title: [Psychosocial functioning of adults with late diagnosed autism spectrum disorders--a retrospective study].
abstract: BACKGROUND
  The first time diagnosis of autism spectrum disorder (ASD) after passing childhood and adolescence is still considered a rare event. However, in recent years an increasing demand for diagnostic clarifications with suspected ASD in adulthood challenges this view. There is insufficient knowledge about the neuropsychological characterisation and psychosocial outcome of this adult subgroup in the autistic spectrum.
  
  
  OBJECTIVE
  To determine the psychosocial functioning (living status, partnerships, level of education, psychiatric history) of adult patients with late diagnosed ASD.
  
  
  METHODS
  In a retrospective study, a chart review was conducted on 178 consecutively diagnosed individuals at a specialised outpatient clinic for adults with ASD. Global ratings of psychosocial functioning, assessment of psychiatric history and neuropsychological and psychopathological investigations were evaluated.
  
  
  RESULTS
  The majority of patients (92 %) diagnosed with ASD suffered from high-functioning autism (HFA)/Asperger syndrome (AS) according to the criteria of ICD-10 (F84.5). The gender ratio was 2:1 favouring males. Mean age at diagnosis (34.1 ± 9.5 years), general intelligence (HAWIE-R, global-IQ 115 ± 20) and self-rated autistic symptoms (autism spectrum quotient [AQ] 39 ± 6) were not discriminative to gender. The psychiatric history revealed a lifetime consultation rate of 78 %, most frequently with depression (50 %). The self-report instrument Beck depression inventory (BDI) identified 30 % of individuals presenting with depressive symptoms in clinical relevant intensity (BDI > 17). Achievement of an independent living status was reported by 68 % of individuals, 58 % reported about current or past intimate partnerships and almost two-thirds of the patients had achieved a higher educational status.
  
  
  CONCLUSIONS
  The majority of ASD diagnosed late in lifetime turned out to be HFA/AS, presenting with high psychosocial adjustment with regard to independent living, educational status and partnerships. The high level of global intelligence supports the hypothesis of cognitively compensated autistic disturbances leading to the diagnosis comparably late in lifetime. The lifetime rate of psychiatric consultations is high, reflecting the importance to consider a diagnosis of ASD even late in life.
authors.affiliation: Klinik für Psychiatrie und Psychotherapie, Universitätsklinik Köln. Fritz-Georg.Lehnhardt@ukkoeln.de
authors.forename: F-G
authors.initials: FG
authors.lastname: Lehnhardt
authors.forename: A
authors.initials: A
authors.lastname: Gawronski
authors.forename: K
authors.initials: K
authors.lastname: Volpert
authors.forename: L
authors.initials: L
authors.lastname: Schilbach
authors.forename: R
authors.initials: R
authors.lastname: Tepest
authors.forename: K
authors.initials: K
authors.lastname: Vogeley
mesh_terms: D000328:Adult; D000367:Age Factors; D020817:Asperger Syndrome / Q000523:psychology; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000453:epidemiology / Q000523:psychology*; D015897:Comorbidity; D003863:Depression / Q000150:complications / Q000523:psychology; D004522:Educational Status; D005260:Female; D006801:Humans; D038801:International Classification of Diseases; D007398:Interpersonal Relations; D008297:Male; D001523:Mental Disorders / Q000209:etiology / Q000523:psychology; D008875:Middle Aged; D009483:Neuropsychological Tests; D010045:Outpatients; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D012737:Sex Factors; D012919:Social Behavior; D055815:Young Adult