Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK.
Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, Camberwell, London, SE5 8AF, UK.
J Autism Dev Disord. 2021 Sep;51(9):3165-3179. doi: 10.1007/s10803-020-04763-2. Epub 2020 Nov 17.
Longitudinal studies have generally reported poor outcomes in adulthood for the majority of individuals (c.50-60%) with autism. Several factors putatively predict outcome (e.g. IQ), but findings remain mixed. This paper presents an updated meta-analysis of autism outcome studies and extends previous findings with additional analyses (including meta-regression). A total of 4088 records was screened and 18 studies, involving 1199 individuals, were included in the quantitative analysis. Estimated percentages indicated that 20.0% of participants were rated as having a good outcome, 26.6% a fair outcome, and 49.3% a poor outcome. Meta-regression indicated that lower IQ in adulthood was predictive of poor outcome; other meta-regression models did not survive correction for multiple comparisons. Overall, outcomes for autistic people are on average poor, and higher IQ appears to be protective against having a poor outcome. The limitations of current constructs of outcome are discussed.
纵向研究一般报告了大多数自闭症患者(约 50-60%)成年后预后较差。有几个假定的因素可以预测结果(例如智商),但研究结果仍存在差异。本文对自闭症预后研究进行了更新的荟萃分析,并通过额外的分析(包括元回归)扩展了先前的发现。共筛选了 4088 条记录,有 18 项研究,涉及 1199 人,纳入了定量分析。估计百分比表明,20.0%的参与者被评为预后良好,26.6%的参与者预后一般,49.3%的参与者预后较差。元回归表明,成年后较低的智商与预后不良相关;其他元回归模型在经过多次比较校正后都没有存活。总体而言,自闭症患者的预后平均较差,较高的智商似乎可以预防预后不良。目前预后结果的局限性也进行了讨论。