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Kuodza GE, Kawai R, LaSalle JM. Intercontinental insights into autism spectrum disorder: a synthesis of environmental influences and DNA methylation. ENVIRONMENTAL EPIGENETICS 2024; 10:dvae023. [PMID: 39703685 PMCID: PMC11658417 DOI: 10.1093/eep/dvae023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2024] [Revised: 10/14/2024] [Accepted: 11/04/2024] [Indexed: 12/21/2024]
Abstract
Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder characterized by a broad range of symptoms. The etiology of ASD is thought to involve complex gene-environment interactions, which are crucial to understanding its various causes and symptoms. DNA methylation is an epigenetic mechanism that potentially links genetic predispositions to environmental factors in the development of ASD. This review provides a global perspective on ASD, focusing on how DNA methylation studies may reveal gene-environment interactions characteristic of specific geographical regions. It delves into the role of DNA methylation in influencing the causes and prevalence of ASD in regions where environmental influences vary significantly. We also address potential explanations for the high ASD prevalence in North America, considering lifestyle factors, environmental toxins, and diagnostic considerations. Asian and European studies offer insights into endocrine-disrupting compounds, persistent organic pollutants, maternal smoking, and their associations with DNA methylation alterations in ASD. In areas with limited data on DNA methylation and ASD, such as Africa, Oceania, and South America, we discuss prevalent environmental factors based on epidemiological studies. Additionally, the review integrates global and country-specific prevalence data from various studies, providing a comprehensive picture of the variables influencing ASD diagnoses over region and year of assessment. This prevalence data, coupled with regional environmental variables and DNA methylation studies, provides a perspective on the complexities of ASD research. Integrating global prevalence data, we underscore the need for a comprehensive global understanding of ASD's complex etiology. Expanded research into epigenetic mechanisms of ASD is needed, particularly in underrepresented populations and locations, to enhance biomarker development for diagnosis and intervention strategies for ASD that reflect the varied environmental and genetic landscapes worldwide.
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Affiliation(s)
- George E Kuodza
- Department of Medical Microbiology and Immunology, Perinatal Origins of Disparities Center, MIND Institute, Genome Center, Environmental Health Sciences Center, University of California Davis, Davis, CA 95616, United States
| | - Ray Kawai
- Department of Medical Microbiology and Immunology, Perinatal Origins of Disparities Center, MIND Institute, Genome Center, Environmental Health Sciences Center, University of California Davis, Davis, CA 95616, United States
| | - Janine M LaSalle
- Department of Medical Microbiology and Immunology, Perinatal Origins of Disparities Center, MIND Institute, Genome Center, Environmental Health Sciences Center, University of California Davis, Davis, CA 95616, United States
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2
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Folatti I, Santangelo G, Sanguineti C, Inci S, Faggioli R, Bertani A, Nisticò V, Demartini B. The Prevalence of Autistic Traits in a Sample of Young Adults Referred to a Generalized Mental Health Outpatient Clinic. Diagnostics (Basel) 2024; 14:2418. [PMID: 39518387 PMCID: PMC11545153 DOI: 10.3390/diagnostics14212418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2024] [Revised: 10/22/2024] [Accepted: 10/29/2024] [Indexed: 11/16/2024] Open
Abstract
BACKGROUND/OBJECTIVES The diagnosis of Autism Spectrum Disorders (ASD) is undergoing significant revisions, impacting prevalence estimates in the general population. Moreover, the rise of a dimensional perspective on psychopathology has broadened our understanding of autism, recognizing that subthreshold autistic features extend throughout the general population. However, there remains a limited understanding of the prevalence of ASD traits in individuals with psychiatric disorders, particularly in young adults, who are at an age where several mental health conditions emerge. The aim of this study was to evaluate the prevalence of ASD traits in a sample of young adults (18-24 years old) attending a generalized mental health outpatient clinic. METHODS A total of 259 young adult patients completed the self-report screening questionnaires Autism Quotient (AQ) and Ritvo Autism and Asperger Diagnostic Scale-Revised (RAADS-R). RESULTS A total of 16.2% of our sample scored above the cut-off in both scales; this percentage decreased to 13.13% when restricting the RAADS-R cut-off to >119, as suggested for clinical samples. The association with sociodemographic features is discussed. CONCLUSIONS We argue that screening for autistic traits should be integrated into the assessment of young adults presenting with nonspecific psychiatric symptoms or psychological distress. Although there is ongoing debate over the use of self-report screening tools, a positive result on both the AQ and RAADS-R should prompt clinicians to pursue a comprehensive diagnostic evaluation using structured or semi-structured interviews.
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Affiliation(s)
- Irene Folatti
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, 20142 Milan, Italy; (I.F.); (G.S.); (C.S.); (S.I.)
| | - Giulia Santangelo
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, 20142 Milan, Italy; (I.F.); (G.S.); (C.S.); (S.I.)
| | - Claudio Sanguineti
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, 20142 Milan, Italy; (I.F.); (G.S.); (C.S.); (S.I.)
| | - Sanem Inci
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, 20142 Milan, Italy; (I.F.); (G.S.); (C.S.); (S.I.)
| | - Raffaella Faggioli
- Unità di Psichiatria 52, Presidio San Paolo, ASST Santi Paolo e Carlo, 20142 Milan, Italy; (R.F.); (B.D.)
| | - Angelo Bertani
- Centro Giovani “Ettore Ponti”, Dipartimento Salute Mentale e Dipendenze, ASST Santi Paolo e Carlo, 20142 Milan, Italy;
| | - Veronica Nisticò
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, 20142 Milan, Italy; (I.F.); (G.S.); (C.S.); (S.I.)
- “Aldo Ravelli” Research Center for Neurotechnology and Experimental Brain Therapeutics, Università degli Studi di Milano, 20142 Milan, Italy
- Dipartimento di Psicologia, Università degli Studi di Milano-Bicocca, 20126 Milan, Italy
| | - Benedetta Demartini
- Unità di Psichiatria 52, Presidio San Paolo, ASST Santi Paolo e Carlo, 20142 Milan, Italy; (R.F.); (B.D.)
- “Aldo Ravelli” Research Center for Neurotechnology and Experimental Brain Therapeutics, Università degli Studi di Milano, 20142 Milan, Italy
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3
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Valderrama A, Nikièma B, Forgeot d’Arc B, Guerrero L, Giroux M. Revealing the Most Vulnerable Groups: Courtesy Stigma in Caregivers of Autistic Persons in Quebec. Front Psychol 2024; 15:1320816. [PMID: 39144608 PMCID: PMC11323393 DOI: 10.3389/fpsyg.2024.1320816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 07/11/2024] [Indexed: 08/16/2024] Open
Abstract
Introduction Caregivers of autistic persons often face "courtesy stigma," a phenomenon by which caregivers experience stigma because of their association with a person whose disability may be stigmatized. Understanding the repercussions of this stigma is crucial not only for caregivers' mental health but also for the quality of care provided to their dependent. This study aimed to explore courtesy stigma among caregivers of autistic persons in Quebec, examining its prevalence and impact in order to identify groups that are particularly susceptible to negative outcomes. Methods This study used a cross-sectional online survey methodology employing quota sampling to collect responses from 194 participants. Data were collected using a computer-assisted web interview (CAWI) platform. The impact of courtesy stigma was measured in terms of care burden, mental health, and overall well-being of caregivers. Results The findings revealed that caregivers frequently experience rejection, isolation, and work-related challenges. Notably, caregivers' health was below average with the lowest reported health outcomes in Quebec. The caregivers who are the most vulnerable to negative outcomes included female caregivers, those aged 45 or older, financially strained households, caregivers of children requiring elevated levels of support, caregivers who isolated due to their autistic dependents, and those who experienced stigmatization directed at themselves or their children in the form of rejection.Interestingly, 60% of respondents reported that the caregiving burden was "not at all" to "somewhat" difficult, raising questions about factors that may mitigate caregiving challenges over time. Conclusion Negative outcomes from courtesy stigma vary depending on certain risk factors and individual characteristic. This study underscores the need for targeted public policies and interventions, particularly for those at a higher risk of experiencing the negative effects of courtesy stigma on the burden of care, overall health, and mental health. By tailoring resources and support for these priority groups, we can better address the challenges faced by families of autistic persons.
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Affiliation(s)
- Alena Valderrama
- Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montreal, QC, Canada
- Sainte-Justine University Hospital and Research Centre of Sainte-Justine Mother and Child University Hospital Center, Montreal, QC, Canada
| | - Béatrice Nikièma
- Sainte-Justine University Hospital and Research Centre of Sainte-Justine Mother and Child University Hospital Center, Montreal, QC, Canada
| | - Baudouin Forgeot d’Arc
- Sainte-Justine University Hospital and Research Centre of Sainte-Justine Mother and Child University Hospital Center, Montreal, QC, Canada
- Psychiatry Department, Faculty of Medicine, University of Montreal, Montréal, QC, Canada
| | - Lucila Guerrero
- Sainte-Justine University Hospital and Research Centre of Sainte-Justine Mother and Child University Hospital Center, Montreal, QC, Canada
- The Office of Patient-Family-Caregiver Partnership, Sainte-Justine Mother and Child University Hospital Center, Montréal, QC, Canada
| | - Mathieu Giroux
- The Office of Patient-Family-Caregiver Partnership, Sainte-Justine Mother and Child University Hospital Center, Montréal, QC, Canada
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4
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Patti MA, Croen LA, Dickerson AS, Joseph RM, Ames JL, Ladd-Acosta C, Ozonoff S, Schmidt RJ, Volk HE, Hipwell AE, Magee KE, Karagas M, McEvoy C, Landa R, Elliott MR, Mitchell DK, D'Sa V, Deoni S, Pievsky M, Wu PC, Barry F, Stanford JB, Bilder DA, Trasande L, Bush NR, Lyall K. Reproducibility between preschool and school-age Social Responsiveness Scale forms in the Environmental influences on Child Health Outcomes program. Autism Res 2024; 17:1187-1204. [PMID: 38794898 PMCID: PMC11186723 DOI: 10.1002/aur.3147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 04/12/2024] [Indexed: 05/26/2024]
Abstract
Evidence suggests core autism trait consistency in older children, but development of these traits is variable in early childhood. The Social Responsiveness Scale (SRS) measures autism-related traits and broader autism phenotype, with two age-dependent forms in childhood (preschool, 2.5-4.5 years; school age, 4-18 years). Score consistency has been observed within forms, though reliability across forms has not been evaluated. Using data from the Environmental Influences on Child Health Outcomes (ECHO) program (n = 853), preschool, and school-age SRS scores were collected via maternal report when children were an average of 3.0 and 5.8 years, respectively. We compared reproducibility of SRS total scores (T-scores) and agreement above a clinically meaningful cutoff (T-scores ≥ 60) and examined predictors of discordance in cutoff scores across forms. Participant scores across forms were similar (mean difference: 3.3 points; standard deviation: 7), though preschool scores were on average lower than school-age scores. Most children (88%) were classified below the cutoff on both forms, and overall concordance was high (92%). However, discordance was higher in cohorts following younger siblings of autistic children (16%). Proportions of children with an autism diagnoses were also higher among those with discordant scores (27%) than among those with concordant scores (4%). Our findings indicate SRS scores are broadly reproducible across preschool and school-age forms, particularly for capturing broader, nonclinical traits, but also suggest that greater variability of autism-related traits in preschool-age children may reduce reliability with later school-age scores for those in the clinical range.
