Bonnet-Brilhault F
UMR Inserm U930, équipe autisme, centre universitaire de pédopsychiatrie, hôpital Bretonneau, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 09, France.
Arch Pediatr. 2017 Apr;24(4):384-390. doi: 10.1016/j.arcped.2017.01.014. Epub 2017 Feb 28.
With approximately 67 million individuals affected worldwide, autism spectrum disorder (ASD) is the fastest growing neurodevelopmental disorder (United Nations, 2011), with a prevalence estimated to be 1/100. In France ASD affects approximately 600,000 individuals (from childhood to adulthood, half of whom are also mentally retarded), who thus have a major handicap in communication and in adapting to daily life, which leads autism to be recognized as a national public health priority. ASD is a neurodevelopmental disorder that affects several domains (i.e., socio-emotional, language, sensori-motor, executive functioning). These disorders are expressed early in life with an age of onset around 18 months. Despite evidence suggesting a strong genetic link with ASD, the genetic determinant remains unclear. The clinical picture is characterized by impairments in social interaction and communication and the presence of restrictive and repetitive behaviors (DSM-5, ICD-10). However, in addition to these two main dimensions there is significant comorbidity between ASD and other neurodevelopmental disorders such as attention deficit hyperactivity disorder or with genetic and medical conditions. One of the diagnostic features of ASD is its early emergence: symptoms must begin in early childhood for a diagnosis to be given. Due to brain plasticity, early interventions are essential to facilitate clinical improvement. Therefore, general practitioners and pediatricians are on the front line to detect early signs of ASD and to guide both medical explorations and early rehabilitation.
自闭症谱系障碍(ASD)在全球约有6700万人受其影响,是增长最快的神经发育障碍(联合国,2011年),估计患病率为1/100。在法国,ASD影响约60万人(从儿童到成人,其中一半还存在智力障碍),这些人在沟通和适应日常生活方面存在重大障碍,这使得自闭症被视为国家公共卫生重点。ASD是一种影响多个领域(即社会情感、语言、感觉运动、执行功能)的神经发育障碍。这些障碍在生命早期就会表现出来,发病年龄约为18个月。尽管有证据表明ASD与遗传有很强的联系,但遗传决定因素仍不清楚。临床表现的特征是社交互动和沟通受损,以及存在限制性和重复性行为(《精神疾病诊断与统计手册》第5版,《国际疾病分类》第10版)。然而,除了这两个主要方面外,ASD与其他神经发育障碍如注意力缺陷多动障碍或与遗传和医学状况之间存在显著的共病现象。ASD的诊断特征之一是其早期出现:症状必须在幼儿期开始才能做出诊断。由于大脑可塑性,早期干预对于促进临床改善至关重要。因此,全科医生和儿科医生处于检测ASD早期迹象以及指导医学检查和早期康复的前沿。