Hitzert B, Schmidt R, Geurts H M, van Alphen S P J
Tijdschr Psychiatr. 2016;58(12):854-862.
Empirical research into the diagnostics and treatment of older adults with autism spectrum disorders (ASD) is very limited; so far, only 17 studies have been published. ASD, however, is not confined to child and adult psychiatry. Increasingly, ASD is being identified and treated within the domain of geriatric psychiatry.
AIM: To investigate diagnostic and therapeutic aspects of ASD in older adults, and to obtain insight into how these aspects are related to ageing.
METHOD: Delphi techniques were employed via rounds of questionnaires put to experts; consensus was considered to have been achieved when a minimum of two-thirds of the experts 'agreed' or 'fully agreed' to a statement on a five-point scale.
RESULTS: Consensus was achieved for 10 of the 17 statements. According to the experts, older patients with ASD, form a specific group in psychiatry. With regard to diagnosis, there was a consensus that increased attention needs to be given to age-related aspects by linking symptoms more specifically to the patient's phase of life and to the ageing process. In the treatment of older adults with ASD, adjustments need to be made in relation to ageing.
CONCLUSION: This study by experts provides additional starting points for more research into specific topics relating to diagnostic and therapeutic aspects of ASD in geriatric psychiatry; these topics include validation of screening and diagnostic instruments, the adjustment of protocols for treatment, psycho-education and the effects of ageing in patients with ASD.
针对患有自闭症谱系障碍（ASD）的老年人的诊断和治疗的实证研究非常有限；到目前为止，仅发表了17项研究。然而，ASD并不局限于儿童和成人精神病学领域。在老年精神病学领域，越来越多的ASD患者被识别和治疗。
调查老年人ASD的诊断和治疗方面，并深入了解这些方面与衰老的关系。
通过向专家发放多轮问卷采用德尔菲技术；当至少三分之二的专家在五点量表上对某一陈述“同意”或“完全同意”时，即认为达成了共识。
17项陈述中有10项达成了共识。专家们认为，患有ASD的老年患者在精神病学中构成一个特殊群体。在诊断方面，达成的共识是，需要通过将症状更具体地与患者的生活阶段和衰老过程联系起来，更多地关注与年龄相关的方面。在治疗患有ASD的老年人时，需要针对衰老进行调整。
专家们进行的这项研究为进一步研究老年精神病学中与ASD诊断和治疗方面相关的特定主题提供了更多的切入点；这些主题包括筛查和诊断工具的验证、治疗方案的调整、心理教育以及ASD患者的衰老影响。