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Grants
- UH3OD023285 NIH ECHO Program, funded by the office of the Director, NIH
- UG3 OD023342 NIH HHS
- UH3OD023288 NIH ECHO Program, funded by the office of the Director, NIH
- U24OD023319 NIH ECHO Program, funded by the office of the Director, NIH
- UH3OD023244 NIH ECHO Program, funded by the office of the Director, NIH
- UH3OD023313 NIH ECHO Program, funded by the office of the Director, NIH
- UH3OD023305 NIH ECHO Program, funded by the office of the Director, NIH
- UH3OD023275 NIH ECHO Program, funded by the office of the Director, NIH
- UH3OD023328 NIH ECHO Program, funded by the office of the Director, NIH
- UH3OD023342 NIH ECHO Program, funded by the office of the Director, NIH
- U2C OD023375 NIH HHS
- UH3OD023271 NIH ECHO Program, funded by the office of the Director, NIH
- U24OD023382 NIH ECHO Program, funded by the office of the Director, NIH
- UH3OD023249 NIH ECHO Program, funded by the office of the Director, NIH
- U2COD023375 NIH ECHO Program, funded by the office of the Director, NIH
- UH3 OD023342 NIH HHS
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Affiliation(s)
- Marisa A Patti
- AJ Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA
| | - Lisa A Croen
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Aisha S Dickerson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Robert M Joseph
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Jennifer L Ames
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Christine Ladd-Acosta
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Sally Ozonoff
- Department of Psychiatry and Behavioral Sciences, MIND Institute, University of California Davis, Sacramento, California, USA
| | - Rebecca J Schmidt
- Department of Public Health Sciences, MIND Institute, University of California Davis, Sacramento, California, USA
| | - Heather E Volk
- Wendy Klag Center for Autism and Developmental Disabilities Research, Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Alison E Hipwell
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kelsey E Magee
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Margaret Karagas
- Department of Epidemiology, Dartmouth Geisel School of Medicine, Hanover, New Hampshire, USA
| | - Cindy McEvoy
- Department of Pediatrics, Papé Pediatric Research Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - Rebecca Landa
- Center for Autism Services, Science and Innovation, Kennedy Krieger Institute, Baltimore, Maryland, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Michael R Elliott
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan, USA
| | - Daphne Koinis Mitchell
- Bradley-Hasbro Research Center and the Department of Pediatrics, Rhode Island Hospital and the Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Viren D'Sa
- Bradley-Hasbro Research Center and the Department of Pediatrics, Rhode Island Hospital and the Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Sean Deoni
- Bradley-Hasbro Research Center and the Department of Pediatrics, Rhode Island Hospital and the Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Michelle Pievsky
- Department of Psychiatry and Human Behavior, Hasbro Children's Hospital, Providence, Rhode Island, USA
| | - Pei-Chi Wu
- Bradley-Hasbro Research Center and the Department of Pediatrics, Rhode Island Hospital and the Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Fatoumata Barry
- Bradley-Hasbro Research Center and the Department of Pediatrics, Rhode Island Hospital and the Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Joseph B Stanford
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Deborah A Bilder
- Department of Psychiatry, University of Utah Huntsman Mental Health Institute, Salt Lake City, Utah, USA
| | - Leonardo Trasande
- Department of Pediatrics, New York University Grossman School of Medicine, New York, New York, USA
| | - Nicole R Bush
- Department of Psychiatry and Behavioral Sciences, Department of Pediatrics, University of California, San Francisco, California, USA
| | - Kristen Lyall
- AJ Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA
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5
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Guay C, Abouzeid N, Forget J, Boulé M. Acceptability and effects of acquiring an assistance or companion dog for families of children on the autism spectrum. Disabil Rehabil Assist Technol 2024; 19:1687-1699. [PMID: 37354544 DOI: 10.1080/17483107.2023.2227657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 06/06/2023] [Accepted: 06/15/2023] [Indexed: 06/26/2023]
Abstract
PURPOSE Assistance and companion dogs have numerous positive effects for family of autistic children, such as supporting their rehabilitation and improving their quality of life. To date, very few studies have compared the effects of both types of dogs. This comparison, considering the limited access to assistance dogs, could be helpful for families wanting to adopt a dog. METHODS An explanatory sequential design with a mixed-method approach was used. First, 85 parents (nassistance dogs = 57; ncompanion dogs = 28) of children aged between 3 and 17 years old (M = 10.73, SD = 3.67) completed an online questionnaire including sociodemographic questions and the Treatment Acceptability Rating Form-Revised (TARF-R). Then, 17 of these participants (nassistance dogs = 14; ncompanion dogs = 3) completed a semi-structured interview. RESULTS The quantitative data analyses showed that parents with assistance dogs were significantly more satisfied: t (83) = -2.12, p = .037, d = 0.49. Significant associations between some sociodemographic variables (e.g., number of children, comorbid condition, reasons for acquiring a dog) and acceptability/satisfaction (TARF-R total scores) were found. The qualitative analysis revealed that families with both dog types observed positive effects. CONCLUSIONS In brief, having an assistance dog constitutes a significant added value; nevertheless, both types of dogs are appreciated.
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Affiliation(s)
- Claudia Guay
- Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada
| | - Nadia Abouzeid
- Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada
| | - Jacques Forget
- Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada
| | - Mélina Boulé
- Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada
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6
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Villegas-Lirola F. Prevalence of Autism Spectrum Disorder in Children in Andalusia (Spain). J Autism Dev Disord 2023; 53:4438-4456. [PMID: 36076115 DOI: 10.1007/s10803-022-05728-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2022] [Indexed: 10/14/2022]
Abstract
Autism Spectrum Disorder (ASD) is socially relevant because of its number and the intensity of the medical and socio-educational response it requires. In Andalusia, one in 70 children will be diagnosed with ASD in 2021. It is much more frequent in boys than in girls, being 5.91 times more likely to present it as a boy than as a girl. The age of diagnosis is increasingly younger, standing at 4.4 years. In more than half of primary schools and more than 75% of secondary schools there are an average of three students with ASD per school. It is necessary to develop a network of preferential care centers for students with ASD to generalize specialized care in ordinary modalities.
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Affiliation(s)
- Francisco Villegas-Lirola
- HUM782 Research Group University of Almeria: Diversity, Disability and Special Educational Needs, Universidad de Almería, 04120, Almería, Spain.
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7
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Abstract
Autism is often considered to reflect categorically 'different brains'. Neuropsychological research on autism spectrum disorder (ASD) however, has struggled to define this difference, or derive clear-cut boundaries between autism and non-autism. Consequently, restructuring or disbanding the ASD diagnosis is becoming increasingly advocated within research. Nonetheless, autism now exists as a salient social construction, of which 'difference' is a key facet. Clinical and educational professionals must influence this cautiously, as changes to autism's social construction may counterproductively affect the quality of life of autistic people. This paper therefore reviews ASD's value as both neuropsychological and social constructs. Although lacking neuropsychological validity, the autism label may be beneficial for autistic self-identity, reduction of stigma, and administering support. Whilst a shift away from case-control ASD research is warranted, lay notions of 'different brains' may be preserved.
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Affiliation(s)
- Daniel Crawshaw
- School of Psychology, University of Nottingham, University Park, Nottingham, UK
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8
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Talantseva OI, Romanova RS, Shurdova EM, Dolgorukova TA, Sologub PS, Titova OS, Kleeva DF, Grigorenko EL. The global prevalence of autism spectrum disorder: A three-level meta-analysis. Front Psychiatry 2023; 14:1071181. [PMID: 36846240 PMCID: PMC9947250 DOI: 10.3389/fpsyt.2023.1071181] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 01/23/2023] [Indexed: 02/11/2023] Open
Abstract
UNLABELLED Autism spectrum disorder (ASD) is one the most disabling developmental disorders, imposing an extremely high economic burden. Obtaining as accurate prevalence estimates as possible is crucial to guide governments in planning policies for identification and intervention for individuals with ASD and their relatives. The precision of prevalence estimates can be heightened by summative analyses of the data collected around the world. To that end, we conducted a three-level mixed-effects meta-analysis. A systematic search of the Web of Science, PubMed, EMBASE, and PsycINFO databases from 2000 up to 13 July 2020 was performed, and reference lists of previous reviews and existing databases of prevalence studies were screened. Overall, 79 studies were included in the analysis of ASD and 59-in the analysis of previously existing relevant diagnoses: 30 for Autistic Disorder (AD), 15 for Asperger Syndrome (AS), and 14 for Atypical Autism (AA) and Pervasive Developmental Disorder - Not Otherwise Specified (PDD-NOS); these research reports covered the period from 1994 to 2019. Pooled prevalence estimates were 0.72% (95% CI = 0.61-0.85) for ASD, 0.25% (95% CI = 0.18-0.33) for AD, 0.13% (95% CI = 0.07-0.20) for AS, and 0.18% (95% CI = 0.10-0.28) for the combined group of AA and PDD-NOS. Estimates were higher (1) for the studies that used records-review surveillance rather than other designs; (2) in North America compared with other geographical regions; and (3) in high-income compared with lower-income countries. The highest prevalence estimates were registered in the USA. There was an increase in autism prevalence estimates over time. The prevalence was also significantly higher for children aged between 6 and 12 years compared to children under the age of 5 and over the age of 13 years. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019131525, identifier CRD42019131525.
