Asperger syndrome: a study on the transition to adult life
Downloads
Published
How to Cite
Issue
Section
DOI:
https://doi.org/10.31766/revpsij.v38n4a4Keywords:
Asperger's syndrome, care, transition, adulthoodAbstract
Introduction: The transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS) is a difficult stage with a high probability of follow-up abandonment. In addition to being at high risk of developing mental disorders, patients with Asperger syndrome (AS) may face difficulties in adjustment. This study examines the clinical development of patients with AS who were referred from the CAMHS of the Hospital Universitario Virgen de las Nieves of Granada to the corresponding AMHS. Methods: An observational, descriptive, cross-sectional study (with a longitudinal component) was performed, using an opportunistic sampling to recruit a group of patients with AS who were discharged from the CAMHS between 2008 and 2019. A total of 23 participants were included, 87% were male, with a mean age of 25±3,2 years, without significant differences between sexes. Results: 78.3% of the participants weren’t receiving any medical care at that moment. Lack of follow-up was associated with poor satisfaction during the transition process. We found high rates of anxiety (76.6%) and depression (46.2%) after discharge from CAMHS and patients significantly improved in autonomy and socialization skills. A better degree of autonomy was associated with higher IQ, and a worse one with higher levels of anxiety and a greater use of antidepressants, as did those patients who had maintained follow-up after discharge. Conclusions: The transition to adulthood in patients with AS is a complicated process in which we found a high percentage of care abandonment and the development of psychiatric comorbidities. Further research is needed to understand the characteristics of the transition process in patients with AS to develop effective strategies to minimize loss of care and its negative consequences.
Downloads
References
Kanner L. Autistic disturbances of affective contact. Nerv Child 1943; 2(3): 217-250.
Hosseini SA, Molla M. Asperger Syndrome. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021
Wing L. Asperger’s syndrome: A clinical account. 115–29. 25. Psychol Med 1981; 11(1): 115-129 DOI: https://doi.org/10.1017/S0033291700053332
American Psychiatric Association (APA). Diagnostic and statistical manual of mental disorders (DSM-III). 3rd ed. Washington, D.C.; 1980
American Psychiatric Association (APA). Manual diagnóstico y estadístico de los trastornos mentales DSM-5. 5th ed.; 2013.
Hodges H, Fealko C, Soares N. Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation. Transl Pediatr 2020;9(1): 55-65. DOI: https://doi.org/10.21037/tp.2019.09.09
American Psychiatric Association (APA). Manual Diagnóstico y Estadístico de los Trastornos Mentales DSM-IV. 4th ed.; 2002.
La Organización Mundial de la Salud (OMS) publica hoy su nueva Clasificación Internacional de Enfermedades (CIE-11); 2018. https://www.who.int/es/news-room/detail/17-06-2018-whoreleases-new-international-classif ication-ofdiseases-%28icd-11%29
Confederación Autismo España. Sobre el TEA. http://www.autismo.org.es/sobre-los-TEA/trastorno-del-especto-del-autismo
Artigas J. Neurocognitive aspects of Asperger’s Syndrome. Rev Neurol 2000;1: 34-44
Cerna Márquez MA, Contreras Martínez LM. Síndrome de Asperger: Revisión sistemática de aspectos neurocognitivos. Acta Pediátrica Hondureña 2018;9(1): 894-907 DOI: https://doi.org/10.5377/pediatrica.v9i1.8588
Fuentes J, Hervás A, Howlin P. ESCAP practice guidance for autism: a summary of evidence-based recommendations for diagnosis and treatment. Eur Child Adoles Psychiatry 2021;30: 961-84 DOI: https://doi.org/10.1007/s00787-020-01587-4
Croen LA, Najjar DV, Ray GT, Lotspeich L, Bernal P. A comparison of health care utilization and costs of children with and without autism spectrum disorders in a large group-model health plan. Pediatrics 2006;118(4): e1203-e1211 DOI: https://doi.org/10.1542/peds.2006-0127
Davignon MN, Qian Y, Massolo M, Croen LA. Psychiatric and medical conditions in transition-aged individuals with ASD. Pediatrics 2018;141(Suppl. 4): S335-S345 DOI: https://doi.org/10.1542/peds.2016-4300K
Singh SP , Tuomainen H. Transition from child to adult mental health services: needs, barriers, experiences and new models of care. World Psychiatry 2015;14(3): 358-61. DOI: https://doi.org/10.1002/wps.20266
Mazurek MO, Stobbe G, Loftin R, Malow BA, Agrawal MM, Tapia M, et al. ECHO Autism Transition: Enhancing healthcare for adolescents and young adults with autism spectrum disorder. Autism 2020;24(3): 633-44 DOI: https://doi.org/10.1177/1362361319879616
Albaladejo Gutierrez E, Pérez Valiente E, Espín Jaime JC. Elaboración de un modelo de herramienta de gestión (Ficha de Transición) para pacientes en transición desde los Servicios de Salud Mental del Niño y el Adolescente hacia la Salud Mental de Adultos. Revista de psiquiatría infanto-juvenil 2020;37(3): 20-8 DOI: https://doi.org/10.31766/revpsij.v37n3a3
