Prevalence and early signs of autism spectrum disorder (ASD) among 18-36 month-old children of Tianjin in China.

OBJECTIVE: The aim of this study is to estimate the prevalence of autism spectrum disorder (ASD) among 18-36 month old children in the Tianjin Municipality of China, and to identify early signs of autistic children and the predictability of each individual symptom. METHODS: A total of 8 000 children were screened to do a questionnaire based on CHAT modified to include more early signs of autism at the age of 18-36 months. Then the at-risk children were reexamined 1.5 years later and ASD children were identified based on DSM-IV. Early signs of autism were analyzed retrospectively by using discriminant function analysis performed among ASD children, children not followed up and children followed up but failing to meet ASD criteria. RESULTS: Three hundred and sixty seven children were screened as being at-risk to ASD, and 22 of them were identified as having ASD in the subsequent diagnosis. The prevalence of ASD was 27.5 per 10 000 in Tianjin of China with a male to female ratio of 4:1. Items addressing social interactions and communications had higher predictability than other items to distinguish autistic children from non-autistic ones. Pretend play, functional play, showing and reading parents' facial expressions distinguished autistic children from those not followed up, nevertheless those followed up but failing to meet ASD criteria were not included. CONCLUSION: The prevalence of ASD found in our study was lower than that reported in some studies by western researchers. Autism has its specific symptoms, such as deficits in social awareness, social relatedness, and social referencing.

Psychological distress and its correlates in Chinese adolescents.

OBJECTIVES: The aim of the present study was to estimate the prevalence of severe psychological distress in Chinese adolescents, and to identify the demographic and psychosocial factors associated with psychological distress in this population. METHOD: A multi-stage stratified sampling procedure was used to select a sample of adolescents (n = 3109) in Heilongjiang Province (Northeast of China), who were aged 13-18 years old. Psychological distress was measured by the Kessler Psychological Distress Scale (K10). A K10 score between 22 and 30 was defined as moderate psychological distress; a score of >or= 31 was defined as severe psychological distress in this study. RESULTS: The rates of moderate and severe psychological distress were 27.9% and 12.2%, respectively in the participants. There were no statistical differences in severe psychological distress by gender. Multivariate analysis showed that family environmental variables, schooling variables, self-perception with life and appearance, perceived health and negative life events were significantly associated with psychological distress. CONCLUSION: Severe psychological distress is prevalent in the Chinese adolescent population. Family dysfunction, higher academic pressure, poor relationship with others and negative self-perception are important risk factors associated with psychological distress in adolescents. More studies using the K10 scale are needed so that national and international comparisons can be made.