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Affiliation(s)
- Oksana I Talantseva
- Center for Cognitive Sciences, Sirius University of Science and Technology, Sirius, Russia.,Laboratory of Translational Developmental Sciences, Department of Psychology, Saint Petersburg State University, Saint Petersburg, Russia
| | - Raisa S Romanova
- Center for Cognitive Sciences, Sirius University of Science and Technology, Sirius, Russia
| | - Ekaterina M Shurdova
- Laboratory of Translational Developmental Sciences, Department of Psychology, Saint Petersburg State University, Saint Petersburg, Russia
| | - Tatiana A Dolgorukova
- Laboratory of Translational Developmental Sciences, Department of Psychology, Saint Petersburg State University, Saint Petersburg, Russia
| | - Polina S Sologub
- Laboratory of Translational Developmental Sciences, Department of Psychology, Saint Petersburg State University, Saint Petersburg, Russia
| | - Olga S Titova
- Laboratory of Translational Developmental Sciences, Department of Psychology, Saint Petersburg State University, Saint Petersburg, Russia
| | - Daria F Kleeva
- Center for Bioelectric Interfaces, National Research University Higher School of Economics, Moscow, Russia
| | - Elena L Grigorenko
- Center for Cognitive Sciences, Sirius University of Science and Technology, Sirius, Russia.,Laboratory of Translational Developmental Sciences, Department of Psychology, Saint Petersburg State University, Saint Petersburg, Russia.,Department of Psychology, University of Houston, Houston, TX, United States.,Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, United States.,Child Study Center, Yale University, New Haven, CT, United States
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9
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Salari N, Rasoulpoor S, Rasoulpoor S, Shohaimi S, Jafarpour S, Abdoli N, Khaledi-Paveh B, Mohammadi M. The global prevalence of autism spectrum disorder: a comprehensive systematic review and meta-analysis. Ital J Pediatr 2022; 48:112. [PMID: 35804408 PMCID: PMC9270782 DOI: 10.1186/s13052-022-01310-w] [Citation(s) in RCA: 119] [Impact Index Per Article: 39.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 06/24/2022] [Indexed: 01/02/2023] Open
Abstract
Background Autism spectrum disorder (ASD) is one of the serious developmental disorders that is usually diagnosed below the age of three years. Although the severity of the disease’s symptoms varies from patient to patient, the ability to communicate with others is affected in all forms of ASD. This study aimed to determine the prevalence of ASD in high-risk groups by continent. Methods The present study was conducted by systematic review and meta-analysis from 2008 to July 2021. Databases such as Science Direct, PubMed, Scopus, SID, Magiran, Web of Science (WoS), and Google Scholar from 2008 to July 2021 were searched to find related studies. Data were analysed using Comprehensive Meta-Analysis software (Version 2). Results A total of 74 studies with 30,212,757 participants were included in this study. The prevalence of ASD in the world was 0.6% (95% confidence interval: 0.4–1%). Subgroup analyses indicated that the prevalence of ASD in Asia, America, Europe, Africa and Australia was 0.4% (95% CI: 0.1–1), 1% (95% CI: 0.8–1.1), 0.5% (95% CI: 0.2–1), 1% (95% CI: 0.3–3.1), 1.7% (95% CI: 0.5–6.1) respectively. Conclusion ASD imposes a heavy health burden on communities around the world. Early detection of ASD can reduce the incidence of developmental disorders and improve patients’ communication skills. Therefore, health policymakers need to be aware of the prevalence and increasing trend of ASD to implement appropriate planning and interventions to reduce its consequences.
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Affiliation(s)
- Nader Salari
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shabnam Rasoulpoor
- Department of Psychiatric Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Shna Rasoulpoor
- Student research committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shamarina Shohaimi
- Department of Biology, Faculty of Science, University Putra Malaysia, Serdang, Selangor, Malaysia
| | - Sima Jafarpour
- Department of Genetics and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nasrin Abdoli
- Department of Psychiatry, Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behnam Khaledi-Paveh
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoud Mohammadi
- Cellular and Molecular Research Center, Gerash University of Medical Sciences, Gerash, Iran.
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10
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Clément MA, Lee K, Park M, Sinn A, Miyake N. The Need for Sensory-Friendly "Zones": Learning From Youth on the Autism Spectrum, Their Families, and Autistic Mentors Using a Participatory Approach. Front Psychol 2022; 13:883331. [PMID: 35800952 PMCID: PMC9254619 DOI: 10.3389/fpsyg.2022.883331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Differences in sensory processing were linked to a diagnosis of autism spectrum disorder (ASD) before its inclusion as a core characteristic in the revised DSM-V. Yet, research focused on sensory processing and meaningful participation of children and youth with ASD remains relatively scarce. Although refinement of the International Classification of Functioning and Disability (ICF) relies on first-person accounts, longitudinal studies that foreground sensory experiences and its impact on involvement in a life situation from first-person perspectives are largely missing from this body of research. Objectives In this sub-study, we drew from a longitudinal participatory research project consisting of two separately funded studies with children and youth with ASD and their families between 2014 and 2021. The participatory project used photovoice (PV) methods to identify the primary concerns related to socio-spatial exclusion (PV-1) and the action steps needed to redress them (PV-2). The objective of this sub-study was to understand what really mattered to children with autism, their parents, autistic youth and an adult mentor to consider how their experiential knowledge could deepen understanding of meaningful participation. Materials and Methods We used an overarching narrative phenomenological and aesthetic theoretical framework to focus data analysis on the bodily sensing experiences related to significant moments or events, followed by an inductive thematic analysis of what mattered about those moments. Results The topical areas of concern that emerged from analyses were: (1) the relationship between sensory experiences and mental health (motion madness); (2) the indivisibility or layering of sensory and social experiences (squishing and squeezing); (3) the impact when "tricks" to stay involved are categorically misunderstood (When you don't respond in the correct way), and (4) how care and consideration of others can lead to innovative solutions for inclusion (I can't be the only one). Listening to the bodily-sensing experiences of children with ASD, autistic youth and adults, and their families in their own terms has implications for remapping the ICF and envisioning sensory curb-cuts to access, initiate and sustain occupational participation for all.
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Affiliation(s)
- Marc-André Clément
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation, Montreal, QC, Canada
| | - Keven Lee
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation, Montreal, QC, Canada
- Lady Davis Institute, Montreal, QC, Canada
| | - Melissa Park
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation, Montreal, QC, Canada
- Lady Davis Institute, Montreal, QC, Canada
| | - Anabel Sinn
- addtothenoise, Los Angeles, CA, United States
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11
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Roman-Urrestarazu A, van Kessel R. Inaccurate prevalence estimates impacts autism policy: A letter to the editor in relation to "Global prevalence of autism: A systematic review update" by Zeidan et al. (2022). Autism Res 2022; 15:1184-1186. [PMID: 35570469 PMCID: PMC9322680 DOI: 10.1002/aur.2734] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 04/16/2022] [Indexed: 11/05/2022]
Affiliation(s)
- Andres Roman-Urrestarazu
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK.,Cambridge Public Health, University of Cambridge, Cambridge, UK.,Department of International Health, School CAPHRI, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA
| | - Robin van Kessel
- Department of International Health, School CAPHRI, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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12
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Bakare MO, Frazier TW, Karpur A, Abubakar A, Nyongesa MK, Mwangi PM, Dixon P, Khaliq I, Gase NK, Sandstrom J, Okidegbe N, Rosanoff M, Munir KM, Shih A. Brief report: Validity and reliability of the Nigerian Autism Screening Questionnaire. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:1581-1590. [PMID: 35261274 PMCID: PMC7613535 DOI: 10.1177/13623613221080250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Informant-report measures for screening symptoms of autism spectrum disorder (ASD) and other neurodevelopmental disorders (NDDs) are needed for low-resource settings if early identification is to be prioritized because early developmental concerns are likely to be expressed by parents and other caregivers. This paper describes the initial psychometric evaluation of the Nigeria Autism Screening Questionnaire (NASQ). Parents and other caregivers completed the NASQ on 12,311 children ages 1 to 18 in a Nigerian population sample as part of the World Bank National General Household Survey conducted in the country in 2016. Factor analyses indicated a parsimonious three-factor structure with social communication/interaction, repetitive sensory motor, and insistence on sameness dimensions. Measurement invariance was excellent across age and sex. Reliability of the subscales and total scale was good, and item response theory analyses indicated good measurement precision in the range from below average to high scores, crucial for screening, and tracking ASD symptoms. Studies with gold standard ASD diagnostic instruments and clinical confirmation are needed to evaluate screening and diagnostic accuracy. The NASQ appears to be a reliable instrument with a clear factor structure and potential for use in screening and tracking ASD symptoms in future Nigerian samples.
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Affiliation(s)
- Muideen O Bakare
- Federal Neuro Psychiatric Hospital, Nigeria.,Childhood Neuropsychiatric Disorders Initiatives (CNDI), Nigeria.,Ike Foundation for Autism (IFA), Nigeria.,World Psychiatric Association (WPA), Switzerland
| | | | | | - Amina Abubakar
- Aga Khan University, Kenya.,KEMRI-Wellcome Trust Research Programme, Kenya
| | | | | | | | | | | | | | | | | | - Kerim M Munir
- World Psychiatric Association (WPA), Switzerland.,Harvard Medical School, USA
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13
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Zeidan J, Fombonne E, Scorah J, Ibrahim A, Durkin MS, Saxena S, Yusuf A, Shih A, Elsabbagh M. Global prevalence of autism: A systematic review update. Autism Res 2022; 15:778-790. [PMID: 35238171 PMCID: PMC9310578 DOI: 10.1002/aur.2696] [Citation(s) in RCA: 814] [Impact Index Per Article: 271.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 02/11/2022] [Accepted: 02/14/2022] [Indexed: 01/20/2023]
Abstract
Prevalence estimates of autism are essential for informing public policy, raising awareness, and developing research priorities. Using a systematic review, we synthesized estimates of the prevalence of autism worldwide. We examined factors accounting for variability in estimates and critically reviewed evidence relevant for hypotheses about biological or social determinants (viz., biological sex, sociodemographic status, ethnicity/race, and nativity) potentially modifying prevalence estimates of autism. We performed the search in November 2021 within Medline for studies estimating autism prevalence, published since our last systematic review in 2012. Data were extracted by two independent researchers. Since 2012, 99 estimates from 71 studies were published indicating a global autism prevalence that ranges within and across regions, with a median prevalence of 100/10,000 (range: 1.09/10,000 to 436.0/10,000). The median male‐to‐female ratio was 4.2. The median percentage of autism cases with co‐occurring intellectual disability was 33.0%. Estimates varied, likely reflecting complex and dynamic interactions between patterns of community awareness, service capacity, help seeking, and sociodemographic factors. A limitation of this review is that synthesizing methodological features precludes a quality appraisal of studies. Our findings reveal an increase in measured autism prevalence globally, reflecting the combined effects of multiple factors including the increase in community awareness and public health response globally, progress in case identification and definition, and an increase in community capacity. Hypotheses linking factors that increase the likelihood of developing autism with variations in prevalence will require research with large, representative samples and comparable autism diagnostic criteria and case‐finding methods in diverse world regions over time.
