Nehmen autistische Störungen zu?

S. Weinmann; S. Roll; S. Willich; J. M. Fegert; M. Kölch

doi:10.1055/s-0038-1627157

Nervenheilkunde, Inhaltsverzeichnis

Nervenheilkunde 2009; 28(11): 819-828
DOI: 10.1055/s-0038-1627157

Übersichtsarbeit

Schattauer GmbH

Nehmen autistische Störungen zu?

Eine kritische Beurteilung epidemiologischer StudienAre autistic disorders increasing in prevalence?A critical evaluation of epidemiological studies

S. Weinmann

¹Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité Universitätsmedizin Berlin

,

S. Roll

¹Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité Universitätsmedizin Berlin

,

S. Willich

¹Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité Universitätsmedizin Berlin

,

J. M. Fegert

²Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Universitätsklinikum Ulm

,

M. Kölch

²Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Universitätsklinikum Ulm

› Institutsangaben

Abstract

Zusammenfassung

Gegenstand und Ziel: Die Prävalenz des frühkindlichen Autismus und anderer Störungen aus dem Autismusspektrum stieg in den letzten Jahren kontinuierlich. Die Prävalenz für den frühkindlichen Autismus lag in den 1970er-Jahren bei unter drei pro 10 000 Kindern, in den 1990er-Jahren bei über 30. Methoden: Literaturrecherche von Studien und Metaanalysen zur Epidemiologie des Autismus und selektive Bewertung der Studienergebnisse hinsichtlich des Erklärungsanteils von methodischen Aspekten und Veränderungen des Versorgungssystems. Ergebnisse: Die Veränderung der Diagnosekriterien, bessere Screeningmethoden und gestiegene Repräsentativität der untersuchten Bezugspopulation, mehr Bewusstsein bei Eltern, Lehrern und Therapeuten und höhere Behandlungsraten können einen Großteil der Steigerung der Prävalenzraten erklären. Sie erklären jedoch nicht die gesamte Zunahme. Schlussfolgerungen: Ein realer Anstieg der Häufigkeit autistischer Syndrome ist nicht auszuschließen. Eine Erklärungsmöglichkeit ist die Zunahme des Anteils an Frühgeburten und an überlebenden Kindern mit prä- und perinatalen Risikofaktoren. Eine Erhebung in Deutschland könnte zur Abschätzung des künftigen Versorgungsbedarfs betragen.

Summary

The prevalence of autism spectrum disorders as reported by epidemiological studies has been rising in the last years. In the USA and other countries the overall estimate of prevalence of typical autism was three per 10 000 in the 70ies and above 30 per 10 000 in the 90ies of the last century. The objective of this paper was to review results of surveys on the prevalence of autism and to discuss if methodological factors are responsible for its increase. We found that change in diagnostic criteria, better case identification, increasing awareness among parents, teachers and professionals and higher treatment rates accounts for the majority of this increase. However it remains a rest that might warrant further explanation. In conclusion a real increase in autism cannot be ruled out. Possible explanations are the increasing rate of preterm births and prenatal environmental factors. A survey on autism in Germany could contribute to define the public health burden and future care needs in this country.

Schlüsselwörter

Autismus - Prävalenz - Erfassungsfehler

Keywords

Autism - prevalence - detection bias

Volltext

Referenzen

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