13 octobre 2014

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

Author information

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



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. 


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.


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. 


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.

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