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Affiliation(s)
- Jinan Zeidan
- Montreal Neurological Institute-Hospital, Faculty of Medicine & Health Sciences, McGill University Montreal, Montreal, Canada
| | - Eric Fombonne
- Department of Psychiatry, Oregon Health and Science University, Portland, Oregon, USA
| | - Julie Scorah
- Montreal Neurological Institute-Hospital, Faculty of Medicine & Health Sciences, McGill University Montreal, Montreal, Canada
| | - Alaa Ibrahim
- Montreal Neurological Institute-Hospital, Faculty of Medicine & Health Sciences, McGill University Montreal, Montreal, Canada
| | - Maureen S Durkin
- Population Health Sciences, Department of Pediatrics, Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Shekhar Saxena
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Afiqah Yusuf
- Montreal Neurological Institute-Hospital, Faculty of Medicine & Health Sciences, McGill University Montreal, Montreal, Canada
| | - Andy Shih
- Autism Speaks, New York City, New York, USA
| | - Mayada Elsabbagh
- Montreal Neurological Institute-Hospital, Faculty of Medicine & Health Sciences, McGill University Montreal, Montreal, Canada
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14
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Mutluer T, Aslan Genç H, Özcan Morey A, Yapici Eser H, Ertinmaz B, Can M, Munir K. Population-Based Psychiatric Comorbidity in Children and Adolescents With Autism Spectrum Disorder: A Meta-Analysis. Front Psychiatry 2022; 13:856208. [PMID: 35693977 PMCID: PMC9186340 DOI: 10.3389/fpsyt.2022.856208] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 04/29/2022] [Indexed: 12/22/2022] Open
Abstract
UNLABELLED Psychiatric comorbidity in autism spectrum disorder (ASD) is a subject of critical scientific importance, affecting the quality of life, prognosis, and functional outcomes. The prevalence of psychiatric disorders vary considerably according to variables such as index subject characteristics, study setting, sampling frame, diagnostic methods used, as well as country of geographic origin. To date, most studies comprise clinical or treatment referral samples in tertiary care or subjects enrolled in clinical trials and genetic cohort collections. Such samples carry the potential for overestimation of both the frequency and severity of psychiatric comorbidity. A systematic literature search was performed using PubMed and Web of Science databases restricted to population-based study publications in the English between May 1, 2015, and May 31, 2020. A comprehensive keyword list was generated to investigate co-occurrence of psychiatric disorders in children and adolescents with ASD. A wide range of DSM-5 based disorders such as anxiety, mood, ADHD, intellectual disability/intellectual developmental disorder, eating/feeding, gender dysphoria and sleep-wake disorders were assessed. Initial search revealed a total of 1674 articles after removal of duplicates. Two independent researchers conducted a parallel-blinded screening process to identify the eligible studies based on titles and abstracts; 39 studies were analyzed in the current review. The main findings show prevalence estimates of 22.9% (95% CI: 17.7- 29.2) for intellectual disability; 26.2% (22-31) for attention-deficit hyperactivity disorder; 11.1% (8.6-14.1) for anxiety disorders; 19.7% (11.9-30.7) for sleep disorders; 7% (5.2- 9.3) for disruptive disorders; 2% (1.3- 3.1) for bipolar disorders; 2.7% (1.8- 4.2) for depression; 1.8% (0.4-8.7) for obsessive-compulsive disorder; and 0.6% (0.3-1.1) for psychosis. Psychiatric comorbidity in population-based studies is lower than in clinical and referred samples. However, our results also indicate that the frequency of psychiatric comorbidity in children and adolescents with ASD in the population context is considerable, without the influence of referral bias implicit in clinical and treatment samples. There is a need for better targeted diagnostic tools to detect psychiatric comorbidity in children and youth in future population-based studies, as an essential component in providing care as well as new insights into the nature and mechanisms of its underlying associations. SYSTEMATIC REVIEW REGISTRATION [https://www.crd.york.ac.uk/prospero/], identifier [CRD42021234464].
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Affiliation(s)
- Tuba Mutluer
- Department of Psychiatry, School of Medicine, Koç University, Istanbul, Turkey.,Research Center for Translational Medicine (KUTTAM), Koç University, Istanbul, Turkey
| | - Herdem Aslan Genç
- Division of Child and Adolescent Psychiatry, Koç University Hospital, Istanbul, Turkey
| | - Aslihan Özcan Morey
- Division of Child and Adolescent Psychiatry, Koç University Hospital, Istanbul, Turkey
| | - Hale Yapici Eser
- Department of Psychiatry, School of Medicine, Koç University, Istanbul, Turkey.,Research Center for Translational Medicine (KUTTAM), Koç University, Istanbul, Turkey
| | | | - Merve Can
- Department of Child and Adolescent Psychiatry, Bakirkoy Prof. Dr. Mazhar Osman Training and Research Hospital for Mental Health and Nervous Disorders, Istanbul, Turkey
| | - Kerim Munir
- Developmental Medicine Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
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15
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Andreas AM, Djuwita R, Helda H, Sekartni R, Suradijono SHR, Wiguna T, Tulaar ABM, Kristianto Y, Hendrik H. Massage Therapy Can Prevent the Risk of Autism Spectrum Disorders in Children. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Abstract
Background: The prevalence of people with autism spectrum disorders in some parts of the world tends to increase, in Indonesia alone, accurate and complete data and information from people with autism spectrum disorders (ASD) are still lacking, so it is feared that many children with risk symptoms of autism spectrum disorders do not get treatment early.
Aim: This study aims to prevent the risk of autism spectrum disorders in children by applying massage therapy based on analysis of the Modified Check List for Autism in Toddler (M-Chat) scores.
Methods: The study was conducted from May 2019 to March 2020 at three public health centers in the city of Jakarta. An analysis was carried out before and after the application of massage in a time series of four periods on 10 children aged 18-36 months with M-Chat scores, then analyzed by receiver operating characteristic (ROC) to obtain a cut off point to determine the risk status of autism spectrum disorders.
Results: The results showed that there was an effect of massage therapy on the M-Chat score of children with autism spectrum disorder risk p=0.004 <0.05 and changes in the M-Chat score of children with autism spectrum disorder risk experienced significant changes after massage in the third and fourth therapy periods. with p = 0.005 and p = 0.007 < 0.05.
Conclusion: The results show that massage therapy can prevent the risk of autism spectrum disorders in children based on the Modified Check List for Autism in Toddler (M-Chat).
Keywords: Massage therapy, babies, autism spectrum disorders, modified checklist for autism in toddler
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16
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Chen J, Chen J, Xu Y, Cheng P, Yu S, Fu Y, Du Y. Retinol-binding protein 4 in combination with lipids to predict the regression phenomenon of autism spectrum disorders. Lipids Health Dis 2021; 20:93. [PMID: 34446012 PMCID: PMC8390196 DOI: 10.1186/s12944-021-01522-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 08/14/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND About 20-40 % of autistic people experience a phenomenon of regression. Retinol binding protein 4 (RBP4) plays an important role as an inflammatory neurotrophic adipokine and is a promising mediator of the fat-brain axis. Abnormal fatty acid metabolism and lipid mediators have been reported to be related to the etiological mechanism in autism, and amelioration of impaired lipid metabolism can be recognized as a treatment strategy for autism. The purpose of this study is to explore the relationship between RBP4, lipids, and the autistic regression phenomenon, and to discuss their potentials as biomarkers for the autistic regression phenomenon. METHODS A total of 60 autistic individuals (18 with regression phenomenon, 42 without regression phenomenon) (ASD group) and 36 healthy controls were enrolled in this case-control study. The levels of RBP4, total cholesterol (TC), high-density lipoprotein (HDLC), low-density lipoprotein (LDLC), and triglyceride (TG) were measured. Childhood Autism Rating Scale (CARS) is used to assess the severity of autism. Ethical measures were performed in compliance with the current Declaration of Helsinki and written informed consent was obtained from the parents before enrollment of the children and adolescents. RESULTS Compared with control subjects, autistic individuals had lower levels of TC (P = 0.007), RBP4 (P = 0.001), and HDLC (P = 0.027). The levels of RBP4 in ASD group were positively correlated with TG (r = 0.355, P = 0.005), HDLC (r = 0.257, P = 0.047), TG/TC (r = 0.376, P = 0.003) and TG/LDLC (r = 0.363, P = 0.004), and were negatively correlated with CARS (r=-0.296, P = 0.003). Further logistic regression demonstrated that decreased RBP4 concentration was associated with the presentation of the autistic regression phenomenon even after the adjustment of the potential confounding factors. CONCLUSIONS Serum RBP4 is associated with the autistic regression phenomenon and the severity of ASD. Further studies are needed to expound whether decreased RBP4 participates in the development of the autistic regression phenomenon.
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Affiliation(s)
- Jianling Chen
- Department of Child & Adolescent Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai, China
| | - Jing Chen
- Department of Child & Adolescent Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai, China
| | - Yun Xu
- Department of Child & Adolescent Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai, China
| | - Peipei Cheng
- Department of Child & Adolescent Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai, China
| | - Shunying Yu
- Department of Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yingmei Fu
- Department of Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yasong Du
- Department of Child & Adolescent Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai, China.
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17
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Hegvik TA, Waløen K, Pandey SK, Faraone SV, Haavik J, Zayats T. Druggable genome in attention deficit/hyperactivity disorder and its co-morbid conditions. New avenues for treatment. Mol Psychiatry 2021; 26:4004-4015. [PMID: 31628418 PMCID: PMC7165040 DOI: 10.1038/s41380-019-0540-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 05/26/2019] [Accepted: 06/10/2019] [Indexed: 01/22/2023]
Abstract
Attention-Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder with only symptomatic care available. Genome-wide association (GWA) studies can provide a starting point in the search for novel drug targets and possibilities of drug repurposing. Here, we explored the druggable genome in ADHD by utilising GWA studies on ADHD and its co-morbid conditions. First, we explored whether the genes targeted by current ADHD drugs show association with the disorder and/or its co-morbidities. Second, we aimed to identify genes and pathways involved in the biological processes underlying ADHD that can be targeted by pharmacological agents. These ADHD-associated druggable genes and pathways were also examined in co-morbidities of ADHD, as commonalities in their aetiology and management may lead to novel pharmacological insights. Strikingly, none of the genes encoding targets of first-line pharmacotherapeutics for ADHD were significantly associated with the disorder, suggesting that FDA-approved ADHD drugs may act through different mechanisms than those underlying ADHD. In the examined druggable genome, three loci on chromosomes 1, 4 and 12 revealed significant association with ADHD and contained nine druggable genes, five of which encode established drug targets for malignancies, autoimmune and neurodevelopmental disorders. To conclude, we present a framework to assess the druggable genome in a disorder, exemplified by ADHD. We highlight signal transduction and cell adhesion as potential novel avenues for ADHD treatment. Our findings add to knowledge on known ADHD drugs and present the exploration of druggable genome associated with ADHD, which may offer interventions at the aetiological level of the disorder.
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Affiliation(s)
- Tor-Arne Hegvik
- K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway
| | - Kai Waløen
- K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway
| | - Sunil K Pandey
- K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway
| | - Stephen V Faraone
- K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway
- Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Jan Haavik
- K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Tetyana Zayats
- K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway.
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA.
