[Asperger's syndrome symptoms in children, adolescents and young adults] / Quand évoquer le syndrome d'Asperger chez l'enfant, l'adolescent et le jeune adulte ?

Asperger's syndrome symptoms in children, adolescents and young adults. Asperger syndrome (AS) is a neurodevelopemental disorder which is classified into autism- spectrums disorders (ASDs). AS is characterized by significant difficulties in social interaction and nonverbal communication, stereotyped and restricted patterns of behaviour, activities and interests. There is no clinically significant delay in cognitive development nor general delay in language. However, there are specific abnormalities such as literal interpretations, miscomprehension of nuance, unusually pedantic and formal speech. Clinical aspects are very heterogeneous and vary depending on age and psychiatric comorbidities. Among the associated disorders, Attention Deficit Hyperactivity Disorder, mood and anxiety disorders are commonly found. To identify these conditions and offer appropriate treatment, elevated vigilance is needed in clinical practice.

Quand évoquer le syndrome d'asperger chez l'enfant, l'adolescent et le jeune adulte ? Le syndrome d'Asperger est un trouble neuro-développemental faisant partie de la grande famille des troubles du spectre de l'autisme. Les personnes ayant un syndrome d'Asperger ont des difficultés dans le domaine des interactions sociales, de la communication verbale et non verbale et peuvent avoir une bizarrerie comportementale avec des stéréotypies et des intérêts restreints. Ils n'ont pas de retard du langage et le développement cognitif n'est pas marqué par un retard global mais par des atteintes spécifiques dans certains domaines comme les fonctions exécutives. Les aspects cliniques sont très hétérogènes, ils varient en fonction de l'âge et des comorbidités psychiatriques. Parmi les troubles associés on retrouve fréquemment le trouble de déficit de l'attention avec ou sans hyperactivité. Une prise en charge précoce, multidisciplinaire et intégrative permet une meilleure qualité de vie et une diminution des complications psychiatriques telles que les troubles anxieux, la dépression et les conduites suicidaires.

Tracking social motivation systems deficits: the affective neuroscience view of autism.

Abnormal functioning of primary brain systems that express and modulate basic emotional drives are increasingly considered to underlie mental disorders including autism spectrum disorders. We hypothesized that ASD are characterized by disruptions in the primary systems involved in the motivation for social bonding. Twenty adults with ASD were compared to 20 neurotypical participants on the basis of self-reports and clinical assessments, including the Social Anhedonia Scale (SAS) and the Affective Neuroscience Personality Scales (ANPS). ASD diagnosis was related to SAS, as well as to positive (PLAYFULNESS) and negative (FEAR) ANPS-traits. In the overall sample, levels of autistic traits (AQ) were related to SAS and PLAYFULNESS. We argue that PLAYFULNESS could be at the root of social bonding impairments in ASD.

Levels of autistic traits in anorexia nervosa: a comparative psychometric study.

BACKGROUND: A number of characteristics associated with Autism Spectrum Disorders (ASD) are over-represented among patients with Anorexia Nervosa (AN) as well as among relatives of these patients. Yet the co-occurrence of autistic traits in AN has not been fully explored and no previous study has directly compared self-reported evaluations of cognitive and socio-affective skills in AN and ASD. METHODS: We aimed to determine the degree of overlap between AN and ASD from scores on questionnaires classically used to measure ASD impairments. Fifteen AN participants, 15 ASD participants and two groups of matched controls completed a battery of self-reports measuring: autistic traits (Autism-Spectrum Quotient), empathy (Empathy Quotient-short and Interpersonal Reactivity Index), systemizing (Systemizing Quotient-short) and alexithymia (Bermond-Vorst Alexithymia Questionnaire-B). Univariate comparisons of mean totalled scores were performed on each measure (patients vs. controls, and AN vs. ASD), and a Principal Component Analysis was used to study subject proximities in a reduced-factor space constructed from AQ, BVAQ-B and IRI subscales. RESULTS: These analyses revealed similarities in a few cognitive domains (Attention Switching, Perspective Taking and Fantasy, lack of emotional introspection) and in some nonspecific affective dimensions (depression and feelings of distress), but also marked dissimilarities in social skills (the ability to communicate emotions to others, empathizing). CONCLUSION: The AN and ASD participants reported similar needs for sameness, and similar difficulties understanding their emotions and taking the perspective of another, but contrasting abilities to feel concerned in interpersonal situations. Our mixed findings encourage further exploration of transdiagnostic similarities and associations between these disorders.

Cortical folding in patients with bipolar disorder or unipolar depression.

BACKGROUND: Analysis of cortical folding may provide insight into neurodevelopment deviations, which, in turn, can predispose to depression that responds particularly poorly to medications. We hypothesized that patients with treatment-resistant depression would exhibit measurable alterations in cortical folding. METHODS: We computed hemispheric global sulcal indices (g-SIs) in T(1)-weighted magnetic resonance images obtained from 76 patients and 70 healthy controls. We separately searched for anatomic deviations in patients with bipolar disorder (16 patients with treatment-resistant depression, 25 with euthymia) and unipolar depression (35 patients with treatment-resistant depression). RESULTS: Compared with healthy controls, both groups of patients with treatment-resistant depression exhibited reduced g-SIs: in the right hemisphere among patients with bipolar disorder and in both hemispheres among those with unipolar depression. Patients with euthymic bipolar disorder did not differ significantly from depressed patients or healthy controls. Among patients with bipolar disorder who were taking lithium, we found positive correlations between current lithium dose and g-SIs in both hemispheres. LIMITATIONS: We cannot estimate the extent to which the observed g-SI reductions are linked to treatment resistance and to what extent they are state-dependent. Furthermore, we cannot disentangle the impact of medications from that of the affective disorder. Finally, there is interindividual variation and overlap of g-SIs among patients and healthy controls that need to be considered when interpreting our results. CONCLUSION: Reduced global cortical folding surface appears to be characteristic of patients with treatment-resistant depression, either unipolar or bipolar. In patients with bipolar disorder, treatment with lithium may modify cortical folding surface.