[Quality assurance of psychiatric work with autistic children and adolescents. Diagnostic value of medical examination].
The literature on associated medical diseases in autism is contradictory and so are the guidelines for medical routine screening. Recommendations draw on epidemiological and population-based research. It was necessary to know the diagnostic yield from patient groups referred to psychiatric clinics. 49 autistic probands were selected from a large clinic pool referred to the Department of Child Psychiatry, Haukeland Sykehus, University Hospital in Bergen, Norway, over the 25 years 1970 to 1995. Detailed analyses were performed regarding referring agent, family history, perinatal data, medical and developmental history, psychometric data, and clinical, neurological and laboratory examination. Our clinical sample deviated from the accepted characteristics of autism: All except one (98%) were mentally retarded. Yet tuberous sclerosis, fragile X syndrome and other known medical disorders said to be associated with autism were not found. More common medical disturbances were found regularly also in those with a higher level of functioning. The likelihood that our blind screening, with comprehensive laboratory examination, would yield positive results was negligible. These clinically important differences, together with a unique make-up of developmental deviances and delays, necessitated individually tailored assessment and treatment in most cases.
Sørensen
E
E
Barnepsykiatrisk avdeling Haukeland Sykehus, Bergen.
D000293:Adolescent; D000296:Adolescent Psychiatry / Q000592:standards*; D000328:Adult; D001321:Autistic Disorder / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D002648:Child; D002665:Child Psychiatry / Q000592:standards*; D002675:Child, Preschool; D006801:Humans; D008403:Mass Screening; D009664:Norway; D011785:Quality Assurance, Health Care