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
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18
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Russell MJ, Michael Scott CW, Murias K, Ben Gibbard W, Cui X, Tough S, Zwicker JD. Cross-ministry data on service use and limitations faced by children in special education. Disabil Health J 2021; 14:101118. [PMID: 34074619 DOI: 10.1016/j.dhjo.2021.101118] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 05/08/2021] [Accepted: 05/10/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Children with disabilities often face limitations that cross support sectors. OBJECTIVE Our aim was to measure cross-ministry service use, outcomes, and functional limitations faced by children who qualified for special education. METHODS We used longitudinal British Columbia ministry data linked to children (0-18y) registered in K-12 education. Children were grouped by special education funding (most to least; Level 1, Level 2, Level 3, Unfunded, and no special education), and related to 1) service use patterns, 2) the age they first used disability services, and 3) functional limitations reported in health visits. We also reported how length of special education use related to disability service use. RESULTS Of 111,274 children, 154(0.1%) were Level 1, 4427(4.0%) Level 2, 2897(2.6%) Level 3, 13472(12.1%) Unfunded, and 90324(81.2%) not in special education. Children with higher funding levels, compared to lower levels of funding, generally were more likely to experience poorer outcomes, have functional limitations, have service needs, and receive early support. One exception was children with serious behavioural/mental health special education coding, which had poorer outcomes for their level of funding. Children received child disability supports early (about half of users started by 4y), but use was mostly limited to those with many years (9+years) of funded special education (70.7% of the all users) and biased to certain special education codes (i.e., Level 1, severe intellectual disability, and autism). CONCLUSIONS This study provides evidence of the long-term, diverse needs of children in special education and may be used to inform decisions surrounding their support.
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Affiliation(s)
- Matthew Joseph Russell
- School of Public Policy, University of Calgary, 906 8th Avenue S.W., 5th Floor, Calgary, Alberta, T2P 1H9, Canada; Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada; PolicyWise for Children & Families, 1000-9925 109 St NW, Edmonton, AB T5K 2J8, Canada.
| | - Craig William Michael Scott
- School of Public Policy, University of Calgary, 906 8th Avenue S.W., 5th Floor, Calgary, Alberta, T2P 1H9, Canada
| | - Kara Murias
- Pediatrics, Cumming School of Medicine, University of Calgary, 28 Oki Drive NW, Calgary, Alberta, T3B 6A8, Canada
| | - W Ben Gibbard
- Pediatrics, Cumming School of Medicine, University of Calgary, 28 Oki Drive NW, Calgary, Alberta, T3B 6A8, Canada
| | - Xinjie Cui
- PolicyWise for Children & Families, 1000-9925 109 St NW, Edmonton, AB T5K 2J8, Canada
| | - Suzanne Tough
- Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada; Pediatrics, Cumming School of Medicine, University of Calgary, 28 Oki Drive NW, Calgary, Alberta, T3B 6A8, Canada
| | - Jennifer D Zwicker
- School of Public Policy, University of Calgary, 906 8th Avenue S.W., 5th Floor, Calgary, Alberta, T2P 1H9, Canada; Faculty of Kinesiology, University of Calgary, 376 Collegiate Blvd NW, Calgary, Alberta, T2N 1N4, Canada
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19
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Hastings SE, Hastings RP, Swales MA, Hughes JC. Emotional and behavioural problems of children with autism spectrum disorder attending mainstream schools. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2021; 68:633-640. [PMID: 36210888 PMCID: PMC9542324 DOI: 10.1080/20473869.2020.1869414] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 12/18/2020] [Accepted: 12/20/2020] [Indexed: 05/30/2023]
Abstract
Emotional and behavioural problems occur more commonly in children with Autism Spectrum Disorder (ASD) compared to other children. Few studies have focused on these problems in children with ASD attending mainstream schools. We assessed via parent report the emotional and behavioural problems in 160 children aged 4-17 years with ASD attending mainstream schools and investigated differences between the primary and secondary aged children. Children with ASD had higher levels of problems across all domains of the Strengths and Difficulties Questionnaire (SDQ) compared to UK norms. Within the ASD sample, SDQ scores were associated with male sex, living in a household with more children, more severe autism symptoms and fewer adaptive skills, and higher levels of family socio-economic risk. No robust primary-secondary school differences were found. Implications for future research and the support of children with ASD in mainstream school settings are discussed.
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Affiliation(s)
| | | | | | - J Carl Hughes
- School of Education and Human Development, Bangor University, Bangor, Gwynedd, UK
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20
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Currie G, Szabo J. Social isolation and exclusion: the parents' experience of caring for children with rare neurodevelopmental disorders. Int J Qual Stud Health Well-being 2020; 15:1725362. [PMID: 32048917 PMCID: PMC7034477 DOI: 10.1080/17482631.2020.1725362] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Purpose: The experiences of parents caring for the complex care needs of children with rare neurodevelopmental disorders are not well understood. Parents struggle to meet their children's medical, behavioural, and social needs within and across health, social, and family systems. The purpose of this study was to explore the parents' experience of caring for medical and social care needs for children with rare neurodevelopmental disorders.Methods: Hermeneutic phenomenology was used for the data analysis. Fifteen parents participated in semi-structured interviews.Results: Interpretive analysis revealed four insights: (a) difference in children's behaviours and disease manifestations led to misunderstanding and vulnerability within social domains, (b) social taboo and stigma were experienced with rarity, (c) fragmented disconnected care from health and social systems impacted families, and (d) incomprehension from friends and family occurs when managing daily care.Conclusion: New interpretations and increased understanding of parents' experiences are required in supporting parents caring for children with complex needs. Understanding parents' experiences could reduce social isolation and exclusion, and mitigate appropriate and supportive practices and services within and across medical, social, and family systems.
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Affiliation(s)
- Genevieve Currie
- School of Nursing and Midwifery, Faculty of Health, Community and Education, Mount Royal University, Calgary, Alberta, Canada
| | - Joanna Szabo
- School of Nursing and Midwifery, Faculty of Health, Community and Education, Mount Royal University, Calgary, Alberta, Canada
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21
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The First National Prevalence of Autism Spectrum Disorder in China. Neurosci Bull 2020; 36:959-960. [PMID: 32860208 DOI: 10.1007/s12264-020-00571-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 06/28/2020] [Indexed: 12/30/2022] Open
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22
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Huang Y, Arnold SR, Foley KR, Trollor JN. Diagnosis of autism in adulthood: A scoping review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 24:1311-1327. [PMID: 32106698 DOI: 10.1177/1362361320903128] [Citation(s) in RCA: 96] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2025]
Abstract
LAY ABSTRACT More adults are getting assessed for possible autism. Here, we give an overview on what is already known about autism diagnosis in adulthood and find areas that need more research. We divided results from the studies we found into six topics of (1) rates of autism in different groups; (2) the process of getting an autism diagnosis in adulthood; (3) gender; (4) personality traits, abilities and behaviours of diagnosed adults; (5) mental and physical health conditions that occur together with autism; and (6) how adults think and feel about being assessed and diagnosed. We found that adults often have strong emotions after being diagnosed, the process of getting a diagnosis can be unclear and different for everyone, and not many support services are available for adults. More research on diagnosing adults with intellectual disability, differences between early and late-diagnosed adults, and support after diagnosis would be useful.
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Affiliation(s)
- Yunhe Huang
- University of New South Wales, Australia
- The Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | - Samuel Rc Arnold
- University of New South Wales, Australia
- The Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | - Kitty-Rose Foley
- University of New South Wales, Australia
- Southern Cross University, Australia
| | - Julian N Trollor
- University of New South Wales, Australia
- The Cooperative Research Centre for Living with Autism (Autism CRC), Australia
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23
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Geryk J, Krsička D, Vlčková M, Havlovicová M, Macek M, Kremlíková Pourová R. The Key Role of Purine Metabolism in the Folate-Dependent Phenotype of Autism Spectrum Disorders: An In Silico Analysis. Metabolites 2020; 10:metabo10050184. [PMID: 32384607 PMCID: PMC7281253 DOI: 10.3390/metabo10050184] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 04/22/2020] [Accepted: 04/23/2020] [Indexed: 01/20/2023] Open
Abstract
Folate deficiency in the critical developmental period has been repeatedly associated with an increased risk of Autism spectrum disorders (ASD), but the key pathophysiological mechanism has not yet been identified. In this work, we focused on identifying genes whose defect has similar consequences to folate depletion in the metabolic network. Within the Flux Balance Analysis (FBA) framework, we developed a method of blocked metabolites that allowed us to define the metabolic consequences of various gene defects and folate depletion. We identified six genes (GART, PFAS, PPAT, PAICS, ATIC, and ADSL) whose blocking results in nearly the same effect in the metabolic network as folate depletion. All of these genes form the purine biosynthetic pathway. We found that, just like folate depletion, the blockade of any of the six genes mentioned above results in a blockage of purine metabolism. We hypothesize that this can lead to decreased adenosine triphosphate (ATP) and subsequently, an S-adenosyl methionine (SAM) pool in neurons in the case of rapid cell division. Based on our results, we consider the methylation defect to be a potential cause of ASD, due to the depletion of purine, and consequently S-adenosyl methionine (SAM), biosynthesis.
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Affiliation(s)
- Jan Geryk
- Correspondence: ; Tel.: +420-224-433-515
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24
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Chiarotti F, Venerosi A. Epidemiology of Autism Spectrum Disorders: A Review of Worldwide Prevalence Estimates Since 2014. Brain Sci 2020; 10:brainsci10050274. [PMID: 32370097 PMCID: PMC7288022 DOI: 10.3390/brainsci10050274] [Citation(s) in RCA: 261] [Impact Index Per Article: 52.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 04/20/2020] [Accepted: 04/21/2020] [Indexed: 12/31/2022] Open
Abstract
The prevalence of Autism Spectrum Disorder (ASD) has increased dramatically in recent decades, supporting the claim of an autism epidemic. Systematic monitoring of ASD allows estimating prevalence and identifying potential sources of variation over time and geographical areas. At present, ASD prevalence estimates are available worldwide, coming either from surveillance systems using existing health and educational databases or from population studies specifically performed. In the present article, we present a review of the ASD prevalence estimates published since 2014. Data confirm a high variability in prevalence across the world, likely due to methodological differences in case detection, and the consistent increase of prevalence estimates within each geographical area.
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25
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Gaulin M, Simard M, Candas B, Lesage A, Sirois C. Combined impacts of multimorbidity and mental disorders on frequent emergency department visits: a retrospective cohort study in Quebec, Canada. CMAJ 2020; 191:E724-E732. [PMID: 31266786 DOI: 10.1503/cmaj.181712] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Multimorbidity and mental disorders are independently associated with frequent visits to the emergency department (≥ 3 visits/yr), but their interaction has been little studied. We aimed to measure the interaction between mental disorders and physical multimorbidity with respect to frequent visits to the emergency department. METHODS We conducted a population-based cohort study of adults in Quebec from 2012 to 2016, using the Quebec Integrated Chronic Disease Surveillance System. We assessed multimorbidity as the number of physical illnesses and mental disorders as serious (psychotic or bipolar disorders), common or absent, using data from 2012 to 2014. We counted emergency department visits from 2014 to 2015. We used logistic regression to estimate interaction on frequent visits to the emergency department from 2 perspectives: of public health (additive scale as differences in risk) and of individual patients (multiplicative scale as odds ratios). RESULTS Each additional physical illness was associated with a greater increase in the absolute risk of frequent visits to the emergency department for people with mental disorders. Between 0 and ≥ 4 physical conditions, the absolute risk increased more for individuals with serious mental disorders (16.2%) than common (15.3%) or no disorders (11.4%). On the relative scale, for people with no mental disorders and ≥ 4 physical conditions, odds of frequent visits to the emergency department were 6.2 (95% confidence interval [CI] 6.08-6.35) times the odds for people with no physical conditions. For individuals with common and serious mental illnesses, corresponding odds ratios were 4.75 (95% CI 4.60-4.90) and 3.7 (95% CI 3.18-3.57), respectively. INTERPRETATION Mental disorders interact with physical multimorbidity to increase the odds of frequent visits to the emergency department. More research is needed on interventions that promote high-quality care for mental illness, especially in the context of physical multimorbidity.
