Gå direkt till huvudinnehållet

Autism (autismspektrumtillstånd)

Senast uppdaterad: Senast reviderad:
Sakkunnig:

Definition:
Autism karakteriseras av allvarliga och varaktiga bristande förmågor inom social ömsesidighet, icke-verbal kommunikation och att förstå, utveckla och bevara relationer. Ofta ingår begränsat, stereotypt och repetitivt beteende, fobier, sömn- och ätstörningar, raserianfall och självdestruktivt beteende.
Förekomst:
Prevalens av autismspektrumtillstånd är minst 1 %.
Symtom:
Symtom visar sig på olika sätt beroende på ålder, grad av autism och intellektuell funktionsnedsättning
Kliniska fynd:
Hos vissa ses tecken på autismspektrumtillstånd vid BVC-kontrollerna. Ofta ses avvikelser i kommunikation och socialt samspel vid samtal med patienten.
Diagnostik:
För att ställa diagnosen bedöms aktuella symtom, utveckling, kognitiv funktion, psykiatrisk differentialdiagnostik/samsjuklighet och somatiska differentialdiagnoser/bakomliggande tillstånd.
Behandling:
Många olika insatser och behandlingar används. 
  1. American Psychiatric Association. MINI-D 5. Diagnostiska kriterier enligt DSM-5. Stockholm: Pilgrim Press AB, 2015.
  2. Bejerot S, Nordin V.Autismspektrumsyndrom ersätter Aspergers syndrom och autism. Lakartidningen.se 2014-09-23. lakartidningen.se  
  3. Idring S, Rai D, Dal H, Dalman C, Sturm H, Zander E, Lee BK, Serlachius E, Magnusson C. Autism spectrum disorders in the Stockholm Youth Cohort: design, prevalence and validity. PLoS One. 2012;7(7):e41280. PMID: 22911770 PubMed  
  4. Idring S, Lundberg M, Sturm H, Dalman C, Gumpert C, Rai D, Lee BK, Magnusson C. Changes in prevalence of autism spectrum disorders in 2001-2011: findings from the Stockholm youth cohort. J Autism Dev Disord. 2015 Jun;45(6):1766-73. doi: 10.1007/s10803-014-2336-y. PMID: 25475364 PubMed  
  5. Volkmar FR, Pauls D. Autism. Lancet 2003; 362: 1133-41. PubMed  
  6. Nicolson R, Szatmari P. Genetic and neurodevelopmental influences in autistic disorder. Can J Psychiatry 2003; 48: 526-37. PubMed  
  7. Chakrabarti S, Fombonne E. Pervasive developmental disorders in preschool children. JAMA, 2001; 285: 3141-2. PMID: 11427137 PubMed  
  8. Klauck SM. Genetics of autism spectrum disorder. Eur J Hum Genet. 2006 Jun;14(6):714-20. PMID: 16721407. PubMed  
  9. Ozonoff S, Young GS, Carter A, Messinger D, Yirmiya N, Zwaigenbaum L, Bryson S, Carver LJ, Constantino JN, Dobkins K, Hutman T, Iverson JM, Landa R, Rogers SJ, Sigman M, Stone WL. Recurrence risk for autism spectrum disorders: a Baby Siblings Research Consortium study. Pediatrics. 2011 Sep;128(3):e488-95. PMID: 21844053 PubMed  
  10. Augustyn M. Autism spectrum disorder: Terminology, epidemiology, and pathogenesis. UpToDate, last reviewed Dec 2019. UpToDate  
  11. Gardener H, Spiegelman D, Buka SL. Perinatal and Neonatal Risk Factors for Autism: A Comprehensive Meta-analysis. Pediatrics 2011; 128: 344-55. pmid:21746727 PubMed  
  12. Newschaffer CJ, Croen LA, Fallin MDet al. Infant siblings and the investigation of autism risk factors. J Neurodev Disord. 2012 Apr 18;4(1):7. PMID: 22958474 PubMed  
  13. Jain A, Marshall J, Buikema A, et al. Autism Occurrence by MMR Vaccine Status Among US Children With Older Siblings With and Without Autism. JAMA 2015; 313: 1534-40. doi:10.1001/jama.2015.3077. PMID: 25898051 PubMed  
  14. Gillberg C, Billstedt E. Autism and Asperger syndrome: coexistence with other clinical disorders. Acta Psychiatr Scand. 2000 Nov;102(5):321-30. doi: 10.1034/j.1600-0447.2000.102005321.x. PMID: 11098802.
