Asperger Syndrome and High-Functioning Autism

by Christopher Gillberg (1998) British Journal of Psychiatry 171, 200-209.

“My own position is different and includes the possibility that in some individuals it might be appropriate to diagnose autism at one point in time and AS at another.” (p. 200)

“There may be a need for (slightly) different criteria and guidelines for clinical practice versus research. In clinical work, one of the most important points is to arrive at the diagnosis which, at the time and in the given demographic/cultural circumstances, will be of most help to the individual and his/her family. This diagnosis has to be rooted in empirically derived knowledge, but should not be used for splitting academic hairs.” (p. 201)

“However, a few clinicians (and researchers) appear to be aware that an individual with AS often meets full or almost full criteria for OCPD.” (p. 201)

“Some young adolescents with AS/HFA may develop catatonic features, raising the possibility that in some instances of catatonia in adult psychiatry, AS/HFA may be an antecedent or comorbid problem” (p. 202)

“Migration from geographically distant cultures has been suggested to be correlated with autism. No studies implicating such migration as a potential contributory factor in the causation of HFA or AS have been published.” (p. 204)

“About half of a total population of AS cases were not referred to doctors or psychologists at school age, even when problems were well recognised by teachers.”

“AS may remain undiagnosed well into adulthood. Even then, it is more likely that, if referral is made, the diagnosis will not be AS, but may come out as schizoid or schizotypal personality disorder, type II schizophrenia, atypical depression, paranoid disorder or obsessive-compulsive disorder. In one population-study that included cases with AS, (Hellgren et al 1994) two out of three individuals had severe alcohol problems already at age 16 years.” (p. 205)

“The clinical studies of Wing and Wolff have suggested a high incidence of suicide in AS.” (p. 205)

“HFA occurs in fewer than 1 in 2000 children. AS may be 5-10 times more common.” (p. 206)

“Asperger syndrome is sometimes mistaken for other psychiatric disorders, such as schizophrenia, paranoia and personality disorders” (p. 206).