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Affiliation(s)
- Myles Gaulin
- Département de médecine sociale et préventive (Gaulin, Candas, Sirois), Faculté de médecine, Université Laval, Québec, Que.; Institut national de santé publique du Québec (INSPQ) (Gaulin, Simard, Lesage, Sirois), Montréal, Que.; Institut national d'excellence en santé et services sociaux (INESSS) (Candas), Québec, Que.; Département de psychiatrie (Lesage), Université de Montréal, Montréal, Que
| | - Marc Simard
- Département de médecine sociale et préventive (Gaulin, Candas, Sirois), Faculté de médecine, Université Laval, Québec, Que.; Institut national de santé publique du Québec (INSPQ) (Gaulin, Simard, Lesage, Sirois), Montréal, Que.; Institut national d'excellence en santé et services sociaux (INESSS) (Candas), Québec, Que.; Département de psychiatrie (Lesage), Université de Montréal, Montréal, Que.
| | - Bernard Candas
- Département de médecine sociale et préventive (Gaulin, Candas, Sirois), Faculté de médecine, Université Laval, Québec, Que.; Institut national de santé publique du Québec (INSPQ) (Gaulin, Simard, Lesage, Sirois), Montréal, Que.; Institut national d'excellence en santé et services sociaux (INESSS) (Candas), Québec, Que.; Département de psychiatrie (Lesage), Université de Montréal, Montréal, Que
| | - Alain Lesage
- Département de médecine sociale et préventive (Gaulin, Candas, Sirois), Faculté de médecine, Université Laval, Québec, Que.; Institut national de santé publique du Québec (INSPQ) (Gaulin, Simard, Lesage, Sirois), Montréal, Que.; Institut national d'excellence en santé et services sociaux (INESSS) (Candas), Québec, Que.; Département de psychiatrie (Lesage), Université de Montréal, Montréal, Que
| | - Caroline Sirois
- Département de médecine sociale et préventive (Gaulin, Candas, Sirois), Faculté de médecine, Université Laval, Québec, Que.; Institut national de santé publique du Québec (INSPQ) (Gaulin, Simard, Lesage, Sirois), Montréal, Que.; Institut national d'excellence en santé et services sociaux (INESSS) (Candas), Québec, Que.; Département de psychiatrie (Lesage), Université de Montréal, Montréal, Que
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26
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Kiselev Y, Handal M, Hjellvik V, Reichborn-Kjennerud T, Stoltenberg C, Suren P, Havdahl A, Skurtveit S. Nationwide Study of Neuropsychiatric Comorbidity and Medicines Use in Children With Autism Spectrum Disorder in Norway. Front Psychiatry 2020; 11:596032. [PMID: 33363486 PMCID: PMC7753175 DOI: 10.3389/fpsyt.2020.596032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 11/18/2020] [Indexed: 12/27/2022] Open
Abstract
Purpose: Autism spectrum disorder (ASD) has a high rate of comorbidity. While many children with ASD are exposed to psychotropic medicines, their efficacy and safety in these patients are unclear. There is a need for more detailed knowledge on which medicines are most commonly used and for which disorders. We aimed to investigate (a) prevalence and incidence rate of ASD among Norwegian children, and further, among newly diagnosed ASD children in 2014, study the (b) co-occurrence of neuropsychiatric disorders, (c) use of psychotropic drugs, and (d) the relationship between co-occurring diagnoses and use of psychotropic drugs. Method: Nationwide registry-based study of children 2-17 years old in Norway. Results: The ASD prevalence was 0.76% and the incidence rate was 0.12% in 2014. Of the children who received an initial ASD diagnosis in 2014 (n = 1,234), 64.8% had one or more co-occurring neuropsychiatric diagnosis. Psychotropic medication use was moderate (~20% used stimulants or hypnotics) in general, and low in children without comorbidity (nearly only hypnotics). There was a good accordance between co-occurring diagnoses and indication for the prescribed medications. Conclusions: Children with newly diagnosed ASD mainly received psychotropic drugs to treat co-occurring neuropsychiatric conditions.
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Affiliation(s)
- Yury Kiselev
- Department of Life Sciences and Health, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Marte Handal
- Norwegian Institute of Public Health, Oslo, Norway
| | | | - Ted Reichborn-Kjennerud
- Norwegian Institute of Public Health, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | - Pål Suren
- Norwegian Institute of Public Health, Oslo, Norway
| | - Alexandra Havdahl
- Norwegian Institute of Public Health, Oslo, Norway.,Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Svetlana Skurtveit
- Norwegian Institute of Public Health, Oslo, Norway.,Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
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27
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Alshaban F, Aldosari M, Al‐Shammari H, El‐Hag S, Ghazal I, Tolefat M, Ali M, Kamal M, Abdel Aati N, Abeidah M, Saad AH, Dekair L, Al Khasawneh M, Ramsay K, Fombonne E. Prevalence and correlates of autism spectrum disorder in Qatar: a national study. J Child Psychol Psychiatry 2019; 60:1254-1268. [PMID: 31069792 PMCID: PMC6899566 DOI: 10.1111/jcpp.13066] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/21/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Few epidemiological data on autism spectrum disorders (ASD) exist for Arabic countries. We conducted the first survey of ASD in Qatar, a population with high consanguinity level. METHODS This cross-sectional survey was conducted from 2015 to 2018 in Qatar school-age children (N = 176,960) from national and immigrant families. Children diagnosed with ASD were identified through medical centers and special needs schools. Records were abstracted and supplemented by parental interviews. Additionally, children attending 93 schools were screened; ASD case status was confirmed in random samples of screen-positive and screen-negative children. Prevalence was estimated after taking into account different sampling fractions and participation rates at each survey phase. RESULTS One thousand three hundred and ninety-three children already diagnosed with ASD were identified. Among 9,074 school survey participants, 760 screen-negative children and 163 screen-positive children were evaluated; 17 were confirmed to have ASD including five children newly diagnosed. Prevalence was 1.14% (95% CI: 0.89-1.46) among 6- to 11-year-olds. ASD was reported in full siblings/extended relatives in 5.9% (95% CI: 0.042-0.080)/11.8% (95% CI: 0.095-0.146) families. First-degree consanguinity in Qatari cases (45%) was comparable to known population levels. Among 844 ASD cases (mean age: 7.2 years; 81% male), most children experienced language delay (words: 75.1%; phrase speech: 91.4%), and 19.4% reported developmental regression. At the time of the survey, persisting deficits in expressive language (19.4%) and peer interactions (14.0%) were reported in conjunction with behavioral problems (ADHD: 30.2%; anxiety: 11.0%). In multivariate logistic regression, ASD severity was associated with parental consanguinity, gestational diabetes, delay in walking, and developmental regression. CONCLUSIONS ASD prevalence in Qatar is consistent with recent international studies. The methods employed in this study should help designing comparable surveys in the region. We estimated that 187,000 youths under age 20 have ASD in Gulf countries. This figure should assist in planning health and educational services for a young, fast-growing population.
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Affiliation(s)
- Fouad Alshaban
- Neurological Disorders Research Center, Qatar Biomedical Research Institute (QBRI)Hamad Bin Khalifa UniversityDohaQatar
| | | | - Hawraa Al‐Shammari
- Neurological Disorders Research Center, Qatar Biomedical Research Institute (QBRI)Hamad Bin Khalifa UniversityDohaQatar
| | - Saba El‐Hag
- Neurological Disorders Research Center, Qatar Biomedical Research Institute (QBRI)Hamad Bin Khalifa UniversityDohaQatar
| | - Iman Ghazal
- Neurological Disorders Research Center, Qatar Biomedical Research Institute (QBRI)Hamad Bin Khalifa UniversityDohaQatar
| | - Mohamed Tolefat
- Department of Clinical ServicesShafallah Center for Children with DisabilitiesDoha
| | - Mogahed Ali
- Department of Clinical ServicesShafallah Center for Children with DisabilitiesDoha
| | - Madeeha Kamal
- Department of PediatricsHamad Medical CorporationDohaQatar
| | | | | | | | - Lobna Dekair
- Department of PediatricsHamad Medical CorporationDohaQatar
| | | | - Katrina Ramsay
- Department of Public Health, Biostatistics and Design UnitOregon Health & Science UniversityPortlandORUSA
| | - Eric Fombonne
- Departments of Psychiatry, Pediatrics, and Behavioral NeurosciencesOregon Health & Science UniversityPortlandORUSA
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28
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Kurjak A, Spalldi Barišić L, Stanojević M, Antsaklis P, Panchal S, Honemeyer U, Moreira Neto R, Tinjić S, Vladareanu R, Esin S, Bomba-Opon D, Međedović E, Hata T. Multi-center results on the clinical use of KANET. J Perinat Med 2019; 47:897-909. [PMID: 31677378 DOI: 10.1515/jpm-2019-0281] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 09/21/2019] [Indexed: 12/21/2022]
Abstract
An extensive review of the literature on the diagnostic and clinical accuracy of Kurjak's antenatal neurodevelopmental test (KANET) and the summarized results of the multi-center study involving 10 centers revealed that four-dimensional ultrasonography (4D US) has become a powerful tool and KANET a valuable test that empowers the clinicians worldwide to evaluate the fetal behavior in a systematic way and contribute to the detection of fetuses that might be at high risk for neurological impairments and in particular cerebral palsy (CP). After 10 years of clinical use, many published papers and multi-center studies, hundreds of trained physicians and numerous tests performed all over the world, KANET has proven its value and has been showing encouraging results so far. The aim of this paper is to show the results from the studies done so far and to reveal the clinical value of the KANET. We expect that data from the larger ongoing collaborative study, the short- and long-term postnatal follow-up will continue to improve our knowledge. Ultimately, we all strive to prevent the CP disorders, autism spectrum disorder (ASD) and other neurological impairments and we are convinced that KANET might be helpful in the realization of this important aim.