  15. Mazzone L, Ruta L, Reale L. Psychiatric comorbidities in asperger syndrome and high functioning autism: diagnostic challenges. Ann Gen Psychiatry. 2012 Jun 25;11(1):16.PMID: 22731684 PubMed  
  16. Dhossche DM, Shah A, Wing L. Blueprints for the assessment, treatment, and future study of catatonia in autism spectrum disorders. Int Rev Neurobiol. 2006;72:267-84. PMID: 16697303. PubMed  
  17. Barn som tänker annorlunda - Barn med autism, Aspergers syndrom och andra autismspektrumtillstånd. Socialstyrelsen. 2010. www.socialstyrelsen.se  
  18. Lai MC, Szatmari P. Sex and gender impacts on the behavioural presentation and recognition of autism. Curr Opin Psychiatry. 2020 Mar;33(2):117-123. PMID: 31815760 PubMed  
  19. Riktlinje Autism. Svenska föreningen för barn- och ungdomspsykiatri (SFBUP). Hämtad 2021-04-28 www.sfbup.se  
  20. ICD-11 for Mortality and Morbidity Statistics (Version: 09/2020), 6A02 Autism spectrum disorder. WHO. Hämtad 2021-01-11 icd.who.int  
  21. Westwood H, Tchanturia K. Autism Spectrum Disorder in Anorexia Nervosa: An Updated Literature Review. Curr Psychiatry Rep. 2017 Jul;19(7):41. PMID: 28540593 PubMed  
  22. Psykiatrisöd. Autismspektrum. Region Stockholm. Hämtad 2021-01-11 psykiatristod.se  
  23. Unenge Hallerbäck M, Lugnegård T, Gillberg C. Is autism spectrum disorder common in schizophrenia? Psychiatry Res. 2012 Jun 30;198(1):12-7. doi: 10.1016/j.psychres.2012.01.016. Epub 2012 Mar 14. PMID: 22421071. PubMed  
  24. Sullivan S, Rai D, Golding J, Zammit S, Steer C. The association between autism spectrum disorder and psychotic experiences in the Avon longitudinal study of parents and children (ALSPAC) birth cohort. J Am Acad Child Adolesc Psychiatry. 2013 Aug;52(8):806-814.e2. doi: 10.1016/j.jaac.2013.05.010. Epub 2013 Jun 24. PMID: 23880491 PubMed  
  25. Autism. Viss.nu. Region Stockholm. Hämtad 21-01-11 viss.nu  
  26. Randall M, Egberts KJ, Samtani A et al. Diagnostic tests for autism spectrum disorder (ASD) in preschool children. Cochrane Database Syst Rev. 2018 Jul 24;7(7):CD009044. PMID: 30075057 PubMed  
  27. Baron-Cohen S, Wheelwright S, Skinner R, Martin J, Clubley E. The autism-spectrum quotient (AQ): evidence from Asperger syndrome/high-functioning autism, males and females, scientists and mathematicians. J Autism Dev Disord. 2001 Feb;31(1):5-17. doi: 10.1023/a:1005653411471. Erratum in: J Autism Dev Disord 2001 Dec;31(6):603. PMID: 11439754 PubMed  
  28. Ritvo RA, Ritvo ER, Guthrie D, Ritvo MJ, Hufnagel DH, McMahon W, Tonge B, Mataix-Cols D, Jassi A, Attwood T, Eloff J. The Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R): a scale to assist the diagnosis of Autism Spectrum Disorder in adults: an international validation study. J Autism Dev Disord. 2011 Aug;41(8):1076-89. doi: 10.1007/s10803-010-1133-5. PMID: 21086033 PubMed  
  29. Lugnegård T, Unenge Hallerbäck M, Hjärthag F, Gillberg C. Social cognition impairments in Asperger syndrome and schizophrenia. Schizophr Res. 2013 Feb;143(2-3):277-84. doi: 10.1016/j.schres.2012.12.001. Epub 2012 Dec 23. PMID: 23266067 PubMed  
  30. Eriksson JM, Andersen LM, Bejerot S. RAADS-14 Screen: validity of a screening tool for autism spectrum disorder in an adult psychiatric population. Mol Autism. 2013 Dec 9;4(1):49. doi: 10.1186/2040-2392-4-49. PMID: 24321513 PubMed  
