Child and Adolescent Psychiatric Clinics of North America : Autism Spectrum Disorder Across the Lifespan : Part II (juillet 2020)

dimanche 31 mai 2020

Le numéro de juillet 2020 de la revue Child and Adolescent Psychiatric Clinics of North America est consacré au TSA en complétant sa thématique sur l’autisme au cours de la vie :

Autism Spectrum Disorder Across the Lifespan : Part II

1. Ghaziuddin M, Ghaziuddin N. Bipolar Disorder and Psychosis in Autism. Child Adolesc Psychiatr Clin N Am ;2020 (Jul) ;29(3):433-441.

Autism seldom occurs in its pure form. Often labeled as behavioral disorders or psychological reactions, comorbid psychiatric disorders are common. Bipolar disorder is one of the most common psychiatric disorders that occur in persons with autism across their life spans. It can be comorbid with and mistaken for several other conditions. Similarly, psychosis occurs in several psychiatric disorders. Schizophrenia is the prototype psychotic disorder that has a close but controversial relationship with autism. Assessment and treatment of bipolar disorder and psychosis should be based on their individual characteristics, family dynamics, and community resources.

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2. Ghaziuddin N, Andersen L, Ghaziuddin M. Catatonia in Patients with Autism Spectrum Disorder. Child Adolesc Psychiatr Clin N Am ;2020 (Jul) ;29(3):443-454.

Catatonia was first described by Karl Ludwig Kahlbaum in 1874, occurring in association with other psychiatric and medical disorders. However, in the nineteenth century the disorder was incorrectly classified as a subtype of schizophrenia. This misclassification persisted until the publication of DSM-5 in 2013 when important changes were incorporated. Although the etiology is unknown, disrupted gamma-aminobutyric acid has been proposed as the underlying pathophysiological mechanism. Key symptoms can be identified under 3 clinical domains : motor, speech, and behavioral. Benzodiazepines and electroconvulsive therapy are the only known effective treatments. Timely recognition and treatment have important outcome, and sometimes lifesaving, implications.

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3. Park SE, Grados M, Wachtel L, Kaji S. Use of Electroconvulsive Therapy in Autism. Child Adolesc Psychiatr Clin N Am ;2020 (Jul) ;29(3):455-465.

The mechanism of action of electroconvulsive therapy (ECT) is not fully elucidated, with prevailing theories ranging from neuroendocrinological to neuroplasticity effects of ECT or epileptiform brain plasticity. Youth with autism can present with catatonia. ECT is a treatment that can safely and rapidly resolve catatonia in autism and should be considered promptly. The literature available for ECT use in youth with autism is consistently growing. Under-recognition of the catatonic syndrome and delayed diagnosis and implementation of the anticatatonic treatment paradigms, including ECT, as well as stigma and lack of knowledge of ECT remain clinical stumbling blocks.

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4. Kunreuther E. Autism Spectrum Disorder and Substance Use Disorder : A Dual Diagnosis Hiding in Plain Sight. Child Adolesc Psychiatr Clin N Am ;2020 (Jul) ;29(3):467-481.

Individuals with autism spectrum disorder (ASD) have a significantly higher risk for developing a substance use disorder (SUD) than the general population yet literature addressing cooccurring ASD and SUD is scarce. This article explores connections between ASD and SUD and the impact on development, screening and treatment. The article proposes culturally constructed narratives associated with both diagnoses may be responsible for the dearth of research and literature. Constructed narratives of ASD and SUD do not naturally intersect and the resulting disconnect can create a cognitive dissonance that could allow the medical and general community to neglect this life-threatening dual diagnosis.

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5. Besag FMC, Vasey MJ. Seizures and Epilepsy in Autism Spectrum Disorder. Child Adolesc Psychiatr Clin N Am ;2020 (Jul) ;29(3):483-500.

Epilepsy and autism frequently co-occur. Epilepsy confers an increased risk of autism and autism confers an increased risk of epilepsy. Specific epilepsy syndromes, intellectual disability, and female gender present a particular risk of autism in individuals with epilepsy. Epilepsy and autism are likely to share common etiologies, which predispose individuals to either or both conditions. Genetic factors, metabolic disorders, mitochondrial disorders, and immune dysfunction all can be implicated.

