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The 'lost generation' in adult psychiatry : psychiatric, neurodevelopmental and sociodemographic characteristics of psychiatric patients with autism unrecognised in childhood

Nyrenius, Johan LU orcid ; Eberhard, Jonas LU ; Ghaziuddin, Mohammad ; Gillberg, Christopher and Billstedt, Eva (2023) In BJPsych Open 9(3).
Abstract

Background Patients with 'underlying' autism spectrum disorder (ASD) constitute a significant minority in adult out-patient psychiatry. Diagnoses of previously unrecognised ASD are increasing in adults. Characteristics of patients with autism within adult out-patient psychiatry have not been sufficiently explored, and there have not been any systematic comparisons of characteristics between patients with and those without autism within adult out-patient psychiatric populations. Aims To examine psychiatrically relevant characteristics in autistic adult psychiatric out-patients, and to compare the characteristics with non-autistic adult psychiatric out-patients. Method We assessed 90 patients who were referred to a Swedish psychiatric... (More)

Background Patients with 'underlying' autism spectrum disorder (ASD) constitute a significant minority in adult out-patient psychiatry. Diagnoses of previously unrecognised ASD are increasing in adults. Characteristics of patients with autism within adult out-patient psychiatry have not been sufficiently explored, and there have not been any systematic comparisons of characteristics between patients with and those without autism within adult out-patient psychiatric populations. Aims To examine psychiatrically relevant characteristics in autistic adult psychiatric out-patients, and to compare the characteristics with non-autistic adult psychiatric out-patients. Method We assessed 90 patients who were referred to a Swedish psychiatric out-patient clinic and screened for ASD during 2019-2020. Sixty-three patients met the DSM-5 criteria for ASD or 'subthreshold' ASD. The 27 who did not meet the criteria for ASD were used as a comparison group. Assessments were made with structured and well-validated instruments, including parent ratings of developmental history. Results No differences were found between the groups regarding self-reported sociodemographic variables. The ASD group showed a higher number of co-occurring psychiatric disorders than the non-ASD group (t(88) = 5.17, 95% CI 1.29-2.91, d = 1.19). Functional level was lower in the ASD group (t(88) = -2.66, 95% CI -9.46 to -1.27, d = -0.73), and was predicted by the number of co-occurring psychiatric disorders. Conclusions The results underscore the need for thorough assessment of psychiatric disorders in autistic patients in adult psychiatric services. ASD should be considered as a possible 'underlying' condition in adult psychiatry, and there is no easy way of ruling out ASD in this population.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
adults, Autism spectrum disorder, comorbidity, neurodevelopmental disorders, psychiatry
in
BJPsych Open
volume
9
issue
3
article number
e89
publisher
Cambridge University Press
external identifiers
  • pmid:37222104
  • scopus:85160950369
ISSN
2056-4724
DOI
10.1192/bjo.2023.13
language
English
LU publication?
yes
id
ad597eca-6550-473f-960b-81532952ab83
date added to LUP
2023-08-21 12:56:24
date last changed
2024-04-20 01:07:28
@article{ad597eca-6550-473f-960b-81532952ab83,
  abstract     = {{<p>Background Patients with 'underlying' autism spectrum disorder (ASD) constitute a significant minority in adult out-patient psychiatry. Diagnoses of previously unrecognised ASD are increasing in adults. Characteristics of patients with autism within adult out-patient psychiatry have not been sufficiently explored, and there have not been any systematic comparisons of characteristics between patients with and those without autism within adult out-patient psychiatric populations. Aims To examine psychiatrically relevant characteristics in autistic adult psychiatric out-patients, and to compare the characteristics with non-autistic adult psychiatric out-patients. Method We assessed 90 patients who were referred to a Swedish psychiatric out-patient clinic and screened for ASD during 2019-2020. Sixty-three patients met the DSM-5 criteria for ASD or 'subthreshold' ASD. The 27 who did not meet the criteria for ASD were used as a comparison group. Assessments were made with structured and well-validated instruments, including parent ratings of developmental history. Results No differences were found between the groups regarding self-reported sociodemographic variables. The ASD group showed a higher number of co-occurring psychiatric disorders than the non-ASD group (t(88) = 5.17, 95% CI 1.29-2.91, d = 1.19). Functional level was lower in the ASD group (t(88) = -2.66, 95% CI -9.46 to -1.27, d = -0.73), and was predicted by the number of co-occurring psychiatric disorders. Conclusions The results underscore the need for thorough assessment of psychiatric disorders in autistic patients in adult psychiatric services. ASD should be considered as a possible 'underlying' condition in adult psychiatry, and there is no easy way of ruling out ASD in this population.</p>}},
  author       = {{Nyrenius, Johan and Eberhard, Jonas and Ghaziuddin, Mohammad and Gillberg, Christopher and Billstedt, Eva}},
  issn         = {{2056-4724}},
  keywords     = {{adults; Autism spectrum disorder; comorbidity; neurodevelopmental disorders; psychiatry}},
  language     = {{eng}},
  number       = {{3}},
  publisher    = {{Cambridge University Press}},
  series       = {{BJPsych Open}},
  title        = {{The 'lost generation' in adult psychiatry : psychiatric, neurodevelopmental and sociodemographic characteristics of psychiatric patients with autism unrecognised in childhood}},
  url          = {{http://dx.doi.org/10.1192/bjo.2023.13}},
  doi          = {{10.1192/bjo.2023.13}},
  volume       = {{9}},
  year         = {{2023}},
}