Update on Autism - Issues in Treatment and Comorbidity ~ Psychiatric Times

[mzmolly]

Autism is demanding increased attention by professional and lay audiences; prevalence seems to be increasing. There are differing opinions about whether the increase is due to greater recognition and reporting, diagnostic expansion and substitution, or increasing acceptability. On the other hand, the increase may be a consequence of environmental toxins or infectious and immune vulnerability and epigenetics or perhaps a combination of social and environmental factors.

Clearly, autism has a large genetic component and multiple genes are involved in various combinations. Nevertheless, the prevalence of autism in the United States and in other countries has increased exponentially; this trend would not happen with a purely genetic disorder. Most autism researchers accept a theory of etiology that starts with a genetic neurodevelopmental vulnerability combined with an environmental stressor through such epigenetic processes as immune function.1

Increasingly, researchers and clinicians refer to autism to describe a wide variety of phenotypes that start with genes and gene expression and range through a variety of metabolic functions to symptoms that cluster diagnostically but have a great deal of individuality. Symptoms can range from mild to severe and may be associated with mental retardation; GI and neurological involvement; and behavioral, emotional, cognitive, and whole body pathology.2

Here we discuss diagnostic assessment and classification, co-occurring or comorbid psychiatric disorders and their differential diagnosis, the medical workup, and possible medical comorbidities. We also review a model for psychosocial treatment as well as psychopharmacological and alternative treatments. We conclude with a brief look at the future of research and treatment.

More at http://www.psychiatrictimes.com/display/article/10168/1694995">Psychiatric Times

[lumberjack_jeff]

1. Exactly.

There's no such thing as a genetic epidemic.

If changing diagnostic criteria, awareness and substitution can't explain 100% of the increase in prevalence, then an environmental factor is involved.

+1 for posting a dispassionate article.

[mzmolly]

2. Thank you for the rec. Dispassionate articles on this subject

are hard to come by these days. ;)

:hi:

[Odin2005]

3. That is because THERE IS NO FUCKING EPIDEMIC.

[mzmolly]

6. Do you think if you use foul language, it helps make your case?

"Study: Childhood Rise in Autism Cases Real"
http://www.webmd.com/brain/autism/news/20050307/study-childhood-rise-in-autism-cases-real

[Odin2005]

7. Yep, gotta keep the hysteria going with bad science!

need that Autism Speaks funding!

[mzmolly]

9. It seems that anything that doesn't ultimately come from Paul Offit's list of talking points, is

deemed unreliable, and brings a caustic response? He's a http://www.pauloffit.com/">vaccine profiteer who makes money from a rotavirus vaccine which was http://vaccinenewsdaily.com/news/212970-pig-virus-dna-found-in-mercks-rotateq-vaccine">pulled from the market for a time, due to contamination with a pig virus. Offit has a financial agenda and a bone to pick with anyone who supports vaccine safety. He generates questionable facts to promote his product, such as, ...http://pediatrics.aappublications.org/cgi/content/full/112/6/1394">formaldehyde doesn't appear to be a cause of cancer in humans. On the other hand, Psych Times is an impartial, scientific source.

[lumberjack_jeff]

8. Everyone's welcome to their own opinion.

They're not entitled to their own facts.

[Odin2005]

10. It's just one study, there are plenty of them countering the assertion.

Including one I posted a while back on the % of older people with Autism, which shows the exact same ratio as children, which means there has been no epidemic.

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=387x1057

[mzmolly]

14. There are not plenty of studies that counter this. In fact your article

indicates the need for studies that duplicate the results you wish to tout.

[Odin2005]

4. What twaddle, there is no damn epidemic.

But a lot of these studies are ultimately funded by money from groups like Autism Speaks that have a vested interest in hysteria.

[mzmolly]

5. "Study Shows Increase Is Real, Not Just Due to Changes in Diagnosis Criteria"

http://www.webmd.com/brain/autism/news/20090108/autism-cases-rise

Autism expert Michael L. Cuccaro, PhD, associate professor of human genetics at the University of Miami, praises Hertz-Picciotto's systematic study of the rise in autism cases. He agrees with her that it's time to consider environmental factors as part of the cause of autism.

[Odin2005]

11. A study countering this nonsense:

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=387x1057

[HuckleB]

12. +1

[mzmolly]

13. What specifically (regarding the OP) are you calling nonsense?

And, how does your article refute it?

"One limitation of the study is its relatively small size, says Brugha. Being the first of its kind, it also needs to be confirmed by other studies."

You posted an article from Time. I'll post one from the CBS ~

http://www.cbsnews.com/stories/2009/12/18/health/main5995630.shtml

"Although some of the increases are due to better detection, a true increase in risk cannot be ruled out," the researchers noted.

In analyzing the numbers, Ashton reports, researchers are wrestling with an important issue: Are there really more autistic children? Or does the growing awareness of the symptoms lead to more diagnoses?

"Based on everything we have right now, I would say it's more likely than not that there is an increase in the number of cases. It's not absolute," Dr. Goldstein said.

[mzmolly]

15. "New Study: Autism Linked to Environment" ~ Scientific American

California's sevenfold increase in autism cannot be explained by changes in doctors' diagnoses and most likely is due to environmental exposures, University of California scientists reported Thursday.

The scientists who authored the new study advocate a nationwide shift in autism research to focus on potential factors in the environment that babies and fetuses are exposed to, including pesticides, viruses and chemicals in household products.

"It's time to start looking for the environmental culprits responsible for the remarkable increase in the rate of autism in California," said Irva Hertz-Picciotto, an epidemiology professor at University of California, Davis who led the study.

Throughout the nation, the numbers of autistic children have increased dramatically over the past 15 years. Autistic children have problems communicating and interacting socially; the symptoms usually are evident by the time the child is a toddler.

http://www.scientificamerican.com/article.cfm?id=autism-rise-driven-by-environment