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Affiliation(s)
- Asim Kurjak
- Department of Obstetrics and Gynecology, Medical School University of Zagreb, Zagreb, Croatia.,University Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina
| | - Lara Spalldi Barišić
- University Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina.,Specialist, Department of Obstetrics and Gynecology, Private Clinic Veritas, Zagreb, Croatia
| | - Milan Stanojević
- Neonatal Unit, Department of OBGYN, Medical School University in Zagreb, University Hospital Sveti Duh, Zagreb, Croatia
| | - Panagiotis Antsaklis
- Fetal and Maternal Medicine, Alexandra Maternity Hospital, Medical School, University of Athens, Athens, Greece
| | - Sonal Panchal
- University Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina.,Dr Nagori's Institute for Infertility and IVF, Ahmedabad, Gujarat, India
| | | | - Raul Moreira Neto
- Clinical Ultrasound and Fetal Medicine Unit - Ecomoinhos, Porto Alegre, Brazil
| | - Suada Tinjić
- University Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina.,Department of Infertility and IVF, Polyclinic "Korak do Života", Tuzla, Bosnia and Herzegovina
| | - Radu Vladareanu
- Department of Obstetrics and Gynecology, UMF Carol Davila, Elias Emergency University Hospital, Bucharest, Romania
| | - Sertaç Esin
- Baskent University, Perinatal Medicine Center, Ankara, Turkey
| | - Dorota Bomba-Opon
- 1st Department of OBGYN, 1st Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Edin Međedović
- Department of Obstetrics and Gynecology, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Toshyuki Hata
- Department of Perinatology and Gynecology, Kagawa University Graduate School of Medicine, Kagawa, Japan
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29
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Tunesi S, Bosio M, Russo AG. Do autistic patients change healthcare services utilisation through the transition age? An Italian longitudinal retrospective study. BMJ Open 2019; 9:e030844. [PMID: 31727653 PMCID: PMC6886997 DOI: 10.1136/bmjopen-2019-030844] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES This paper aims to provide an estimate of the prevalence rate of autism spectrum disorder (ASD) in 8-year-olds in 2017 based on administrative databases and to investigate the change in healthcare service use during the healthcare transition age of 18. DESIGN This research is based on a longitudinal retrospective cohort study. SETTING The data is drawn from the Italian Administrative Healthcare Database (2010-2017). PARTICIPANTS We identified 5607 ASD patients; 331 ASD patients from 2012 to 2015 in the calendar year of their 18th birthday were selected and their health service utilisation during a 5-year period-ranging from 2 years preceding and succeeding their 18th year-were investigated. INTERVENTIONS None. PRIMARY AND SECONDARY OUTCOME MEASURES Prevalence, incidence and proportion of ASD patients receiving specific healthcare services were included in the outcome measures. RESULTS Prevalence of ASD at age 8 was 5.4/1000. Global access to health and social services was lower both before and after age 18 (46.5% at 16; 68.0% at 18; 54.1% at 20). The percentage of patients receiving a neuropsychiatric consultation decreased after age 18 (30.8% at 18; 5.4% at 20). Community mental health services (CMHS) utilisation rate increased above 18 years of age. Regarding psychiatric visits, for both outpatient and CMHS, an increase was observed from 17.8% at age 18 to 25.4% at age 20. The utilisation of rehabilitation services decreased with age, dropping from 17.8% at age 16 to 1.8% at age 20. Psychiatric outpatient services remained stable across ages at about 14%. CONCLUSION Our findings suggest that ASD patients changed clinical reference services with age from neuropsychiatric and rehabilitative services towards psychiatric and community-based services as they transitioned from paediatric to adult healthcare services.
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Affiliation(s)
- Sara Tunesi
- Epidemiology Unit, Agency for Health Protection of Milan, Milan, Italy
| | - Marco Bosio
- Agency for Health Protection of Milan, Milan, Italy
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30
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Cramm H, Smith G, Samdup D, Williams A, Rühland L. Navigating health care systems for military-connected children with autism spectrum disorder: A qualitative study of military families experiencing mandatory relocation. Paediatr Child Health 2019; 24:478-484. [PMID: 31660044 PMCID: PMC6812301 DOI: 10.1093/pch/pxy179] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Accepted: 07/27/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Most military families experience mandatory relocation, or posting, several times during the military career. For Canadian military families who must access provincial or territorial health care systems, maintaining reasonable continuity of care is a persistent issue. Such challenges may be amplified when a child in a military family has special needs within the health and educational systems. OBJECTIVE The purpose of this qualitative study was to gain a better understanding of Canadian Armed Forces families' experiences in navigating health care systems on behalf of a child with autism spectrum disorder (ASD) in the context of mandatory relocation. METHODS Parents of children with ASD, where at least one parent serves in the Canadian Armed Forces and had faced military-related relocation, were recruited. Semi-structured interviews were recorded, transcribed verbatim, and analyzed thematically. RESULTS Twelve participants represented 12 families and 15 children with ASD. Participants discussed two primary themes. (1) High mobility inherent in the military lifestyle can create disruptions and discontinuities to service, including delays in diagnosis or intervention, losses and gains in available services determined by the direction of posting, and the need to start health care access processes over again when relocating. (2) Navigating health systems for children with ASD creates personal stress and frustration related to relocating, and has career implications for both parents. CONCLUSIONS Military-related relocation can create significant disruption in access to health and educational services for Canadian military families who have a child with ASD, and take a personal toll on these families.
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Affiliation(s)
- Heidi Cramm
- School of Rehabilitation Therapy, Queen’s University, Kingston, Ontario, Canada
| | - Garth Smith
- Department of Pediatrics, Queen’s University, Kingston, Ontario, Canada
- KidsInclusive, Hotel Dieu Hospital, Kingston, Ontario, Canada
| | - Dawa Samdup
- Department of Pediatrics, Queen’s University, Kingston, Ontario, Canada
- KidsInclusive, Hotel Dieu Hospital, Kingston, Ontario, Canada
| | - Ashley Williams
- School of Rehabilitation Therapy, Queen’s University, Kingston, Ontario, Canada
| | - Lucia Rühland
- School of Rehabilitation Therapy, Queen’s University, Kingston, Ontario, Canada
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31
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Benachenhou S, Etcheverry A, Galarneau L, Dubé J, Çaku A. Implication of hypocholesterolemia in autism spectrum disorder and its associated comorbidities: A retrospective case-control study. Autism Res 2019; 12:1860-1869. [PMID: 31385649 DOI: 10.1002/aur.2183] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 07/17/2019] [Indexed: 12/26/2022]
Abstract
Autism spectrum disorder (ASD) has been associated with low cholesterol levels in a limited number of studies. However, the prevalence of hypocholesterolemia as well as the degree of association with ASD remains to be elucidated. We therefore sought to investigate the lipid profiles of a group of French-Canadian ASD individuals. The medical records of 79 ASD individuals and 79 age and gender-matched healthy controls were retrospectively reviewed. The fasting lipid profiles including total cholesterol (TC), high-density lipoprotein, triglycerides, and low-density lipoprotein were extracted for individuals of both groups along with the following clinical data: anthropometric measurements, medication use and associated disorders. Lipid parameters were compared to age and gender-based normative population and categorized in centile groups. The prevalence of hypocholesterolemia was revealed to be more than threefold higher in ASD individuals as compared to the general population (23%; P = 0.005). The 25th centile was determined as a potential TC threshold that could best predict the ASD (odds ratio [OR] = 3.04; 95% confidence interval [CI]: 1.58-6.65; P < 0.001). This study identified specific ASD comorbidities associated with hypocholesterolemia: TC levels below the 10th centile were associated with a higher rate of ASD-associated intellectual disability (OR = 3.33; 95% CI: 1.26-8.00) and anxiety/depression (OR = 4.74; 95% CI: 1.40-15.73). Overall, these results support a potential association between hypocholesterolemia and ASD occurrence. Application of this study to larger populations is urging to provide more extensive data that may further elucidate the association between hypocholesterolemia and ASD. Autism Res 2019, 12: 1860-1869. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Association of autism spectrum disorder (ASD) with abnormally low levels of cholesterol (hypocholesterolemia) has been documented before. These studies were incomplete, and the conclusion remains speculative. Here, we reviewed the medical records of 79 French-Canadian ASD individuals and compared their total cholesterol (TC) levels to healthy individuals matched for age and gender. We observed four times more hypocholesterolemia in ASD than in the general population. Furthermore, low TC in ASD was associated with higher rates of ASD-associated intellectual disability and anxiety/depression. Our results support an association between hypocholesterolemia and ASD and open novel opportunities for the diagnosis and treatment of specific forms of ASD.
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Affiliation(s)
- Sérine Benachenhou
- Biochemistry Department, Faculty of Medicine and Health Sciences, Universite de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Antoine Etcheverry
- Biochemistry Department, Faculty of Medicine and Health Sciences, Universite de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Luc Galarneau
- Biochemistry Department, Faculty of Medicine and Health Sciences, Universite de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Jean Dubé
- Biochemistry Department, Faculty of Medicine and Health Sciences, Universite de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Artuela Çaku
- Biochemistry Department, Faculty of Medicine and Health Sciences, Universite de Sherbrooke, Sherbrooke, Quebec, Canada
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32
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Pérez-Crespo L, Prats-Uribe A, Tobias A, Duran-Tauleria E, Coronado R, Hervás A, Guxens M. Temporal and Geographical Variability of Prevalence and Incidence of Autism Spectrum Disorder Diagnoses in Children in Catalonia, Spain. Autism Res 2019; 12:1693-1705. [PMID: 31317678 PMCID: PMC6900126 DOI: 10.1002/aur.2172] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 06/26/2019] [Accepted: 06/27/2019] [Indexed: 12/16/2022]
Abstract
This study aims to estimate the prevalence of autism spectrum disorders (ASD) in 2017 and the ASD diagnosis incidence between 2009 and 2017 in children living in Catalonia region in Spain, and their temporal and geographical variability. We used administrative data for all children aged 2–17 years who were insured in the public Catalan Health System between 2009 and 2017. We identified all ASD cases diagnosed between 2009 and 2017 (ICD‐9 codes 299.0, 299.1, 299.8, and 299.9). We estimated the ASD prevalence in 2017 and the overall annual incidence between 2009 and 2017, then stratified by sex, age group, and healthcare area. We used Poisson regression models to assess temporal trends in the incidence and mixed‐effects Poisson regression models to assess geographical variability. We observed an ASD prevalence of 1.23% (95% confidence interval [CI] 1.21–1.25) in 2017, with 1.95% (95% CI 1.92–1.99) for boys and 0.46% (95% CI 0.44–0.48) for girls, the highest prevalence being in 11‐ to 17‐year‐olds (1.80%, 95% CI 1.76–1.83). The ASD diagnosis incidence increased from 0.07% (95% CI 0.06–0.09) in 2009 to 0.23% (95% CI 0.21–0.24) in 2017, with a higher increase in girls, and in children aged 2–5 years at the time of diagnosis. We only observed geographical differences in prevalence in the 2017 data. We also detected a threefold increase in the diagnosis incidence overall, which was even more pronounced in girls and at early ages. In conclusion, the ASD prevalence observed in this study was 1.23% in 2017, with a sex ratio of 4.5 in favor of boys, which is consistent with previous studies. Autism Res2019. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary Autism spectrum disorders (ASD) are currently well known in our society as one of the most common neurodevelopmental disorders during childhood. The results of our study showed that, in 2017 in Catalonia, slightly more than one in a 100 children had an ASD diagnosis, it was more common in boys than in girls, and also in older children. In addition, between 2009 and 2017, we observed an increase in the number of new cases diagnosed each year. The data presented in this study will assist in planning and evaluating the needs of health services in this geographical region.
