ and significant lower scores in EQ in comorbid patients.
CONCLUSIONS
Results show that the frequency of Asperger-Syndrome seems to be substantially increased in adult ADHD (versus the prevalence of 0.06% in the general population), indicating that investigators of adult ADHD should also be attentive to autism-spectrum disorders. Especially the AQ seems to be a potential screening instrument for Asperger-Syndrome in adult ADHD-patients.
Topics: Adolescent; Adult; Asperger Syndrome; Attention Deficit Disorder with Hyperactivity; Child; Comorbidity; Empathy; Female; Humans; Male; Middle Aged; Psychiatric Status Rating Scales; Young Adult
PubMed: 23793277
DOI: No ID Found