Improving control over euthanasia of persons with psychiatric illness: Lessons from the first Belgian criminal court case concerning euthanasia DOI Creative Commons
Marc D. Binder, Sien Loos, Sigrid Sterckx

et al.

Frontiers in Psychiatry, Journal Year: 2022, Volume and Issue: 13

Published: July 19, 2022

Belgium is one of very few countries that legally allow euthanasia for suffering caused by psychiatric illness. In the first criminal trial in physicians involved euthanasia, three recently faced accusation "murder poisoning," allegedly having failed to comply with several requirements Belgian Euthanasia Law granting request a woman from Although all were acquitted, case generated much debate among policy makers, medical professionals, and general public.We use this as starting point critical analysis adequacy three-level control system established Law, it applied evaluation requests persons who suffer unbearably This based on information presented during well was published press.Our highlights substantial problems assessment request. The patient euthanized without been substantiated her illness had no prospect improvement could not be alleviated. three-step enshrined promoted Federal Control Evaluation Commission appears have at each level.To evaluate mental illness, should complemented mandating advice two psychiatrists, face-to-face discussions between involved. parallel process evaluating request, treatment track guaranteed where reasonable evidence-based treatments recovery-oriented options are tried.

Language: Английский

Prevalence of Autism Spectrum Disorder and Co-morbidities in Children and Adolescents: A Systematic Literature Review DOI Creative Commons

C. Bougeard,

F. Picarel-Blanchot, R. Schmid

et al.

Frontiers in Psychiatry, Journal Year: 2021, Volume and Issue: 12

Published: Oct. 27, 2021

Objective: Individuals with autism spectrum disorder often present somatic and/or psychiatric co-morbid disorders. The DSM-5 allows for consideration of additional diagnoses besides ASD and may have impacted the prevalence co-morbidities as well being limited in capturing true differences observed between males females. We describe frequently children adolescents (<18 years) United States five European countries. Methods: Two systematic literature reviews were conducted PubMed Embase period 2014-2019 focusing on nine interest based their frequency severity: Attention Deficit Hyperactivity Disorder (ADHD), anxiety, depressive disorders, epilepsy, intellectual disability (ID), sleep sight/hearing impairment/loss, gastro-intestinal syndromes (GI). Results: Thirteen studies 33 included. Prevalence was 1.70 1.85% US aged 4 8 years respectively, while Europe ranged 0.38 1.55%. Additionally, current evidence is supportive a global increase over past years. Substantial heterogeneity observed: ADHD (0.00-86.00%), anxiety (0.00-82.20%), disorders (0.00-74.80%), epilepsy (2.80-77.50%), ID (0.00-91.70%), (2.08-72.50%), impairment/loss (0.00-14.90%/0.00-4.90%), GI (0.00-67.80%). Studies heterogeneous terms design method to estimate prevalence. Gender appears represent risk factor (higher males) epilepsy/seizure females) age also associated (increasing until adolescence). Conclusion: Our results provide descriptive review its adolescents. These insights can be valuable clinicians parents/guardians autistic children. has increased time bring clinical presentation, which further advocates personalized approaches treatment support. Having clear understanding important raise awareness among stakeholders.

Language: Английский

Citations

197

The Prevalence and Characteristics of Children With Profound Autism, 15 Sites, United States, 2000-2016 DOI
Michelle M. Hughes, Kelly Shaw,

Monica DiRienzo

et al.

Public Health Reports, Journal Year: 2023, Volume and Issue: 138(6), P. 971 - 980

Published: April 19, 2023

Autism spectrum disorder (autism) is a heterogeneous condition that poses challenges in describing the needs of individuals with autism and making prognoses about future outcomes. We applied newly proposed definition profound to surveillance data estimate percentage children who have describe their sociodemographic clinical characteristics.