  31. Healy S, Nacario A, Braithwaite RE, Hopper C. The effect of physical activity interventions on youth with autism spectrum disorder: A meta-analysis. Autism Res. 2018 Jun;11(6):818-833. PMID: 29693781 PubMed  
  32. Millward C, Ferriter M, Calver S, Connell-Jones G. Gluten- and casein-free diets for autistic spectrum disorder. Cochrane Database Syst Rev. 2008 Apr 16;(2):CD003498. doi: 10.1002/14651858.CD003498.pub3. Update in: Cochrane Database Syst Rev. 2019 Apr 02;4:CD003498. PMID: 18425890 PubMed  
  33. Piwowarczyk A, Horvath A, Łukasik J, Pisula E, Szajewska H. Gluten- and casein-free diet and autism spectrum disorders in children: a systematic review. Eur J Nutr. 2018 Mar;57(2):433-440. PMID: 28612113 PubMed  
  34. Sömnstörningar hos barn – kunskapsdokument. Läkemedelsverket (2015). www.lakemedelsverket.se  
  35. Rossignol DA, Frye RE. Melatonin in autism spectrum disorders: a systematic review and meta-analysis. Dev Med Child Neurol. 2011 Sep;53(9):783-792. PMID: 21518346 PubMed  
  36. Reichow B, Hume K, Barton EE, Boyd BA. Early intensive behavioral intervention (EIBI) for young children with autism spectrum disorders (ASD). Cochrane Database Syst Rev. 2018 May 9;5(5):CD009260. doi: 10.1002/14651858.CD009260.pub3. PMID: 29742275 PubMed  
  37. Rogers SJ, Estes A, Lord C, Vismara L, Winter J, Fitzpatrick A, Guo M, Dawson G. Effects of a brief Early Start Denver model (ESDM)-based parent intervention on toddlers at risk for autism spectrum disorders: a randomized controlled trial. J Am Acad Child Adolesc Psychiatry. 2012 Oct;51(10):1052-65. PMID: 23021480 PubMed  
  38. Hesselmark E, Plenty S, Bejerot S. Group cognitive behavioural therapy and group recreational activity for adults with autism spectrum disorders: a preliminary randomized controlled trial. Autism. 2014 Aug;18(6):672-83. PMID: 24089423 PubMed  
  39. Whitehouse AJO, Varcin KJ, Pillar S et al. Effect of Preemptive Intervention on Developmental Outcomes Among Infants Showing Early Signs of Autism: A Randomized Clinical Trial of Outcomes to Diagnosis. JAMA Pediatr. 2021 Nov 1;175(11):e213298. doi: 10.1001/jamapediatrics.2021.3298. Epub 2021 Nov 1. PMID: 34542577 PubMed  
  40. Lag (1993:387) om stöd och service till vissa funktionshindrade. Hämtad 2021-01-13 www.riksdagen.se  
  41. Sanchack KE, Thomas CA. Autism Spectrum Disorder: Primary Care Principles. Am Fam Physician. 2016 Dec 15;94(12):972-979. PMID: 28075089. PubMed  
  42. Gotham K, Pickles A, Lord C. Trajectories of autism severity in children using standardized ADOS scores. Pediatrics. 2012 Nov;130(5):e1278-84. PMID: 23090336 PubMed  
  43. Farley MA, McMahon WM, Fombonne E, et al. Twenty-year outcome for individuals with autism and average or near-average cognitive abilities. Autism Res 2009; 2: 109-18. PubMed  
  44. Billstedt E, Gillberg IC, Gillberg C. Aspects of quality of life in adults diagnosed with autism in childhood: a population-based study. Autism. 2011 Jan;15(1):7-20. doi: 10.1177/1362361309346066. Epub 2010 Oct 5. PMID: 20923888. PubMed  
  • Maria Unenge Hallerbäck, med dr, klinisk lektor i psykiatri, Örebro universitet och överläkare, barn- och ungdomspsykiatrin, Region Värmland
  • Anna Nager, docent och specialist i allmänmedicin, Karolinska institutet