Libro Blanco de la Psiquiatría del Niño y el Adolescente [Internet]. Fundación Alicia Koplowitz. 2014. http://www.madrid.org/cs/
Fegert J, Hauth I, Banaschewski T, Freyberger H. Transitions from adolescence to adulthood: the challenges to establish “transition psichiatry”. Key Issue Paper; 2016. https://www.escap.eu/uploads/Events/Geneva%202017/key-issuepaper-eckpunkte-transitionspsychiatrie-englischfinal.pdf
Singh SP, Toumainen H, de Girolamo G, Maras A, Santosh P, McNicholas F et al. Protocol for a cohort study of adolescent mental health service users with a nested cluster randomised controlled trial to assess the clinical and cost-effectiveness of managed transition in improving transitions from child to adult mental health services (the MILESTONE study). BMJ Open 2017;7: e016055
Instituto de investigación sanitaria del Hospital Clínico San Carlos. Proyecto Crecer; 2019. https://unidaddeinnovacion.shealth.eu/proyecto-crecer
Signorini G, Singh S, Marsanic VB, Dieleman G, Dodig-Curkovic K, Franic T, et al.. The interface between child/adolescent and adult mental health services: results from a European 28-country survey. Eur Child Adolesc Psychiatry 2018; 27(4): 501-511 DOI: https://doi.org/10.1007/s00787-018-1112-5
Anderson KA, Sosnowy C, Kou A, Shattuck P. Transition of individuals with autism to adulthood: a review of qualitative studies. Pediatrics 2018; 141(Suppl 4): S318-S327. DOI: https://doi.org/10.1542/peds.2016-4300I
Bennett AE, Miller JS, Stollon N, Prasad R, Blum NJ. Autism Spectrum Disorder and Transition-Aged Youth. Curr Psychiatry Rep. 2018;20(11): 103. DOI: https://doi.org/10.1007/s11920-018-0967-y
Ghaziuddin M, Greden J. Depression in children with autism/pervasive developmental disorders: a case-control family history study. J Autism Dev Disord. 1998;28(2): 111-15. DOI: https://doi.org/10.1023/A:1026036514719
Kelly R, O’Malley M, Antonijevic S. ‘Just trying to talk to people … It’s the hardest’: Perspectives of adolescents with high-functioning autism spectrum disorder on their social communication skills. Child language teaching and therapy 2018;34(3): 319-34. DOI: https://doi.org/10.1177/0265659018806754
Barendse E, Hendricks M, Thoonen G, Aldenkamp A, Kessels R. Social behaviour and social cognition in high-functioning adolescents with autism spectrum disorder (ASD): two sides of the same coin. Cogn Process. 2018;19(4): 545-555. DOI: https://doi.org/10.1007/s10339-018-0866-5
Posar A, Visconti P. Long-term outcome of autism spectrum disorder. Turk Pediatri Ars. 2019;54(4): 207-12. DOI: https://doi.org/10.14744/TurkPediatriArs.2019.16768
Magiati I, Tay XW, Howlin P. Cognitive, language, social and behavioural outcomes in adults with autism spectrum disorders: a systematic review of longitudinal follow-up studies in adulthood. Clin Psychol Rev. 2014;34(1): 72-86 DOI: https://doi.org/10.1016/j.cpr.2013.11.002
Platos M, Pistula E. Service use, unmet needs, and barriers to services among adolescents and young adults with autism spectrum disorder in Poland. BMC Health Serv Res. 2019;19(1): 587 DOI: https://doi.org/10.1186/s12913-019-4432-3
Vasa RA, Mazurekb MO. An update on anxiety in youth with autism spectrum disorders. Curr Opin Psychiatry. 2015;28(2): 83-90 DOI: https://doi.org/10.1097/YCO.0000000000000133
Paula-Pérez I, Martos-Pérez J. Asperger’s syndrome and high-functioning autism: comorbidity with anxiety and mood disorders. Rev Neurol. 2009;48(Suppl 2): S31-S34 DOI: https://doi.org/10.33588/rn.48S02.2008702
Sawyer SM, Azzopardi PS, Wickremarathne D, George C P. The age of adolescence. The Lancet 2018;2(3): 223-28 DOI: https://doi.org/10.1016/S2352-4642(18)30022-1
Nicolaidis C, Raymaker D, McDonald K, Dern S, Boisclair WC, Ashkenazy E, Baggs A. Comparison of healthcare experiences in autistic and non-autistic adults: A cross-sectional online survey facilitated by an academic community partnership. J Gen Intern Med. 2013;28(6): 761-69. DOI: https://doi.org/10.1007/s11606-012-2262-7
Mazurek MO, Curran A, Burnette C, Sohl K. ECHO autism STAT: Accelerating early access to autism diagnosis. Journal of Autism and Developmental Disorders 2019;49(1): 127-37. DOI: https://doi.org/10.1007/s10803-018-3696-5
Thompson C, Bölte S, Falkmer T, Girdler S. To be understood: Transitioning to adult life for people with Autism Spectrum Disorder. Plos One 2018;13(3): e0194758 DOI: https://doi.org/10.1371/journal.pone.0194758
Santosh P, Singh J, Adams L, et al. MILESTONE Consortium. Validation of the Transition Readiness and Appropriateness Measure (TRAM) for the Managing the Link and Strengthening Transition from Child to Adult Mental Healthcare in Europe (MILESTONE) study. BMJ Open 2020;10(6):e033324 DOI: https://doi.org/10.1136/bmjopen-2019-033324
© 2021 AEPNyA Todos los derechos reservados