Language: Английский

Citations

51

Autism spectrum disorder in ICD-11—a critical reflection of its possible impact on clinical practice and research DOI Creative Commons
Inge Kamp‐Becker

Molecular Psychiatry, Journal Year: 2024, Volume and Issue: 29(3), P. 633 - 638

Published: Jan. 25, 2024

Abstract This perspective article compares and contrasts the conceptualization of Autism Spectrum Disorder (ASD) in ICD-11 DSM-5. By guiding user through text, it is argued that, contrast to DSM-5, allows a high variety symptom combinations, which results an operationalization ASD that favor extreme diverse picture, yet possibly at expense precision, including unforeseeable effects on clinical practice, care, research. The utility questionable as this can hardly be differentiated from other mental disorders autism-like traits. It moves away observable, behavioral, neurodevelopmental disorder inner experience measured objectively. contains many vague subjective concepts lead non-falsifiable diagnoses. bears large danger false positive diagnoses, further increased prevalence rates, limitations access ASD-specific services increasing non-specificity treatments. For research, hypothesis specificity will reduced additional increase already heterogeneity with effect replication studies hampered. could limit our understanding etiology biological pathways risk precision medicine, i.e., targeted approach for individual treatment strategies based precise diagnostic markers, more far becoming reality. Thus, precise, quantitative description objective measurement symptoms are suggested define phenotype. Identification core subtypes/endophenotypes necessary next step advance classification systems. Therefore, employing finely grained, objective, characterization relatable neurobehavioral central significance.

Language: Английский

Citations

23

Commentary: Best practices and processes for assessment of autism spectrum disorder – the intended role of standardized diagnostic instruments DOI Creative Commons
Somer Bishop, Catherine Lord

Journal of Child Psychology and Psychiatry, Journal Year: 2023, Volume and Issue: 64(5), P. 834 - 838

Published: April 2, 2023

Development of standardized diagnostic instruments has facilitated the systematic characterization individuals with autism spectrum disorders (ASD) in clinical and research settings. However, overemphasis on scores from specific significantly detracted original purpose these tools. Rather than provide a definitive "answer," or even confirmation diagnosis, were designed to aid clinicians process gathering information about social communication, play, repetitive sensory behaviors relevant diagnosis treatment planning. Importantly, many are not validated for certain patient populations, including those severe vision, hearing, motor, and/or cognitive impairments, they cannot be administered via translator. In addition, circumstances, such as need wear personal protective equipment (PPE), behavioral factors (e.g., selective mutism) may interfere administration scoring procedures, rendering invalid. Thus, understanding uses limitations tools within well similarities differences between populations instrument validation samples, is paramount. Accordingly, payers other systems must mandate use cases when their would inappropriate. To ensure equitable access appropriate assessment services, it imperative that diagnosticians trained best practice methods autism, if, how, appropriately employ instruments.

Language: Английский

Citations

44

Multidimensional motor performance in children with autism mostly remains stable with age and predicts social communication delay, language delay, functional delay, and repetitive behavior severity after accounting for intellectual disability or cognitive delay: A SPARK dataset analysis DOI
Anjana Bhat

Autism Research, Journal Year: 2022, Volume and Issue: 16(1), P. 208 - 229

Published: Dec. 19, 2022

Abstract When motor difficulties continue into adolescence/adulthood, they could negatively impact an individual with autism spectrum disorder (ASD)'s daily living skills, physical fitness, as well and mental health/well‐being. Few studies have examined in children ASD a function of sex or age; however, greater cognitive challenges are associated worse general performance. Based on the Developmental Coordination Disorder‐Questionnaire (DCD‐Q) data from SPARK study sample, 87%–88% were at‐risk for impairment that persisted until 15 years was related to their core co‐occurring difficulties. Bhat et al. confirmed multiple dimensions predicted conditions after accounting age sex. However, presence intellectual disability (ID) delay not controlled previous analysis. Additionally, effects age, sex, ability multidimensional sample been discussed before. Therefore, this analysis examines (presence ID level delay) performance using DCD‐Q. Except fine domains did change ASD. Females without improved scores performed better compared males ID. Children had across than those Even controlling ID/cognitive delay; predictive social communication repetitive behavior severity, language functional delays. Gross skills contributed more competence predicting delay. gross severity Both, In light consistent findings ASD, adding issues specifier within definition provide clear clinical route movement clinicians address individuals

