Komorbide psychiatrische Störungen und Differenzialdiagnostik bei nicht-intelligenzgeminderten Erwachsenen mit Autismus-Spektrum-Störung

Zusammenfassung

Autismus-Spektrum-Störungen (ASS) ohne Intelligenzminderung werden häufig erst im Erwachsenenalter diagnostiziert. Wenig ist bekannt über komorbide psychiatrische Störungen und differenzialdiagnostische Abgrenzung von ASS im Erwachsenenalter, insbesondere im Hinblick auf Persönlichkeitsstörungen (PS). Welche komorbiden psychiatrischen Störungen treten bei Personen mit ASS auf? Welches sind die häufigsten Differenzialdiagnosen zu ASS in einer Inanspruchnahmestichprobe? Bei 118 Erwachsenen mit Verdacht auf eine autistische Störung wurde eine autismus-spezifische Diagnostik angewandt und die Punktprävalenzen weiterer psychiatrischer Störungen erfasst. 59 (50%) erfüllten die Kriterien einer ASS. Von diesen lag bei 36% eine komorbide psychiatrische Störung der DSM-IV Achse-I vor, wobei Affektive Störungen (24%) und Soziale Phobien (14%) am häufigsten waren. Die häufigsten Differenzialdiagnosen waren Depression, Soziale Phobie, Paranoide PS, Selbstunsichere PS und Narzisstische PS.

Abstract

Autism spectrum conditions (ASC) without intellectual disability are often diagnosed late in life. Little is known about co-occurring psychia­tric disorders and differential diagnosis of ASC in adulthood, particularly with regard to personality disorders. What kind of comorbid psychia­tric disorders occur in ASC? Which are the most prevalent differential diagnoses in a sample of patients who seek autism specific clinical diagnostics? 118 adults who were referred with a presumed diagnosis of autistic disorder, were diagnosed with autism specific instruments and the prevalence of further psychiatric disorders was investigated. 59 (50%) fulfilled the criteria of ASC. 36% of the individuals with ASC fulfilled also criteria for a DSM-IV axis-I psychiatric disorder. Affective disorders (24%) and social phobia (14%) were the most prevalent comorbid disorders. The most frequent differential diagnoses were depression, social phobia, paranoid, avoidant and narcissistic personality disorder.

Schlüsselwörter

Autismus - Asperger-Syndrom - Diagnostik - komorbide Störungen - schizoid

Keywords

autism - Asperger syndrome - diagnostics - comorbidity - schizoid

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