Psychiatric Follow up of Children and Adolescent with Past History of Autism

Background:  Autism spectrum disorders (ASDs) were once considered lifelong disorders, but recent studies show that some children with diagnosis of ASD no longer meet the criteria for ASD. These children are considered to have achieved optimal outcome (OO)( Fein 2013 ,Orienstein 2014,Mukaddes 2014). Despite the presence of a few studies reporting optimal outcome in this group, there is lack of follow up studies in this group.

Objectives:  The present study aims to assess the psychiatric disorders in individuals who lost the diagnosis of autism.

Methods:  Twenty six individuals (21 male, 5 female) were included in this study with the age range: 6-16 years old (mean age: 9,1923 +/- 2,87081). They all lost the diagnosis of autism at least two years before follow up examination.The participants were recruited from a group of individuals with past history of autism who were diagnosed and assessed previously by the first author. The characteristics of this group has been described in another study from the same group (Mukaddes et al 2014). From 39 individuals who lost the diagnosis of autism and were reported earlier, individuals who achieved optimal outcome at least two years before were included.All individuals were assessed by a team of child psychiatrists and a clinical psychologist.The follow up clinical assessment  was done 2 to 8 years   after losing the diagnosis of autism. Assessment and Measurements included:a)Systematic psychiatric interview with both children and parents based on Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime Version  (K-SADS -PL) ,b) Intelligence quotient (IQ.) assessed using the Wechsler Intelligence Scale for Children—revised version(WISC-R) ,c) Autistic features were assessed using Social Comunication questionnaire (SCQ)(current ).All data were organized in Microsoft Excel 2010, and all statistical tests were conducted in Excel. Relationships between parametric values were assessed using the Pearson correlation coefficient in the Statistical Package for Social Sciences (SPSS) 18.0, SPSS Inc., Chicago, Illinois, USA.

Results:   According to K-SADS -Lifetime, 92.3 % of individuals (n:24) had at least one psychiatric disorder. ADHD (% 69.2 , n:18), specific phobia (% 46.2 , n:12) and OCD (% 38.5 ,n:10) were the most common life time disorders in this group.K-SADS -P revealed the presence of psychiatric disorders in 76.9 % of the group (n:20) . ADHD (% 53.8 , n:14), Specific Phobia (% 46.2 , n:12) and OCD (%19.2 , n:5) were the most common psychiatric disorders in K-SADS -P.Based on WISC-R test, all the participants showed performance in non- retarded range. Their Full IQs were between 73-148.Their SCQ revealed the total score between 1 -13 (cutoff score>15 is necessary for ASD).

Conclusions:   The present study shows that although some children lose the diagnosis of autism, they are prone to develop other psychiatric disorders later in life. Therefore, long term psychiatric follow up of this group seems necessary even after achieving optimal outcome.