Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK; Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan.
Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK; Department of Psychology, University of Cyprus, Nicosia, Cyprus.
Lancet. 2014 Mar 8;383(9920):896-910. doi: 10.1016/S0140-6736(13)61539-1. Epub 2013 Sep 26.
Autism is a set of heterogeneous neurodevelopmental conditions, characterised by early-onset difficulties in social communication and unusually restricted, repetitive behaviour and interests. The worldwide population prevalence is about 1%. Autism affects more male than female individuals, and comorbidity is common (>70% have concurrent conditions). Individuals with autism have atypical cognitive profiles, such as impaired social cognition and social perception, executive dysfunction, and atypical perceptual and information processing. These profiles are underpinned by atypical neural development at the systems level. Genetics has a key role in the aetiology of autism, in conjunction with developmentally early environmental factors. Large-effect rare mutations and small-effect common variants contribute to risk. Assessment needs to be multidisciplinary and developmental, and early detection is essential for early intervention. Early comprehensive and targeted behavioural interventions can improve social communication and reduce anxiety and aggression. Drugs can reduce comorbid symptoms, but do not directly improve social communication. Creation of a supportive environment that accepts and respects that the individual is different is crucial.
自闭症是一组异质性神经发育障碍，其特征是早期社交沟通困难，以及异常受限、重复的行为和兴趣。全球患病率约为 1%。自闭症影响男性多于女性，且常伴有共病（>70%有并存状况）。自闭症个体具有异常的认知特征，如社交认知和社会知觉受损、执行功能障碍以及异常的感知和信息处理。这些特征由系统水平的非典型神经发育所支撑。遗传学在自闭症的发病机制中起着关键作用，与发育早期的环境因素有关。大效应罕见突变和小效应常见变异共同导致风险。评估需要多学科和发展性，早期发现对于早期干预至关重要。早期全面和有针对性的行为干预可以改善社交沟通，减少焦虑和攻击行为。药物可以减轻共病症状，但不能直接改善社交沟通。创造一个接受和尊重个体差异的支持性环境至关重要。
