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[德国大学医院针对成人自闭症谱系障碍(ASD)的诊断和治疗服务评估]

[Evaluation of diagnostic and therapeutic services in German university hospitals for adults with autism spectrum disorder (ASD)].

作者信息

Michel T M, Sheldrick A J, Frentzel T G, Herpertz-Dahlmann B, Herpertz S, Habel U, Bruegmann E, Schneider K, Schneider F

机构信息

Klinik und Poliklinik für Psychiatrie und Psychotherapie, RWTH Aachen Universität, Pauwelsstrasse 30, Aachen.

出版信息

Fortschr Neurol Psychiatr. 2010 Jul;78(7):402-13. doi: 10.1055/s-0029-1245494. Epub 2010 Jul 6.

Abstract

INTRODUCTION

Autism spectrum disorders (ASD), are pervasive developmental disorders, which are defined by qualitative impairment in reciprocal social interaction and communication as well as by stereotyped repetitive behaviour. Newer epidemiological studies report a prevalence of 1 %. However, parents and self-help organisations report a considerable lack of diagnostic services, especially in the university hospital setting. In order to receive funding for adequate treatment at an "autism therapy centre", a Consultant psychiatrist has to diagnose ASD.

METHODS

We assessed the diagnostic and therapeutic facilities for adults with ASD by sending out questionnaires to 33 German university hospitals. Furthermore, we evaluated the demographic data of the first 74 patients that presented at the specialist clinic for adults with ASD at the Department for Psychiatry and Psychotherapy, RWTH Aachen University.

RESULTS

At the time of the evaluation, only 9 university hospitals in Germany offered a specialist clinic for diagnostics and/or treatment for adults with ASD. A comorbid psychiatric disorder was diagnosed in 52.9 % of the patients presenting at the specialist clinic for adult ASD. These were mostly mental retardation and affective disorders. The most common differential diagnosis for the patients presenting at the service were affective and personality disorders.

CONCLUSION

There is still great need of specialist services at university hospitals in Germany for adults with ASD, although more services have been established over the past few years. Over half of the patients with ASD had other psychiatric comorbid disorders, which were mostly mental retardation and affective disorders. The most common differential diagnosis for patients presenting at the clinics were personality disorders and depression.

摘要

引言

自闭症谱系障碍(ASD)是一种广泛性发育障碍,其定义为社交互动和沟通方面的质性损害以及刻板重复行为。最新的流行病学研究报告显示患病率为1%。然而,家长和自助组织报告称诊断服务严重不足,尤其是在大学医院环境中。为了在“自闭症治疗中心”获得足够治疗的资金,精神科顾问医生必须诊断出ASD。

方法

我们通过向33家德国大学医院发放问卷,评估了针对成年ASD患者的诊断和治疗设施。此外,我们还评估了亚琛工业大学精神病学与心理治疗系成人ASD专科门诊的前74名患者的人口统计学数据。

结果

在评估时,德国只有9家大学医院设有针对成年ASD患者的诊断和/或治疗专科门诊。在成人ASD专科门诊就诊的患者中,52.9%被诊断出患有共病精神障碍。这些主要是智力障碍和情感障碍。前来该服务就诊的患者最常见的鉴别诊断是情感障碍和人格障碍。

结论

尽管在过去几年中已经建立了更多服务,但德国大学医院对成年ASD患者的专科服务仍有很大需求。超过一半的ASD患者患有其他共病精神障碍,主要是智力障碍和情感障碍。在诊所就诊的患者最常见的鉴别诊断是人格障碍和抑郁症。

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