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自闭症谱系障碍成年人的健康状况。

The health status of adults on the autism spectrum.

作者信息

Croen Lisa A, Zerbo Ousseny, Qian Yinge, Massolo Maria L, Rich Steve, Sidney Stephen, Kripke Clarissa

机构信息

Kaiser Permanente Northern California-Oakland, USA

Kaiser Permanente Northern California-Oakland, USA.

出版信息

Autism. 2015 Oct;19(7):814-23. doi: 10.1177/1362361315577517. Epub 2015 Apr 24.

Abstract

Compared to the general pediatric population, children with autism have higher rates of co-occurring medical and psychiatric illnesses, yet very little is known about the general health status of adults with autism. The objective of this study was to describe the frequency of psychiatric and medical conditions among a large, diverse, insured population of adults with autism in the United States. Participants were adult members of Kaiser Permanente Northern California enrolled from 2008 to 2012. Autism spectrum disorder cases (N = 1507) were adults with autism spectrum disorder diagnoses (International Classification of Diseases-9-Clinical Modification codes 299.0, 299.8, 299.9) recorded in medical records on at least two separate occasions. Controls (N = 15,070) were adults without any autism spectrum disorder diagnoses sampled at a 10:1 ratio and frequency matched to cases on sex and age. Adults with autism had significantly increased rates of all major psychiatric disorders including depression, anxiety, bipolar disorder, obsessive-compulsive disorder, schizophrenia, and suicide attempts. Nearly all medical conditions were significantly more common in adults with autism, including immune conditions, gastrointestinal and sleep disorders, seizure, obesity, dyslipidemia, hypertension, and diabetes. Rarer conditions, such as stroke and Parkinson's disease, were also significantly more common among adults with autism. Future research is needed to understand the social, healthcare access, and biological factors underlying these observations.

摘要

与一般儿科人群相比,患有自闭症的儿童同时患有医学和精神疾病的几率更高,但对于成年自闭症患者的总体健康状况却知之甚少。本研究的目的是描述美国大量、多样化、有保险的成年自闭症患者中精神和身体疾病的发生频率。参与者是2008年至2012年期间北加利福尼亚凯撒医疗集团的成年成员。自闭症谱系障碍病例(N = 1507)是指在医疗记录中至少两次单独记录有自闭症谱系障碍诊断(国际疾病分类第九版临床修订版代码299.0、299.8、299.9)的成年人。对照组(N = 15070)是未患有任何自闭症谱系障碍诊断的成年人,按10:1的比例抽样,性别和年龄与病例相匹配。患有自闭症的成年人患所有主要精神疾病的几率显著增加,包括抑郁症、焦虑症、双相情感障碍、强迫症、精神分裂症和自杀未遂。几乎所有身体疾病在成年自闭症患者中也明显更为常见,包括免疫疾病、胃肠道和睡眠障碍、癫痫、肥胖、血脂异常、高血压和糖尿病。中风和帕金森病等罕见疾病在成年自闭症患者中也明显更为常见。需要未来的研究来了解这些观察结果背后的社会、医疗保健获取和生物学因素。

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