Fombonne Eric
McGill University, Department of Psychiatry, The Montreal Children's Hospital, 4018 St. Catherine St. W., Montreal, QC H3Z 1P2, Canada.
J Autism Dev Disord. 2003 Aug;33(4):365-82. doi: 10.1023/a:1025054610557.
This paper was commissioned by the committee on the Effectiveness of Early Education in Autism of the National Research Council (NRC). It provides a review of epidemiological studies of pervasive developmental disorders (PDD) which updates a previously published article (The epidemiology of autism: a review. Psychological Medicine 1999; 29: 769-786). The design, sample characteristics of 32 surveys published between 1966 and 2001 are described. Recent surveys suggest that the rate for all forms of PDDs are around 30/10,000 but more recent surveys suggest that the estimate might be as high as 60/10,000. The rate for Asperger disorder is not well established, and a conservative figure is 2.5/10,000. Childhood disintegrative disorder is extremely rare with a pooled estimate across studies of 0.2/10,000. A detailed discussion of the possible interpretations of trends over time in prevalence rates is provided. There is evidence that changes in case definition and improved awareness explain much of the upward trend of rates in recent decades. However, available epidemiological surveys do not provide an adequate test of the hypothesis of a changing incidence of PDDs.
本文由美国国家研究委员会（NRC）自闭症早期教育有效性委员会委托撰写。它对广泛性发育障碍（PDD）的流行病学研究进行了综述，更新了之前发表的一篇文章（《自闭症流行病学综述》。《心理医学》1999年；29：769 - 786）。文中描述了1966年至2001年间发表的32项调查的设计、样本特征。近期调查表明，所有形式的PDD发病率约为30/10000，但最新调查显示该估计值可能高达60/10000。阿斯伯格障碍的发病率尚未明确确定，保守估计为2.5/10000。儿童期崩解性障碍极为罕见，各项研究的汇总估计值为0.2/10000。文中对患病率随时间变化趋势的可能解释进行了详细讨论。有证据表明，病例定义的变化和认知度的提高可以解释近几十年来发病率上升的大部分原因。然而，现有的流行病学调查并未对PDD发病率变化的假设进行充分检验。