Language: Английский

Citations

41

Autism Spectrum Disorder and auditory sensory alterations: a systematic review on the integrity of cognitive and neuronal functions related to auditory processing DOI Creative Commons

Ana Margarida Gonçalves,

Patrícia Monteiro

Journal of Neural Transmission, Journal Year: 2023, Volume and Issue: 130(3), P. 325 - 408

Published: March 1, 2023

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition with wide spectrum of symptoms, mainly characterized by social, communication, and cognitive impairments. Latest diagnostic criteria according to DSM-5 (Diagnostic Statistical Manual Mental Disorders, Fifth Edition, 2013) now include sensory issues among the four restricted/repetitive behavior features defined as "hyper- or hypo-reactivity input unusual interest in aspects environment". Here, we review auditory alterations patients ASD. Considering updated for ASD, examined research evidence (2015-2022) integrity function auditory-related tasks, peripheral system, central nervous system diagnosed Taking into account different approaches experimental study designs, reappraise knowledge on reflect how these might be linked symptomatology

Language: Английский

Citations

38

Where do neurodevelopmental conditions fit in transdiagnostic psychiatric frameworks? Incorporating a new neurodevelopmental spectrum DOI
Giorgia Michelini, Christina Carlisi, Nicholas R. Eaton

et al.

World Psychiatry, Journal Year: 2024, Volume and Issue: 23(3), P. 333 - 357

Published: Sept. 16, 2024

Features of autism spectrum disorder, attention‐deficit/hyperactivity learning disorders, intellectual disabilities, and communication motor disorders usually emerge early in life are associated with atypical neurodevelopment. These “neurodevelopmental conditions” grouped together the DSM‐5 ICD‐11 to reflect their shared characteristics. Yet, reliance on categorical diagnoses poses significant challenges both research clinical settings (e.g., high co‐occurrence, arbitrary diagnostic boundaries, within‐disorder heterogeneity). Taking a transdiagnostic dimensional approach provides useful alternative for addressing these limitations, accounting underpinnings across neurodevelopmental conditions, characterizing common co‐occurrence developmental continuity other psychiatric conditions. Neurodevelopmental features have not been adequately considered frameworks, although this would fundamental implications practices. Growing evidence from studies structure conditions indicates that cluster together, delineating spectrum” ranging normative impairing profiles. Studies genetic underpinnings, overlapping cognitive neural profiles, similar course efficacy support/treatment strategies indicate validity spectrum. Further, alongside dimensions has utility, as it fuller view an individual's needs strengths, greater prognostic utility than categories. Based compelling body evidence, we argue incorporating new into frameworks considerable potential transforming our understanding, classification, assessment, practices around

Language: Английский

Citations

14

Presence and correlates of autistic traits among patients with social anxiety disorder DOI Creative Commons
Barbara Carpita, Benedetta Nardi, Chiara Bonelli

et al.

Frontiers in Psychiatry, Journal Year: 2024, Volume and Issue: 14

Published: Jan. 19, 2024

Introduction Due to their similar behavioral presentation, it can sometimes be challenging distinguish between a social anxiety disorder (SAD) and the avoidance that is frequently described in autism spectrum (ASD). Moreover, growing body of evidences reporting significant proportion subjects with ASD also meet requirements for SAD and, vice versa, tend exhibit higher prevalence autistic traits. Aim In this framework, current study aims evaluate correlates traits sample adult diagnosed healthy controls (HC), evaluating which dimensions may statistically predict symptoms. Methods 56 clinical diagnosis gender age matched HC were recruited from Psychiatric Clinic University Pisa. Subjects assessed SCID-5, Social Anxiety Spectrum – Short Version (SHY- SV) Adult Autism Subthreshold (AdAS Spectrum). Results group scored significantly all AdAS SHY-SV domains total score compared no difference. domain scores, strongly positively correlated score. Childhood/Adolescence, Non-Verbal Communication, Empathy Restricted interests Rumination scores predictors Conclusion Our results confirm link population, describing not only high levels adults, but correlations many core features two disorders predictive role on

Language: Английский

Citations

12

Prevalence of Autism Spectrum Disorder and Co-Morbidities in Children and Adolescents: A Systematic Literature Review DOI

C. Bougeard,

F. Picarel-Blanchot, R. Schmid

et al.

