Özgür Börte Gürbüz, Nasıroğlu Serhat, Özbay Hasan Can, Aksu Hatice
Department of Child and Adolescent Psychiatry, Aydın Adnan Menderes University Faculty of Medicine, Aydın, Türkiye.
Department of Psychology, Antalya Bilim University Faculty of Economics, Administrative and Social Sciences, Antalya, Türkiye.
Psychiatry Clin Psychopharmacol. 2025 Apr 16;35(3):253-260. doi: 10.5152/pcp.2025.241070.
Background: The objective of this research is to present the demographic and clinical features of children diagnosed with autism spectrum disorder (ASD) in the past, who have achieved an optimal level of improvement. One of the recurrent inquiries of the parents of children with an ASD diagnosis pertains to the prognosis of their offspring and the potential for improvement. This study aims to investigate children who lose the ASD diagnosis (LAD). Methods: This study retrospectively reviewed the medical records of 1465 children and adolescents aged 0-18 who were diagnosed with ASD between December 2017 and June 2021, and followed up by a child and adolescent psychiatrist. The files of a total of 50 LAD patients were analyzed. In addition to sociodemographic information, the patient's educational background, prenatal and postnatal complications, developmental milestones, other medical conditions, medications used, symptoms at the time of ASD diagnosis, and developmental/mental assessment results were also examined. Results: A sample of 50 cases was obtained and analyzed. The majority of the sample consisted of males, with a median age of 2.45 (min 1.17-max 7) years at the time of receiving the ASD diagnosis, and 5.5 (min 2.25-max 11.3) years at the time of losing the diagnosis. There was a positive and moderately significant relationship between the age of receiving the diagnosis and the age of losing the diagnosis (r=0.634, P < .001). Ninety-two percent of the sample received a mean of 2.29 ± 1.77 years of special education. Additionally, 26% of the sample still had an additional psychiatric diagnosis, with attention deficit hyperactivity disorder and speech sound disorder being the most common. Eighteen percent of the sample was found to be taking medication, primarily risperidone. Conclusion: This study shows that a subset of monitored children may lose their diagnosis, but further research to determine the clinical characteristics, symptomatology, and biological factors of this group of children will be more informative regarding optimal outcome processes.
本研究的目的是呈现过去被诊断为自闭症谱系障碍（ASD）且已达到最佳改善水平的儿童的人口统计学和临床特征。自闭症谱系障碍患儿的家长经常询问的问题之一是其子女的预后及改善的可能性。本研究旨在调查不再被诊断为自闭症谱系障碍（LAD）的儿童。方法：本研究回顾性分析了2017年12月至2021年6月期间被诊断为自闭症谱系障碍的1465名0至18岁儿童和青少年的病历，并由一名儿童和青少年精神科医生进行随访。共分析了50例不再被诊断为自闭症谱系障碍患者的档案。除社会人口统计学信息外，还检查了患者的教育背景、产前和产后并发症、发育里程碑、其他医疗状况、使用的药物、自闭症谱系障碍诊断时的症状以及发育/心理评估结果。结果：获得并分析了50例样本。样本中的大多数为男性，接受自闭症谱系障碍诊断时的中位年龄为2.45岁（最小1.17岁 - 最大7岁），不再被诊断时的年龄为5.5岁（最小2.25岁 - 最大11.3岁）。接受诊断的年龄与不再被诊断的年龄之间存在正相关且具有中度显著关系（r = 0.634，P <.001）。92%的样本平均接受了2.29 ± 1.77年的特殊教育。此外，26%的样本仍有其他精神科诊断，注意力缺陷多动障碍和语音障碍最为常见。18%的样本被发现正在服药，主要是利培酮。结论：本研究表明，一部分接受监测的儿童可能不再被诊断为自闭症谱系障碍，但进一步研究确定这组儿童的临床特征、症状学和生物学因素，将为最佳结局过程提供更多信息。
