[Evaluation of diagnostic and therapeutic services in German university hospitals for adults with autism spectrum disorder (ASD)].
BACKGROUND
Autism spectrum disorders (ASD), are pervasive developmental disorders, which are defined by qualitative impairment in reciprocal social interaction and communication as well as by stereotyped repetitive behaviour. Newer epidemiological studies report a prevalence of 1 %. However, parents and self-help organisations report a considerable lack of diagnostic services, especially in the university hospital setting. In order to receive funding for adequate treatment at an "autism therapy centre", a Consultant psychiatrist has to diagnose ASD.


METHODS
We assessed the diagnostic and therapeutic facilities for adults with ASD by sending out questionnaires to 33 German university hospitals. Furthermore, we evaluated the demographic data of the first 74 patients that presented at the specialist clinic for adults with ASD at the Department for Psychiatry and Psychotherapy, RWTH Aachen University.


RESULTS
At the time of the evaluation, only 9 university hospitals in Germany offered a specialist clinic for diagnostics and/or treatment for adults with ASD. A comorbid psychiatric disorder was diagnosed in 52.9 % of the patients presenting at the specialist clinic for adult ASD. These were mostly mental retardation and affective disorders. The most common differential diagnosis for the patients presenting at the service were affective and personality disorders.


CONCLUSIONS
There is still great need of specialist services at university hospitals in Germany for adults with ASD, although more services have been established over the past few years. Over half of the patients with ASD had other psychiatric comorbid disorders, which were mostly mental retardation and affective disorders. The most common differential diagnosis for patients presenting at the clinics were personality disorders and depression.
Michel
T M
TM
Klinik und Poliklinik für Psychiatrie und Psychotherapie, RWTH Aachen Universität, Pauwelsstrasse 30, Aachen. tmichel@ukaachen.de
Sheldrick
A J
AJ
Frentzel
T G
TG
Herpertz-Dahlmann
B
B
Herpertz
S
S
Habel
U
U
Bruegmann
E
E
Schneider
K
K
Schneider
F
F
D000328:Adult; D020817:Asperger Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D015897:Comorbidity; D003937:Diagnosis, Differential; D005260:Female; D005858:Germany / Q000453:epidemiology; D006268:Health Facilities / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000453:epidemiology; D009483:Neuropsychological Tests; D010554:Personality Disorders / Q000150:complications / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D012959:Socioeconomic Factors