Ruggieri Víctor
Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Buenos Aires, Argentina. E-mail:
Medicina (B Aires). 2020;80 Suppl 2:12-16.
Autism is a neurodevelopmental disorder characterized by a qualitative alteration in social interaction and communication, associated with restricted interests and stereotyped behaviors. People with autism are four times more likely to develop depression, than the general population, it is even considered as the most common mental health condition in people with autism spectrum disorders (ASD). One of the challenges is to recognize the manifestations related to depression in people with ASD, in whom, in general, it is expressed differently in relation to those with typical development. Depression in people with autism can manifest itself with restlessness and insomnia and not with feelings of sadness, so it is essential to be attentive and not justify all behavioral problems to autism. Young adults with ASD have higher baseline levels of almost all the depression characteristics listed in the DSM-5, which can lead to overdiagnosis or underreporting of depression. On the other hand, adults with autism have an increased risk of experiencing suicidal thoughts, planning suicide, carrying it out and even dying from suicide. Many of them have a history of depression, harassment and loneliness. It is essential the early detection of depression, develop appropriate tools for diagnosis in autism as well as generate awareness of the risk of ideation or suicide, a problem that only in recent years has been addressed with greater depth. In this paper I analyze depression in autism, the risk of suicidal ideation and suicide, prioritizing clinical aspects, their evaluation and risk factors.
自闭症是一种神经发育障碍,其特征是社交互动和沟通存在质性改变,并伴有兴趣受限和刻板行为。自闭症患者患抑郁症的可能性是普通人群的四倍,它甚至被认为是自闭症谱系障碍(ASD)患者中最常见的心理健康状况。其中一个挑战是识别自闭症患者中与抑郁症相关的表现,一般来说,自闭症患者的抑郁症表现与典型发育人群有所不同。自闭症患者的抑郁症可能表现为烦躁不安和失眠,而不是悲伤情绪,因此必须保持警惕,不能将所有行为问题都归因于自闭症。患有ASD的年轻人几乎所有在《精神疾病诊断与统计手册》第5版(DSM-5)中列出的抑郁症特征基线水平都较高,这可能导致抑郁症的过度诊断或报告不足。另一方面,自闭症成年人有更高的自杀念头、自杀计划、实施自杀甚至自杀死亡风险。他们中的许多人有抑郁症、骚扰和孤独的病史。早期发现抑郁症、开发针对自闭症的适当诊断工具以及提高对自杀念头或自杀风险的认识至关重要,这一问题直到近年来才得到更深入的探讨。在本文中,我分析了自闭症中的抑郁症、自杀念头和自杀风险,重点关注临床方面、评估方法和风险因素。