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      ESCAP practice guidance for autism: a summary of evidence-based recommendations for diagnosis and treatment

      research-article
      1 , , 2 , 3 , (ESCAP ASD Working Party)
      European Child & Adolescent Psychiatry
      Springer Berlin Heidelberg
      Autism, Diagnosis and treatment, ESCAP review

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          Abstract

          Across Europe, there is increased awareness of the frequency and importance of autism spectrum disorder (ASD), which is now recognised not only as a childhood disorder but as a heterogeneous, neurodevelopmental condition that persists throughout life. Services for individuals with autism and their families vary widely, but in most European countries, provision is limited. In 2018, European Society of Child and Adolescent Psychiatry (ESCAP) identified the need for a Practice Guidance document that would help to improve knowledge and practice, especially for individuals in underserviced areas. The present document, prepared by the ASD Working Party and endorsed by the ESCAP Board on October 3, 2019, summarises current information on autism and focuses on ways of detecting, diagnosing, and treating this condition.

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          The online version of this article (10.1007/s00787-020-01587-4) contains supplementary material, which is available to authorized users.

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          Most cited references140

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          Large-Scale Exome Sequencing Study Implicates Both Developmental and Functional Changes in the Neurobiology of Autism

          We present the largest exome sequencing study of autism spectrum disorder (ASD) to date (n = 35,584 total samples, 11,986 with ASD). Using an enhanced analytical framework to integrate de novo and case-control rare variation, we identify 102 risk genes at a false discovery rate of 0.1 or less. Of these genes, 49 show higher frequencies of disruptive de novo variants in individuals ascertained to have severe neurodevelopmental delay, whereas 53 show higher frequencies in individuals ascertained to have ASD; comparing ASD cases with mutations in these groups reveals phenotypic differences. Expressed early in brain development, most risk genes have roles in regulation of gene expression or neuronal communication (i.e., mutations effect neurodevelopmental and neurophysiological changes), and 13 fall within loci recurrently hit by copy number variants. In cells from the human cortex, expression of risk genes is enriched in excitatory and inhibitory neuronal lineages, consistent with multiple paths to an excitatory-inhibitory imbalance underlying ASD.
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            What Is the Male-to-Female Ratio in Autism Spectrum Disorder? A Systematic Review and Meta-Analysis

            To derive the first systematically calculated estimate of the relative proportion of boys and girls with autism spectrum disorder (ASD) through a meta-analysis of prevalence studies conducted since the introduction of the DSM-IV and the International Classification of Diseases, Tenth Revision.
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              The ICD-10 Classification of Mental and Behavioural Disorders : Clinical Descriptions and Diagnostic Guidelines

              Provides clinical descriptions diagnostic guidelines and codes for all mental and behavioural disorders commonly encountered in clinical psychiatry. The book was developed from chapter V of the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). The clinical descriptions and diagnostic guidelines were finalized after field testing by over 700 clinicians and researchers in 110 institutes in 40 countries making this book the product of the largest ever research effort designed to improve psychiatric diagnosis. Every effort has been made to define categories whose existence is scientifically justifiable as well as clinically useful. The classification divides disorders into ten groups according to major common themes or descriptive likeness a new feature which makes for increased convenience of use. For each disorder the book provides a full description of the main clinical features and all other important but less specific associated features. Diagnostic guidelines indicate the number balance and duration of symptoms usually required before a confident diagnosis can be made. Inclusion and exclusion criteria are also provided together with conditions to be considered in differential diagnosis. The guidelines are worded so that a degree of flexibility is retained for diagnostic decisions in clinical work particularly in the situation where provisional diagnosis may have to be made before the clinical picture is entirely clear or information is complete. ... As befitting a publication of considerable influence the amount of work that went into preparing ICD-10 has been formidable... - The International Journal of Social Psychiatry
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                Author and article information

                Contributors
                fuentes.j@telefonica.net
                Journal
                Eur Child Adolesc Psychiatry
                Eur Child Adolesc Psychiatry
                European Child & Adolescent Psychiatry
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                1018-8827
                1435-165X
                14 July 2020
                14 July 2020
                2021
                : 30
                : 6
                : 961-984
                Affiliations
                [1 ]GRID grid.429915.2, ISNI 0000 0004 1794 0058, Child and Adolescent Psychiatrists, , Policlínica Gipuzkoa Research Consultant, GAUTENA Autism Society, ; Paseo de Miramón 174, 20016 San Sebastián, Spain
                [2 ]GRID grid.22294.3f, Child and Adolescent Psychiatrists, , University Hospital MutuaTerrassa, AGAUR Clinical and Genetic Research Group IGAIN, ; Barcelona, Spain
                [3 ]GRID grid.13097.3c, ISNI 0000 0001 2322 6764, Emeritus Professor of Clinical Child Psychology, Institute of Psychiatry, Psychology and Neuroscience, , King’s College, ; London, UK
                Author information
                http://orcid.org/0000-0001-5488-5543
                http://orcid.org/0000-0003-0051-5752
                http://orcid.org/0000-0002-1804-6053
                Article
                1587
                10.1007/s00787-020-01587-4
                8140956
                32666205
                0617e50d-aa31-44c0-a86d-7ca106d2f94d
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 23 July 2019
                : 24 June 2020
                Categories
                Original Contribution
                Custom metadata
                © Springer-Verlag GmbH Germany, part of Springer Nature 2021

                Clinical Psychology & Psychiatry
                autism,diagnosis and treatment,escap review
                Clinical Psychology & Psychiatry
                autism, diagnosis and treatment, escap review

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