Cook Julia, Hull Laura, Mandy Will
Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK.
Bristol Medical School, University of Bristol, Bristol, UK.
Neuropsychiatr Dis Treat. 2024 Mar 7;20:505-514. doi: 10.2147/NDT.S372723. eCollection 2024.
Biases exist in the diagnostic process for autism spectrum disorder (henceforth "autism"), which result in some girls and women being diagnosed later or missed entirely. Current diagnostic tools may not capture the full range of behavioural presentations of autism, leading to under-identification. This review explores why these biases may occur, and how diagnostic procedures could be adapted to better identify autistic girls and women. We recommend that diagnostic assessments are adjusted to capture a broader range of behavioural exemplars of autism; that camouflaging of autistic traits is taken into account; and that care is taken to ensure co-occurring mental health conditions do not overshadow autism diagnosis. We offer recommendations, building on gold-standard diagnostic guidelines, for how diagnostic procedures can be improved for girls and women.
自闭症谱系障碍(以下简称“自闭症”)的诊断过程中存在偏差,这导致一些女孩和女性被诊断得较晚或完全被漏诊。当前的诊断工具可能无法涵盖自闭症所有的行为表现,从而导致识别不足。本综述探讨了这些偏差可能产生的原因,以及诊断程序如何进行调整以更好地识别自闭症女孩和女性。我们建议调整诊断评估,以涵盖更广泛的自闭症行为范例;考虑自闭症特征的伪装情况;并注意确保共病的心理健康状况不会掩盖自闭症的诊断。我们在金标准诊断指南的基础上,就如何改进针对女孩和女性的诊断程序提出了建议。