Syndrome d'Asperger chez les hommes plus de deux décennies: la stabilité et prédicteurs de diagnostic

Traduction: G.M.

J Child Psychol Psychiatry. 2014 Oct 4. doi: 10.1111/jcpp.12334. [Epub ahead of print]

Asperger syndrome in males over two decades: stability and predictors of diagnosis

Helles A¹, Gillberg CI, Gillberg C, Billstedt E.

Author information

• ¹Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.

Abstract

OBJECTIVE:

To examine the diagnostic stability of a childhood diagnosis of Asperger Syndrome (AS) into adulthood in a prospective longitudinal study, and identify the predictors of stability.
Examiner la stabilité de diagnostic d'un diagnostic d'enfance de syndrome d'Asperger (SA) à l'âge adulte dans une étude longitudinale prospective, et identifier les facteurs prédictifs de la stabilité. 

METHODS:

One hundred males with AS diagnosed in childhood (T0) according to Gillberg's AS criteria, were followed up prospectively into adulthood over an average of 19 years (range 13-26 years). Fifty males (mean age 30 years) participated in this second follow-up (T2) of the cohort. Seventy-six had participated in a previous follow-up (T1) at mean age 22 years (47 participated in both follow-ups). Diagnosis at T2 was assessed using three sets of diagnostic criteria (Gillberg's AS criteria, DSM-IV Pervasive Developmental Disorder (PDD) and DSM-5 Autism Spectrum Disorder (ASD) criteria) and compared to previous assessments. Background predictors of diagnostic stability were analyzed. General functioning at T2 was assessed and compared to T1.

RESULTS:

There was a decline in the stability of AS diagnosis over time, the rate dropping from 82% at T1 to 44% at T2, when using the Gillberg criteria. There was also a significant decrease in the rate of cases fulfilling any PDD diagnosis according to the DSM-IV, from 91% at T1 to 76% at T2 in the 47 cases followed up twice. Severity of autism spectrum symptoms at T1 was the main predictor of diagnostic stability at T2. Twenty percent of those meeting criteria for a PDD diagnosis according to DSM-IV, did not meet DSM-5 ASD criteria although they had marked difficulties in everyday life.
Il y avait une diminution de la stabilité du diagnostic de TSA au fil du temps, le taux passant de 82% à 44% de T1 à T2, en utilisant les critères Gillberg. Il y avait également une diminution significative du taux de cas qui répondent à tout diagnostic de TED selon le DSM-IV, de 91% au T1 à 76% au T2 dans les 47 cas suivi deux fois. La gravité des symptômes du spectre autistique à T1 était le principal facteur prédictif de la stabilité de diagnostic au T2. Vingt pour cent de ces critères de réunion pour un diagnostic de TED selon le DSM-IV, ne répondait pas aux critères de TSA du DSM-5 bien qu'ils aient marqué des difficultés dans la vie quotidienne. 

CONCLUSION:

Asperger Syndrome, when considered as an ASD/PDD diagnosis, was fairly stable into adulthood, but there was a significant increase over time in cases no longer meeting criteria for an ASD diagnosis according to the DSM-IV, or AS according to the Gillberg criteria. Cases with a stable diagnosis showed significantly more core ASD symptoms in adolescence/young adulthood.
Le syndrome d'Asperger, considéré comme un diagnostic de TSA / TED, a été relativement stable à l'âge adulte, mais il y avait une augmentation significative au cours du temps dans les cas ne répondant plus aux critères d'un diagnostic de TSA selon le DSM-IV, ou SA selon les critères Gillberg.
Les cas avec un diagnostic stable ont montré beaucoup plus de symptômes qui forment le cœur des TSA à l'adolescence / adulte jeune.

© 2014 Association for Child and Adolescent Mental Health.

PMID:25283685