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6. Madra M, Ringel R, Margolis KG. Gastrointestinal Issues and Autism Spectrum Disorder. Child Adolesc Psychiatr Clin N Am ;2020 (Jul) ;29(3):501-513.

Gastrointestinal disorders are one of the most common medical conditions that are comorbid with autism spectrum disorders. These comorbidities can cause greater severity in autism spectrum disorder symptoms, other associated clinical manifestations, and lower quality of life if left untreated. Clinicians need to understand how these gastrointestinal issues present and apply effective therapies. Effective treatment of gastrointestinal problems in autism spectrum disorder may result in marked improvements in autism spectrum disorder behavioral outcomes. This article discusses the gastrointestinal disorders commonly associated with autism spectrum disorders, how they present, and studied risk factors.

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7. Sarcia B. The Impact of Applied Behavior Analysis to Address Mealtime Behaviors of Concern Among Individuals with Autism Spectrum Disorder. Child Adolesc Psychiatr Clin N Am ;2020 (Jul) ;29(3):515-525.

Feeding difficulties among individuals with autism spectrum disorder are common. The science of applied behavior analysis (ABA) has been employed to address these difficulties. Ample publications exist that demonstrate that ABA is consistently effective in increasing the consumption of new foods and drinks, increasing chewing and swallowing behavior, decreasing problem behavior at mealtime, and improving skills such as self-feeding. This article details the application of the basic principles of ABA, reinforcement, extinction, and punishment to treat feeding difficulties.

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8. Beck KB, Conner CM, Breitenfeldt KE, Northrup JB, White SW, Mazefsky CA. Assessment and Treatment of Emotion Regulation Impairment in Autism Spectrum Disorder Across the Life Span : Current State of the Science and Future Directions. Child Adolesc Psychiatr Clin N Am ;2020 (Jul) ;29(3):527-542.

Emotion regulation (ER) is the ability to modify arousal and emotional reactivity to achieve goals and maintain adaptive behaviors. ER impairment in autism spectrum disorder (ASD) is thought to underlie many problem behaviors, co-occurring psychiatric symptoms, and social impairment, and yet is largely unaddressed both clinically and in research. There is a critical need to develop ER treatment and assessment options for individuals with ASD across the life span, given the multitude of downstream effects on functioning. This article summarizes the current state of science in ER assessment and treatment and identifies the most promising measurement options and treatments.

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9. Pecora LA, Hooley M, Sperry L, Mesibov GB, Stokes MA. Sexuality and Gender Issues in Individuals with Autism Spectrum Disorder. Child Adolesc Psychiatr Clin N Am ;2020 (Jul) ;29(3):543-556.

This article reviews relevant literature on sexuality in individuals with autism spectrum disorder (ASD). Findings reveal a growing awareness of desire for sexual and intimate relationships in individuals with ASD. However, core impairments of ASD lead to difficulties establishing requisite knowledge and skills necessary to attain a healthy sexuality and facilitate relationships. Consequently, individuals with ASD present with increased risk of engaging in inappropriate sexual behaviors and sexual victimization than their typically developing peers. The literature asserts the need to implement effective sexual education programs to assist in development of healthy sexual identity and relationships that meet each individual’s needs.

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10. Keating CT, Cook JL. Facial Expression Production and Recognition in Autism Spectrum Disorders : A Shifting Landscape. Child Adolesc Psychiatr Clin N Am ;2020 (Jul) ;29(3):557-571.

Social "difficulties" associated with ASD may be a product of neurotypical-autistic differences in emotion expression and recognition. Research suggests that neurotypical and autistic individuals exhibit expressive differences, with autistic individuals displaying less frequent expressions that are rated lower in quality by non-autistic raters. Autistic individuals have difficulties recognizing neurotypical facial expressions ; neurotypical individuals have difficulties recognizing autistic expressions. However, findings are mixed. Task-related factors (e.g., intensity of stimuli) and participant characteristics (e.g., age, IQ, comorbid diagnoses) may contribute to the mixed findings. The authors conclude by highlighting important areas for future research and the clinical implications of the discussed findings.

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11. Wisner-Carlson RW, Pekrul SR, Flis T, Schloesser R. Acts of Medical Kindness for People with Autism. Child Adolesc Psychiatr Clin N Am ;2020 (Jul) ;29(3):xi-xiv.

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