Chandrasekhar Tara, Sikich Linmarie
Assistant Professor of Psychiatry, University of North Carolina at Chapel Hill School of Medi-cine; University of North Carolina Hospitals, Chapel Hill, North Carolina, USA.
Associate Professor of Psychiatry, Director, ASPIRE Research Program, University of North Carolina at Chapel Hill School of Medi-cine; University of North Carolina Hospitals, Chapel Hill, North Carolina, USA.
Dialogues Clin Neurosci. 2015 Jun;17(2):219-27. doi: 10.31887/DCNS.2015.17.2/tchandrasekhar.
Diagnosis and treatment of comorbid neuropsychiatric illness is often a secondary focus of treatment in individuals with autism spectrum disorder (ASD), given that substantial impairment may be caused by core symptoms of ASD itself. However, psychiatric comorbidities, including depressive disorders, are common and frequently result in additional functional impairment, treatment costs, and burden on caregivers. Clinicians may struggle to appropriately diagnose depression in ASD due to communication deficits, atypical presentation of depression in ASD, and lack of standardized diagnostic tools. Specific risk and resilience factors for depression in ASD across the lifespan, including level of functioning, age, family history, and coping style, have been suggested, but require further study. Treatment with medications or psychotherapy may be beneficial, though more research is required to establish guidelines for management of symptoms. This review will describe typical presentations of depression in individuals with ASD, review current information on the prevalence, assessment, and treatment of comorbid depression in individuals with ASD, and identify important research gaps.
鉴于自闭症谱系障碍（ASD）的核心症状可能会造成严重损害，共病神经精神疾病的诊断和治疗在ASD患者中往往是次要的治疗重点。然而，包括抑郁症在内的精神共病很常见，并且经常导致额外的功能损害、治疗费用以及照顾者的负担。由于沟通缺陷、ASD中抑郁症的非典型表现以及缺乏标准化诊断工具，临床医生可能难以对ASD患者的抑郁症进行准确诊断。虽然已经提出了ASD患者一生中患抑郁症的特定风险和恢复力因素，包括功能水平、年龄、家族史和应对方式，但仍需要进一步研究。药物治疗或心理治疗可能有益，不过还需要更多研究来制定症状管理指南。本综述将描述ASD患者抑郁症的典型表现，回顾有关ASD患者共病抑郁症的患病率、评估和治疗的当前信息，并确定重要的研究空白。
