Аутистические расстройства в подростковом возрасте

The urgency of the problem is determined by thelack of data on the prevalence, evolution of forms of autism in adolescence.The aim was to study the clinical and psychopathological features of autism spectrum disorders in adolescence to address rehabilitation and social events.The material of the study included 48 patients with autism spectrum disorders, who were divided into three groups according to ICD-10 and the typology of autism spectrum disorders: 1st - Kanner’s syndrome ( n = 15), 2nd - psychotic forms of autism ( n = 18), 3rd - Asperger’s syndrome ( n = 15).Methods. It was investigated the performance, allowed to estimate the severity of autism on a rating scale of children’s autism the CARS, the level of cognitive functioning by the test D. Wechsler, research thinking and personality characteristics.Results. It has been found that in determining the qualification of the forecast is a form of autism. The most favorable indicators were in the syndrome of Asperger and Kanner’s syndrome with adverse and psychotic forms. Prognostic criteria can be determined - the degree autization (CARS), the level of intelligence (IQ), thinking performance, personal characteristics and the presence of decompensation or comorbid disorders in puberty. Evolution of autistic syndromes should be considered from the age dynamics of the positions and preferably within the autistic continuum that should not be reflected on the change in diagnosis.Conclusion. Studying of clinical psychopathological, psychological and social characteristics of adolescents with autistic frustration showed that autism form is defining in qualification of the forecast.

подростковый возраст, расстройства аутистического спектра, динамика аутизма, прогноз, adolescence, autism spectrum disorder, autism dynamics, prognosis

1. Тиганов А.С., Башина В.М. Современные подходы к пониманию аутизма в детстве. Журн. неврол. и психиатр. 2005;105:4-13

2. Kanner L. Autistic disturbances of affective contact. Nervous Child. 1943;2:217-250. Reprinted in (1968). Acta Paedopsychiatr. 35(4):100-36. PMID 4880460 [PubMed - индексируются для MEDLINE

3. Lоtter V. Epidemiology of autistic conditions in young children. Prevalence, Social Psychiatry. 1966;1:124-135. doi.org/10.1007/bf00584048

4. Wing L., Gould J. Severe impairments of social interaction and associated abnormalities in children epidemiology and classification. J. Autism and Develop. Disord. 1979;9:11-29. doi.org/10.1007/bf01531288

5. Ремшмидт Х. Аутизм. Клинические проявления, причины и лечение: пер. с нем. М.: Медицина, 2003

6. Психиатрия детского и подросткового возраста / Под ред. К. Гиллберга и Л. Хеллгрена; под общей ред. академика РАМН П.И. Сидорова; пер. со швед. Ю.А. Макковеевой. М.: ГЭОТАР-МЕД, 2004

7. Алёхина С.В. Проект по созданию комплексной помощи детям с РАС в России. Аутизм и нарушения развития. 2015;47(2):3-7. URL: http://www.inclusive-edu.ru/ content/File/alehina/autism_2015_2_alehina.pdf. Ссылка активна на 27.02.2016

8. Wing L., Potter D. The epidemiology of autistic spectrum disorders: is the prevalence rising? Ment. Retard. Develop. Disabil. Res. Rev. 2002;8(3):151-161. doi.org/10.1002/mrdd.10029

9. Szpir M. Tracing the origins of autism: a spectrum of new studies. Environ. Health Perspect. 2006;114(7):A412-A418. doi.org/10.1289/ehp.114-a412

10. Fombonne E. Epidemiology of pervasive developmental disorders. Pediatr. Res. 2009;65:591-598. doi:10.1203/PDR.0b013e31819e7203

11. Rutter M. Incidence of autism spectrum disorders: changes over time and their meaning. Acta Paediatrica. 2005;94(1):2-15. doi.org/10.1111/j.1651-2227.2005.tb01779.x

12. Eaves L.C., Ho H.H. Young adult outcome of autism spectrum disorders. J. Autism Dev. Disord. 2008;38(4):73-47. doi:10.1007/s10803-007-0441-x. PMID 17764027

13. Психотерапия детей и подростков: Пер. с нем. / Под ред. Х. Ремшмидта. М.: Мир, 2000:476-502

14. Бородина Л.Г. Смена диагноза РАС после 18 лет: мнение психиатра. Аутизм и нарушения развития. 2015;48(3):41- 43. doi:10.17759/autdd.2015130306

15. Расстройства аутистического спектра у детей: Научно-практическое руководство / Под ред. Н.В. Симашковой. М.: Авторская академия, 2013

16. Schopler E., Reichler R., Renner B.R. The Childhood Autism Rating Scale (CARS). Western Psychological Services. Los Angeles, 1988

17. Зверева Н.В., Горячева Т.Г. Клиническая психология детей и подростков: Учебник для студ. учреждений высш. проф. образования. М.: Издательский центр «Академия», 2013

18. Зверева Н.В., Коваль-Зайцев А.А., Хромов А.И. Патопсихологические методики оценки когнитивного развития детей и подростков при эндогенной психической патологии (зрительное восприятие и мышление). М.: ООО «Издательство МБА», 2014