FOCUS The Journal of Lifelong Learning in Psychiatry, Journal Year: 2024, Volume and Issue: 22(2), P. 212 - 228

Published: April 1, 2024

Objective: Individuals with autism spectrum disorder often present somatic and/or psychiatric co-morbid disorders. The DSM-5 allows for consideration of additional diagnoses besides ASD and may have impacted the prevalence co-morbidities as well being limited in capturing true differences observed between males females. We describe frequently children adolescents (<18 years) United States five European countries. Methods: Two systematic literature reviews were conducted PubMed Embase period 2014–2019 focusing on nine interest based their frequency severity: Attention Deficit Hyperactivity Disorder (ADHD), anxiety, depressive disorders, epilepsy, intellectual disability (ID), sleep sight/hearing impairment/loss, gastro-intestinal syndromes (GI). Results: Thirteen studies 33 included. Prevalence was 1.70 1.85% U.S aged 4 8 years respectively, while Europe ranged 0.38 1.55%. Additionally, current evidence is supportive a global increase over past years. Substantial heterogeneity observed: ADHD (0.00–86.00%), anxiety (0.00–82.20%), disorders (0.00–74.80%), epilepsy (2.80–77.50%), ID (0.00–91.70%), (2.08–72.50%), impairment/loss (0.00–14.90%/0.00–4.90%), GI (0.00–67.80%). Studies heterogeneous terms design method to estimate prevalence. Gender appears represent risk factor (higher males) epilepsy/seizure females) age also associated (increasing until adolescence). Conclusion: Our results provide descriptive review its adolescents. These insights can be valuable clinicians parents/guardians autistic children. has increased time bring clinical presentation, which further advocates personalized approaches treatment support. Having clear understanding important raise awareness among stakeholders. Appeared originally Front Psychiatry 2021; 12:744709

Language: Английский

Citations

11

Autism Spectrum Disorder, Oral Implications, and Oral Microbiota DOI Creative Commons

Emiliana D’Angelo,

Fausto Fiori,

Giuseppe Andrea Ferraro

et al.

Children, Journal Year: 2025, Volume and Issue: 12(3), P. 368 - 368

Published: March 15, 2025

Background/Objectives: Autism spectrum disorder (ASD) is a complex neurodevelopmental characterized by difficulties in social interaction, communication, and repetitive behaviors. Recent evidence indicates significant relationship between ASD imbalances microbiota, particularly the oral gastrointestinal areas. This review examines impact of self-injurious behaviors (SIB), sensory sensitivity, dietary choices on comorbidities associated with ASD. Methods: An extensive literature was conducted using PubMed Scopus. The focus human studies full-text availability, utilizing search terms related to ASD, health, disorders. research evaluated for methodological quality its relevance connections Results: Individuals face unique health challenges, including injuries from increased which complicate hygiene care. Selective eating can lead nutritional deficiencies worsen issues. Dysbiosis gut marked altered levels acetate, propionate, butyrate, interferes gut-brain oral-brain connections, contributing behavioral neurological symptoms. Treatment options such as probiotics, fecal microbiota transfer, integration therapies potentially alleviate symptoms improve life. Conclusions: suggests bidirectional influence through neuroinflammatory mechanisms metabolic disturbances. Proactive strategies focusing dental may help reduce enhance overall management underscoring need further into microbiota–host interactions their therapeutic potential.

Language: Английский

Citations

1