University College London, UK.
Autism. 2017 Aug;21(6):706-727. doi: 10.1177/1362361316669087. Epub 2016 Dec 14.
Studies assessing sex/gender differences in autism spectrum conditions often fail to include typically developing control groups. It is, therefore, unclear whether observed sex/gender differences reflect those found in the general population or are particular to autism spectrum conditions. A systematic search identified articles comparing behavioural and cognitive characteristics in males and females with and without an autism spectrum condition diagnosis. A total of 13 studies were included in meta-analyses of sex/gender differences in core autism spectrum condition symptoms (social/communication impairments and restricted/repetitive behaviours and interests) and intelligence quotient. A total of 20 studies were included in a qualitative review of sex/gender differences in additional autism spectrum condition symptoms. For core traits and intelligence quotient, sex/gender differences were comparable in autism spectrum conditions and typical samples. Some additional autism spectrum condition symptoms displayed different patterns of sex/gender differences in autism spectrum conditions and typically developing groups, including measures of executive function, empathising and systemising traits, internalising and externalising problems and play behaviours. Individuals with autism spectrum conditions display typical sex/gender differences in core autism spectrum condition traits, suggesting that diagnostic criteria based on these symptoms should take into account typical sex/gender differences. However, awareness of associated autism spectrum condition symptoms should include the possibility of different male and female phenotypes, to ensure those who do not fit the 'typical' autism spectrum condition presentation are not missed.
研究评估自闭症谱系障碍中的性别差异时，往往未能纳入典型的对照组。因此，目前尚不清楚观察到的性别差异是否反映了普通人群中的差异，还是自闭症谱系障碍特有的差异。系统搜索确定了比较男性和女性自闭症谱系障碍患者与无自闭症谱系障碍患者的行为和认知特征的文章。共有 13 项研究纳入了自闭症谱系障碍核心症状（社交/沟通障碍、受限/重复行为和兴趣）和智商的性别差异的荟萃分析。共有 20 项研究纳入了自闭症谱系障碍附加症状性别差异的定性综述。对于核心特征和智商，自闭症谱系障碍和典型样本中的性别差异相当。一些自闭症谱系障碍的附加症状在自闭症谱系障碍和正常发育群体中表现出不同的性别差异模式，包括执行功能、同理心和系统思维特征、内化和外化问题以及游戏行为的测量。自闭症谱系障碍患者在核心自闭症谱系障碍特征上表现出典型的性别差异，这表明基于这些症状的诊断标准应考虑到典型的性别差异。然而，对相关自闭症谱系障碍症状的认识应包括不同男性和女性表型的可能性，以确保不会遗漏不符合“典型”自闭症谱系障碍表现的人。