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Affiliation(s)
- Laura Pérez-Crespo
- ISGlobal, Barcelona, Spain.,Pompeu Fabra University, Barcelona, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Albert Prats-Uribe
- Preventive Medicine and Public Health Training Unit, Parc de Salut Mar-Pompeu, Fabra University-Public Health Agency of Barcelona, Barcelona, Spain.,Centre for Statistics in Medicine, Botnar Research Centre, NDORMS, University of Oxford, Oxford, UK
| | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Barcelona, Spain
| | - Enric Duran-Tauleria
- Institut Global d'Atenció Integral del Neurodesenvolupament (IGAIN), Barcelona, Spain
| | - Ricard Coronado
- Hospital General de Granollers, Granollers, Spain.,Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine and Public Health, Autonomous University of Barcelona, Barcelona, Spain
| | - Amaia Hervás
- Institut Global d'Atenció Integral del Neurodesenvolupament (IGAIN), Barcelona, Spain.,Child and Adolescent Mental Health Unit, Hospital Universitari Mútua de Terrassa, Barcelona, Spain
| | - Mònica Guxens
- ISGlobal, Barcelona, Spain.,Pompeu Fabra University, Barcelona, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands
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Zeidan J, Shikako-Thomas K, Ehsan A, Maioni A, Elsabbagh M. Progress and gaps in Quebec's autism policy: a comprehensive review and thematic analysis. Canadian Journal of Public Health 2019; 110:485-496. [PMID: 31016679 DOI: 10.17269/s41997-019-00202-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 03/15/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Consistent with a national and global trend, prevalence estimates of autism have risen steadily in Quebec, causing concerns regarding quality and availability of diagnostic and intervention services as well as policies guiding service delivery and their efficacy. We conducted an analysis of Quebec's autism policies to determine recent advances, challenges and gaps in the planning and delivery of provincial autism services. METHODS We identify autism policy priorities in Quebec through a comprehensive review and a thematic analysis of past and present policies, consider their compliance with national and international human rights and health frameworks and identify policy gaps. RESULTS Autism policies articulated at a provincial level in Quebec are comprehensive, well grounded in international and national frameworks and considerate of existing barriers in the systems. Quebec policies reflect long-standing recognition of many barriers affecting service utilization and quality. Root cause of challenges currently confronting the policy environment in Quebec includes limitations in: specific measures to enhance a person-centred approach across the lifespan, evaluation of economic costs associated with autism, utilization of research evidence, and enactment of policies. CONCLUSION Early intervention services, building capacity in existing resources through training programs, and integrating research through research translation initiatives can help the Québec government improve the quality and efficacy of services while reducing long-term costs to the systems and promoting quality of life for individuals with autism and their families.
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Affiliation(s)
- Jinan Zeidan
- Montreal Neurological Institute, McGill University, Montreal, Canada.
| | - Keiko Shikako-Thomas
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - Annahita Ehsan
- Institut des Sciences Sociales, University of Lausanne, Lausanne, Switzerland
| | - Antonia Maioni
- Department of Political Science, McGill University, Montreal, Canada
| | - Mayada Elsabbagh
- Department of Psychiatry, Montreal Neurological Institute at McGill University, Montreal, Canada
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Relation Between Infant Microbiota and Autism?: Results from a National Cohort Sibling Design Study. Epidemiology 2019; 30:52-60. [PMID: 30273187 DOI: 10.1097/ede.0000000000000928] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Hypotheses concerning adverse effects of changes in microbiota have received much recent attention, but unobserved confounding makes them difficult to test. We investigated whether surrogate markers for potential adverse microbiota change in infancy affected autism risk, addressing unobserved confounding using a sibling study design. METHODS This is a population-based, prospective cohort study including all singleton live births in Denmark from 1997 to 2010. The exposure variables were cesarean delivery and antibiotic use in the first 2 years of life. The outcome was a subsequent autism diagnosis. We used the between- and within-sibling model and compared it with sibling-stratified Cox models and simpler standard Cox models that ignored sibship. RESULTS Of our study population including 671,606 children, who were followed for up to 15 years (7,341,133 person-years), 72% received antibiotics, 17.5% were delivered by cesarean, and 1.2% (8,267) developed autism. The standard Cox models predicted that both cesarean (compared with vaginal) delivery and antibiotics increased the risk of autism. In the sibling-stratified Cox model, only broader spectrum antibiotics were associated with increased risk of autism: hazard ratio (HR) = 1.16 (95% confidence interval = 1.01, 1.36). The between-within model estimated no exposure effects: intrapartum cesarean HR = 1.06 (0.89, 1.26); prelabor cesarean HR = 0.97 (0.83, 1.15); exclusively penicillin HR = 1.05 (0.93, 1.18); and broader spectrum antibiotics HR = 1.05 (0.95, 1.16). CONCLUSIONS The between-within model rendered more precise estimates than sibling-stratified Cox models, and we believe that it also provided more valid estimates. Results from these preferred models do not support a causal relation between antibiotic treatment during infancy, cesarean delivery, and autism. See video abstract at, http://links.lww.com/EDE/B432.
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Hata T, Kanenishi K, Mori N, AboEllail MAM, Hanaoka U, Koyano K, Kato I, Kusaka T. Prediction of postnatal developmental disabilities using the antenatal fetal neurodevelopmental test: KANET assessment. J Perinat Med 2018; 47:77-81. [PMID: 30098288 DOI: 10.1515/jpm-2018-0169] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 06/28/2018] [Indexed: 11/15/2022]
Abstract
Objective To assess the usefulness of the antenatal fetal neurodevelopmental test for the prediction of postnatal developmental disabilities. Methods Fetal behavior was assessed with Kurjak's antenatal neurodevelopmental test (KANET) using four-dimensional ultrasound between 28 and 38 weeks of gestation. A score range of 0-5 was characterized as abnormal, from 6 to 9 was considered borderline, and 10-16 was normal. After birth, follow-up was conducted for at least 2 years in all fetuses. Results There were 337 normal (95.47%) and 16 borderline (4.53%) cases among the 353 cases studied, whereas there was no abnormal case. Five cases with postnatal developmental disabilities (one case of Werdig-Hoffmann disease diagnosed just after delivery, one case of autism spectrum disorder diagnosed at 24 months, one case of Ullrich congenital muscular dystrophy diagnosed at 9 months and two cases of developmental disorders diagnosed at age 3 and 18 months) were noted among the 337 normal cases (1.48%), whereas three cases with developmental disabilities (one case of motor development delay diagnosed at 6 months, one case of Duchenne muscular dystrophy diagnosed at 18 months and one case of autism spectrum disorder diagnosed at age 30 months) were found among the 16 borderline cases (18.75%). There was a significant difference in the prevalence of postnatal developmental disabilities between the normal and borderline KANET groups (P<0.001). Conclusion Our results suggest that the KANET assessment may be a useful diagnostic modality for the prediction of postnatal developmental disabilities.
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Affiliation(s)
- Toshiyuki Hata
- Department of Perinatology and Gynecology, Kagawa University Graduate School of Medicine, Miki, Kagawa, Japan
| | - Kenji Kanenishi
- Department of Perinatology and Gynecology, Kagawa University Graduate School of Medicine, Miki, Kagawa, Japan
| | - Nobuhiro Mori
- Department of Perinatology and Gynecology, Kagawa University Graduate School of Medicine, Miki, Kagawa, Japan
| | | | - Uiko Hanaoka
- Department of Perinatology and Gynecology, Kagawa University Graduate School of Medicine, Miki, Kagawa, Japan
| | - Kosuke Koyano
- Department of Pediatrics, Kagawa University Graduate School of Medicine, Miki, Kagawa, Japan
| | - Ikuko Kato
- Department of Pediatrics, Kagawa University Graduate School of Medicine, Miki, Kagawa, Japan
| | - Takashi Kusaka
- Department of Pediatrics, Kagawa University Graduate School of Medicine, Miki, Kagawa, Japan
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Cawthorpe D. A 16-Year Cohort Analysis of Autism Spectrum Disorder-Associated Morbidity in a Pediatric Population. Front Psychiatry 2018; 9:635. [PMID: 30555361 PMCID: PMC6281889 DOI: 10.3389/fpsyt.2018.00635] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 11/08/2018] [Indexed: 12/30/2022] Open
Abstract
Introduction: This chapter presents the analysis of physician-diagnosed International Classification of Diseases (ICD version 9) disorders and diseases associated with autism spectrum disorders (ASD) in a 16-year pediatric cohort. Materials and Methods: The sample (n = 47,180; 62% male) consisted of children in the Alberta Health Services Calgary Health Region catchment under the age of 3 years, who received any physician-assigned ICD 9 diagnosis before the age of three between April 1993 and December 31, 1994. There were 111 females and 609 males with ASD diagnosed at any time between 1993 and 2010. The results detail the 16-year odds ratio (OR) associations of ASD diagnosis within the major classes of international classification of diseases (ICD 9) stratified by age and sex in the cohort. Further, for those suffering from ASD and any other disorder or disease, the analysis presents by sex, age, and duration, the proportions of all index physician-assigned ICD diagnoses, arising significantly before and after the index ASD diagnosis. Results: The rate of treated ASD in the cohort was 1 in 65 and the 16-year population rate of ASD was 62 per 10,000. For males with an ASD over the 16 year period, the ORs were significantly greater than the value one for 15 of the 17 main ICD classes and for 10 of the main ICD classes for females. Different age strata presented a more specific account of the main ICD class OR profiles. More specifically, 28 ICD disorders significantly preceded and 95 ICD disorders significantly followed ASD for females. Thirty-eight ICD disorders significantly preceded and 234 ICD disorders significantly followed ASD for males. Conclusions: The results largely confirm past studies focusing on more constrained sets of ASD morbidity. The age-stratified ORs gauge the order of risk in time for the cohort. The proportions of specific ICD disorders arising before and after ASD may be useful in respect to informing basic ASD research and ASD clinical management. Limitations are discussed.
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Affiliation(s)
- David Cawthorpe
- Cumming School of Medicine, Departments of Psychiatry and Community Health Sciences, Institute for Child and Maternal Health, The University of Calgary, Calgary, AB, Canada
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Fleury MJ, Fortin M, Rochette L, Grenier G, Huỳnh C, Pelletier É, Lesage A, Vasiliadis HM. Utilisation de l’urgence au Québec des patients avec des troubles mentaux incluant les
troubles liés aux substances psychoactives. SANTE MENTALE AU QUEBEC 2018. [DOI: 10.7202/1058613ar] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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