International Meeting for Autism Research (London, May 15-17, 2008): Sex differences in core autism symptoms in cases with autistic disorder

Saturday, May 17, 2008

Champagne Terrace/Bordeaux (Novotel London West)

11:30 AM

L. Hjort , North Atlantic Neuro-Epidemiology Alliances (NANEA), Department of Epidemiology, Institute of Public Health, University of Aarhus, DK-8000 Århus C, Denmark

E. Parner , Department of Biostatistics, Institute of Public Health, University of Aarhus, DK-8000 Århus C, Denmark

M. B. Lauritsen , Regional Psychiatric Center for Children and Adolescents, Viborg, Denmark

M. Jørgensen , Århus University Hospital, Regional Psychiatric Center for Children and Adolescents, Risskov, Denmark

S. Lemcke , North Atlantic Neuro-Epidemiology Alliances (NANEA), Department of Epidemiology, Institute of Public Health, University of Aarhus, DK-8000 Århus C, Denmark

S. Toft , Århus University Hospital, Regional Psychiatric Center for Children and Adolescents, Risskov, Denmark

P. Thorsen , North Atlantic Neuro-Epidemiology Alliances (NANEA), Department of Epidemiology, Institute of Public Health, University of Aarhus, DK-8000 Århus C, Denmark

Background:

Sex differences in core autism symptoms have not been fully investigated. Boys with autism have been reported to show less pretend play, more inappropriate stereotypic play, and more unusual visual interests than girls with autism. Cognitive ability is hypothesized to influence core autism symptoms.

Objectives:

To study sex differences in core autism symptoms according to DSM-IV diagnostic criteria.

Methods:

All children born in Denmark from 1990-1999 registered with a diagnosis of autistic disorder in The Danish Central Psychiatric Register by February 1, 2001 formed the population. Register diagnoses were validated by DSM-IV diagnostic criteria of autistic disorder using a record review method. Cases with a confirmed diagnosis constituted the study cohort: a total of 469 cases, 92 girls, 377 boys. The DSM-IV lists four items in each of the three autism core areas: impaired social interaction, impaired communication, and restricted/stereotyped behaviour. Compliance with six items or more confirm the diagnosis.

Results:

Males met on average 0.63 (95%CI=0.20-1.06; p=0.004) more items from DSM-IV diagnostic criteria than females. Further, males on average met 0.29 (95%CI=0.07-0.51; p=0.011) more items concerning impaired communication and 0.28 (95%CI=0.07-0.50; p=0.011) more items concerning restricted behaviours than females. A similar trend was seen concerning impaired social interaction.

For autism cases without mental retardation males overall met on average 0.69 (95%CI=-0.06-1.44; p= 0.073) more items than females and on average 0.66 (95%CI=0.29-1.02; p=0.001) more items concerning restricted behaviours when adjusting for age. Similar trends were seen concerning impaired communication and impaired social interaction. For cases with mental retardation largely the same trend was found.

Conclusions:

In a population-based cohort of validated cases of autistic disorder compliance with DSM-IV diagnostic criteria items differed significantly between sexes: Consistently males met more items than females. Current diagnostic criteria may favour diagnosis of males. More studies are needed on female autistic behaviour.

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