19. Tuchman R.F., Rapin I. Regression in pervasive developmental disorders: seizures and epileptiform electroencephalogram correlates. Pediatrics. 1997;99(4):560-566. doi.org/10.1542/peds.99.4.560

20. Tuchman R. Autism. Neurologic Clinics. 2003;21(4):915-932. doi.org/10.1016/s0733-8619(03)00011-2

21. Kagan-Kushnir T., Roberts S.W., Snead O.C. 3rd. Scree- ning electroencephalograms in autism spectrum disor- ders: evidence-based guideline. J. Child. Neurol. 2005; 20(3):197-206. PMID: 15832609 [PubMed - indexed for MEDLINE]

22. Remshmidt H. Autism. Clinical manifestations, causes and treatment: trans. from german. Moscow: Medicine, 2003

23. Psychiatry childhood and adolescence / Under ed. Ch. Gillberg and L. Hellgren, rus. ed. under the general editorship of academician P.I. Sidorova; trans. from swedish Y.A. Makkoveevoy. Moscow: GEOTAR-MED, 2004

24. Alekhina S.V. The project establish comprehensive care for children with ASD in Russia. Autism and Developmental Disorders. 2015;47(2):3-7. (In Russ)

25. Available at: http://www.inclusive-edu.ru/content/File/ alehina/autism_2015_2_alehina.pdf. Accessed February 27, 2016

26. Wing L., Potter D. The epidemiology of autistic spectrum disorders: is the prevalence rising? Ment. Retard. Develop. Disabil. Res. Rev. 2002;8(3):151-161. doi.org/10.1002/mrdd.10029

27. Szpir M. Tracing the origins of autism: a spectrum of new studies. Environ Health Perspect. 2006;114(7):A412-A418. 25 doi.org/10.1289/ehp.114-a412

28. Fombonne E. Epidemiology of pervasive developmental disorders. Pediatr. Res. 2009;65:591-598. doi:10.1203/PDR.0b013e31819e7203

29. Rutter M. Incidence of autism spectrum disorders: changes over time and their meaning. Acta Paediatrica. 2005;94(1):2-15. doi.org/10.1111/j.1651-2227.2005.tb01779.x

30. Eaves L.C., Ho H.H. Young adult outcome of autism spectrum disorders. J. Autism Dev. Disord. 2008;38(4):73-47. doi:10.1007/s10803-007-0441-x. PMID 17764027

31. Psychotherapy for children and adolescents: trans. from german / Under. ed. H. Remshmidt. Moscow: Mir, 2000:476-502

32. Borodina LG. Change diagnosis autism spectrum disorders time after the age of 18: the opinion of a psychiatrist. Autism and Developmental Disorders. 2015;48(3):41-43. (In Russ). doi:10.17759/autdd.2015130306

33. Autism spectrum disorders in children. Scientific-practical guide / Under ed. N.V. Simashkovoi. Moscow: Author’s Academy, 2013

34. Schopler E., Reichler R., Renner B.R. The Childhood Autism Rating Scale (CARS). Western Psychological Services. Los Angeles, 1988

35. Zvereva N.V., Goryacheva T.G. Clinical psychology of children and adolescents: the textbook for students. institutions of higher. prof. education. Moscow: Publishing Centre «Academy», 2013

36. Zvereva N.V., Koval’-Zaitsev A.A., Khromov A.I. Metod pato- psychological for assessing the cognitive development of children and adolescents with endogenous mental disorders (visual perception and thinking). Moscow: OOO «Publisher MBA», 2014

37. Tuchman R.F., Rapin I. Regression in pervasive developmental disorders: seizures and epileptiform electroencephalogram correlates. Pediatrics. 1997;99(4):560-566. doi.org/10.1542/peds.99.4.560

38. Tuchman R. Autism. Neurologic Clinics. 2003;21(4):915-932. doi.org/10.1016/s0733-8619(03)00011-2

39. Kagan-Kushnir T., Roberts S.W., Snead O.C. 3rd. Screening electroencephalograms in autism spectrum disorders: evidence- based guideline. J. Child. Neurol. 2005;20(3):197-206. PMID: 15832609 [PubMed - indexed for MEDLINE]

40. Bolton P.F., Carcani-Rathwell I., Hutton J. et al. Epilepsy in autism: features and correlates. Br. J. Psychiat. 2011;198(4):289-294. doi: 10.1192/bjp.bp.109.076877

41. Малинина Е.В., Забозлаева И.В., Саблина Т.Н., Сединкин А.А. Аутизм, эпилепсия и эпилептиформная активность. Психиатрия. 2013;60(04):11-15. Bolton P.F., Carcani-Rathwell I., Hutton J. et al. Epilepsy in autism: features and correlates. Br. J. Psychiat. 2011;198(4):289- 294. doi: 10.1192/bjp.bp.109.076877

42. Башина В.М. Аутизм в детстве. М.: Медицина, 1999. 240 с. Bashina V.M. Autism in childhood. Moscow: Medicine, 1999