Autism-related diseases: clinical analysis of 295 children with major development disorders

OBJECTIVE: Known since the first descriptions in 1943, diseases related to autism and associated disorders have incited a growing body of work. Both t heoretical interrogations (what is the pathogenic role of autism?) and prac tical measures (management, screening) are implied. Nevertheless the freque ncy of autism-related disease has varied from 10 to 37% depending on the se ries reported. We studied the frequency of these factors in a population of children with major development disorders cared for at the Tours universit y hospital over a 39-month period. PATIENTS AND METHODS: We reviewed retrospectively the medial features of 29 5 children examined in our psychiatrics and neurophysiology unit for childr en at the Tours center for major development disorders (based on the DSM IV diagnostic criteria) between September 1995 and December 1998. We divided these factors into 4 categories: hereditary diseases, serious medical condi tions, minimal physical disorders and ante-or perinatal antecedents. RESULTS: Among these 295 children, 26.5% had a proven or probable hereditar y disease, 19% had a serious medical condition and 21.7% had minimal physic al disorders. Among the children with a serious medical condition, 34.4% al so had ante- or perinatal antecedents. Among the 33% without any medical fa ctor, 77% also had ante- or perinatal antecedents. CONCLUSION: Our data point out the quantitative importance of medical facto rs associated with major development disorders. They imply a close pluridis ciplinary collaboration between child psychiatrists, pediatricians and gene ticians in order to identify these disorders and develop an integrated mana gement scheme. On a more theoretical level, it appears possible to identify subgroups of children among such a population based on associated diseases and neuropsychological patterns. This dimension would be useful for resear ch into the pathogenic mechanisms involved.