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      Practitioner’s review: medication for children and adolescents with autism spectrum disorder (ASD) and comorbid conditions Translated title: Practitioner Review: Medikamentöse Behandlung von Kindern und Jugendlichen mit Autismus-Spektrum-Störung (ASS) und Komorbiditäten

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          Abstract

          Alleviating the multiple problems of children with autism spectrum disorder (ASD) and its comorbid conditions presents major challenges for the affected children, parents, and therapists. Because of a complex psychopathology, structured therapy and parent training are not always sufficient, especially for those patients with intellectual disability (ID) and multiple comorbidities. Moreover, structured therapy is not available for a large number of patients, and pharmacological support is often needed, especially in those children with additional attention deficit/hyperactivity and oppositional defiant, conduct, and sleep disorders.

          Translated abstract

          Die Linderung der vielfältigen Probleme von Kindern mit Autismus-Spektrum-Störung (ASS) und ihrer Begleiterkrankungen stellt für die betroffenen Kinder, Eltern und Therapeuten eine große Herausforderung dar. Aufgrund einer komplexen Psychopathologie reichen strukturierte Therapie und Elterntraining nicht immer aus, insbesondere bei Menschen mit geistiger Behinderung (GB) und multiplen Komorbiditäten. Darüber hinaus steht für viele Patienten keine strukturierte Therapie zur Verfügung, und häufig ist pharmakologische Unterstützung erforderlich, insbesondere bei Kindern, bei denen eine Aufmerksamkeitsdefizit‑/Hyperaktivitätsstörung und oppositionelle Trotz‑, Verhaltens- oder Schlafstörungen hinzukommen.

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          Psychiatric disorders in children with autism spectrum disorders: prevalence, comorbidity, and associated factors in a population-derived sample.

          Autism spectrum disorders are now recognized to occur in up to 1% of the population and to be a major public health concern because of their early onset, lifelong persistence, and high levels of associated impairment. Little is known about the associated psychiatric disorders that may contribute to impairment. We identify the rates and type of psychiatric comorbidity associated with ASDs and explore the associations with variables identified as risk factors for child psychiatric disorders. A subgroup of 112 ten- to 14-year old children from a population-derived cohort was assessed for other child psychiatric disorders (3 months' prevalence) through parent interview using the Child and Adolescent Psychiatric Assessment. DSM-IV diagnoses for childhood anxiety disorders, depressive disorders, oppositional defiant and conduct disorders, attention-deficit/hyperactivity disorder, tic disorders, trichotillomania, enuresis, and encopresis were identified. Seventy percent of participants had at least one comorbid disorder and 41% had two or more. The most common diagnoses were social anxiety disorder (29.2%, 95% confidence interval [CI)] 13.2-45.1), attention-deficit/hyperactivity disorder (28.2%, 95% CI 13.3-43.0), and oppositional defiant disorder (28.1%, 95% CI 13.9-42.2). Of those with attention-deficit/hyperactivity disorder, 84% received a second comorbid diagnosis. There were few associations between putative risk factors and psychiatric disorder. Psychiatric disorders are common and frequently multiple in children with autism spectrum disorders. They may provide targets for intervention and should be routinely evaluated in the clinical assessment of this group.
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            Global Prevalence of Autism and Other Pervasive Developmental Disorders

            We provide a systematic review of epidemiological surveys of autistic disorder and pervasive developmental disorders (PDDs) worldwide. A secondary aim was to consider the possible impact of geographic, cultural/ethnic, and socioeconomic factors on prevalence estimates and on clinical presentation of PDD. Based on the evidence reviewed, the median of prevalence estimates of autism spectrum disorders was 62/10 000. While existing estimates are variable, the evidence reviewed does not support differences in PDD prevalence by geographic region nor of a strong impact of ethnic/cultural or socioeconomic factors. However, power to detect such effects is seriously limited in existing data sets, particularly in low-income countries. While it is clear that prevalence estimates have increased over time and these vary in different neighboring and distant regions, these findings most likely represent broadening of the diagnostic concets, diagnostic switching from other developmental disabilities to PDD, service availability, and awareness of autistic spectrum disorders in both the lay and professional public. The lack of evidence from the majority of the world's population suggests a critical need for further research and capacity building in low- and middle-income countries. Autism Res 2012, 5: 160–179. © 2012 International Society for Autism Research, Wiley Periodicals, Inc.
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              A proposed diagnostic scheme for people with epileptic seizures and with epilepsy: report of the ILAE Task Force on Classification and Terminology.

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                Author and article information

                Contributors
                christian.popow@meduniwien.ac.at
                susanne.ohmann@meduniwien.ac.at
                paul.plener@meduniwien.ac.at
                Journal
                Neuropsychiatr
                Neuropsychiatr
                Neuropsychiatrie
                Springer Vienna (Vienna )
                0948-6259
                2194-1327
                23 June 2021
                23 June 2021
                2021
                : 35
                : 3
                : 113-134
                Affiliations
                GRID grid.22937.3d, ISNI 0000 0000 9259 8492, Dept. Child and Adolescent Psychiatry, , Medical University of Vienna, ; Waehringer Guertel 18–20, 1090 Vienna, Austria
                Author information
                http://orcid.org/0000-0002-0496-1453
                Article
                395
                10.1007/s40211-021-00395-9
                8429404
                34160787
                2d5b969e-abaf-4ca6-a1c1-c8e3a0aa7a70
                © The Author(s) 2021

                Open Access This 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
                : 12 January 2021
                : 15 May 2021
                Funding
                Funded by: Medical University of Vienna
                Categories
                Review
                Custom metadata
                © Springer-Verlag GmbH Austria, ein Teil von Springer Nature 2021

                autism spectrum disorder,adhd,children and adolescents,pharmacotherapy,autismus-spektrum-störung,adhs,kinder und jugendliche,pharmakotherapie

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