Doherty Mary, Chown Nick, Martin Nicola, Shaw Sebastian C K
University College Dublin, Dublin, Ireland; London South Bank University, London, UK; and Brighton and Sussex Medical School, Hove, UK.
London South Bank University, London, UK.
BJPsych Open. 2024 Oct 30;10(6):e183. doi: 10.1192/bjo.2024.756.
Diagnosis of autism falls under the remit of psychiatry. Recognition that psychiatrists could be autistic is recent. Psychiatrists are the second largest specialty group in Autistic Doctors International, a peer support group for autistic doctors.
To explore the experiences of autistic psychiatrists in relation to recognising themselves and others as autistic.
This was a qualitative study using loosely structured interviews and an interpretive phenomenological analysis.
Eight autistic senior psychiatrists based in the UK participated. One had a childhood diagnosis, two had been diagnosed in adulthood and the remainder self-identified as autistic as adults. Recognition of autism followed diagnosis of their children or encounters with autistic patients. Barriers to self-recognition included lack of autism training, the deficit-based diagnostic criteria and stereotypical views of autism. Recognising that they were autistic led to the realisation that many colleagues were also likely to be autistic, particularly in neurodevelopmental psychiatry. All participants reported the ability to quickly recognise autistic patients and to develop a good rapport easily, once they were aware of their own autistic identity. Difficulties recognising patients as autistic occurred before self-recognition when they shared autistic characteristics and experiences. 'If we don't recognise ourselves as autistic how on earth can we diagnose patients accurately?'
Autistic psychiatrists face multiple barriers to recognising that they are autistic. Lack of self-recognition may impede diagnostic accuracy with autistic patients. Self-recognition and disclosure by autistic psychiatrists may be facilitated by reframing the traditional deficit-based view of autism towards a neurodiversity-affirmative approach, with consequent benefits for autistic patients.
自闭症的诊断属于精神病学范畴。认识到精神科医生可能患有自闭症是最近才有的事。在“国际自闭症医生”这个自闭症医生的同伴支持组织中，精神科医生是第二大专业群体。
探讨自闭症精神科医生在认识自己和他人患有自闭症方面的经历。
这是一项定性研究，采用结构松散的访谈和解释现象学分析。
8名英国的自闭症资深精神科医生参与了研究。其中1人童年时被诊断为自闭症，2人成年后被诊断，其余人成年后自我认定为自闭症患者。对自闭症的认识是在他们的孩子被诊断或接触自闭症患者之后。自我认知的障碍包括缺乏自闭症培训、基于缺陷的诊断标准以及对自闭症的刻板看法。认识到自己患有自闭症后，他们意识到许多同事也可能患有自闭症，尤其是在神经发育精神病学领域。所有参与者都表示，一旦意识到自己的自闭症身份，就能迅速识别出自闭症患者，并轻松建立良好的关系。在自我认知之前，当患者具有自闭症特征和经历时，很难将他们识别为自闭症患者。“如果我们自己都不承认自己患有自闭症，那我们怎么能准确诊断患者呢？”
自闭症精神科医生在认识到自己患有自闭症方面面临多重障碍。缺乏自我认知可能会妨碍对自闭症患者的诊断准确性。将传统的基于缺陷的自闭症观点转变为肯定神经多样性的方法，可能有助于自闭症精神科医生进行自我认知和披露，从而使自闭症患者受益。
