[Case study of 10 subjects diagnosed with autism spectrum disorders in adulthood and currently under long-term follow-up].

This study involved 10 adults with autism spectrum disorders (ASD) who were referred to a specialized developmental disability clinic and were being treated for periods extending to years. Checks included past diagnoses, the chief complaint at the first examination, psychiatric symptoms, medication, employment, and whether a diagnosis of ASD would have been possible during their formative years. Their age at referral was 21-30 and, at the time of this study, they were aged 25-40. There were eight males and two females, and their treatment periods were between four and 16 years. Using DSM-IV-TR criteria, six were diagnosed with autistic disorders and four with PDDNOS. Wing and Gould criteria showed nine with Asperger syndrome and one with autism. Their IQ ranged from 88 to 121, with the mean score being 103 (SD = 10.0). Eight of the 10 had previously been examined in psychiatric clinics, which identified two as having depression, two with schizophrenia, one with Obsessive-Compulsive Disorder, and one with autism/Asperger syndrome, and there was no diagnosis for the other two. For these eight cases, the PDD-Autism Society Japan Rating Scale (PARS) was used. The PARS early childhood peak score ranged from 9 to 41, so all reached the cutoff point of 9. At the time of this study, the following psychiatric symptoms were noted: three cases of depression, two of anxiety, one with auditory hallucinations, and one who displayed odd behavior and facial expressions that became apparent during the follow-up. In two cases there seemed to be no apparent psychiatric co-morbidity. The current PARS scores of 8 cases were between 12 and 38, and four cases exceeded the cutoff point of 20. One was taking anti-psychotic drugs for auditory hallucinations, four were using SSRI for anxiety and depression, and one was occasionally prescribed medication for anxiety. Four were not on medication. When diagnosing ASD in adulthood, interviewing using such instruments as PARS seemed useful. We should keep in mind that families tend not to recognize co-morbid psychotic symptoms.