Asperger's disorder in the emergency psychiatric setting

Asperger's syndrome (AS) is a pervasive developmental disorder that may be unrecognized, especially if signs of other psychiatric disorders coexist. T he objectives of this paper are: 1) to ascertain the prevalence of AS in th e emergency psychiatric setting; and 2) to describe features of AS which ma y help to differentiate these patients from patients with psychotic disorde rs. Among 2500 patients admitted to a psychiatric intensive care unit, 5 (0 .2%) received a diagnosis of AS, for the first time. Besides impairment of social interaction, common features were the following: male gender, left h andedness, obsessive-compulsive symptoms, cognitive hyper-abilities, violen t behavior, sense of humor, low WAIS total score, high WAIS verbal/performa nce score ratio, unusual, restricted interest and clumsiness. Comorbid schi zophrenia is difficult to rule out in these patients. Psychotic symptoms sh ould not be overvalued in making the diagnosis when specific features of AS are present. (C) 2001 Elsevier Science Inc. All rights reserved.