Charman Tony
Behavioural and Brain Sciences Unit, Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK.
Eur Child Adolesc Psychiatry. 2002 Dec;11(6):249-56. doi: 10.1007/s00787-002-0297-8.
Until recently best estimate prevalence rates for autism spectrum disorders (ASD) were 0.5/1,000 for autism and 2.0/1,000 for the broader spectrum. Three recent studies have suggested a significantly higher prevalence rate for ASD of 6.0/1,000 (mean 95 % CI = 4.8-8.0).
Possible determinants of the apparent increase in the prevalence of ASD are outlined. Methodological aspects of the three recent studies are examined.
Increased recognition, the broadening of the diagnostic concept over time and methodological differences across studies may account for most or all of the apparent increase in prevalence, although this cannot be quantified.
Findings from ongoing studies should help confirm or disconfirm the putative rate of 6.0/1,000 for all ASD. The possibility that autism has been over-diagnosed in recent studies needs to be ruled out. Notwithstanding these outstanding questions, it appears likely that the current true prevalence of ASD is considerably greater than previously recognised. This has significant implications for our scientific understanding of ASD and for families and services. Future directions for epidemiological research are outlined.
直到最近，自闭症谱系障碍（ASD）的最佳估计患病率为自闭症0.5/1000，更广泛谱系为2.0/1000。最近的三项研究表明，ASD的患病率显著更高，为6.0/1000（平均95%可信区间=4.8-8.0）。
概述了ASD患病率明显上升的可能决定因素。研究了最近三项研究的方法学方面。
认识的提高、诊断概念随时间的拓宽以及各研究之间的方法学差异可能解释了患病率明显上升的大部分或全部原因，尽管这无法量化。
正在进行的研究结果应有助于证实或否定所有ASD假定的6.0/1000的患病率。需要排除近期研究中自闭症被过度诊断的可能性。尽管存在这些悬而未决的问题，但目前ASD的实际患病率似乎很可能远高于此前的认识。这对我们对ASD的科学理解以及对家庭和服务都有重大影响。概述了流行病学研究的未来方向。
