Children with autism grow up. Use of the DISCO (Diagnostic Interview for Social and COmmunicative disorders) in population-based cohorts

• Main Author: Billstedt, Eva
• Format: Doctoral or Postdoctoral Thesis
• Language: English
• Published: 2007
• Subjects: DISCO; autism; Asperger syndrome; diagnosis; prevalence; outcome; quality of life; Faroe Islands
• Online Access: http://hdl.handle.net/2077/2576; http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=17029020; http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16119476

Objectives: Examine the prevalence and outcome of autism in child and adult population cohorts using the Diagnostic Interview for Social and COmmunication disorders (DISCO). Method: The Faroe Islands school population aged 7-18 years (n=7689) was screened for autism and cases raising suspicion were examined and tested. Parents were interviewed using the DISCO. Clinical diagnoses were established on the basis of all available information. Prevalence rates for autistic disorder, atypical autism and Asperger syndrome were calculated. The autism outcome was looked at in 3 partly overlapping population cohorts of individuals (n=120) diagnosed in childhood as suffering from autism or atypical autism from the region of Göteborg, Sweden. They were re-examined at ages 17-40 years, 13-22 years after diagnosis. Parents and carers were interviewed using the DISCO. Strict operationalised criteria for outcome were used. Diagnostic stability over time was analysed. Symptom profiles on the basis of the DISCO were reviewed and background factors contributing to outcome in adult age were assessed. Aspects of Quality of Life were examined. Results: The prevalence of autism, atypical autism and Asperger syndrome in the Faroe Islands child population was 0.56%. The boy:girl ratio was 4.8:1. The DISCO was very useful in eliciting the information needed for a correct clinical diagnosis. The overall outcome of autism in the Göteborg population was psychosocially poor with few adults leading independent lives. Mortality was high (5%) and seemed to be associated with medical disorders including epilepsy. All but one of the individuals included in the follow-up study (n=108) still met criteria for autism or atypical autism. A small subgroup showed better psychosocial outcomes. They had all had some spoken language at age 3 years. Those with a childhood diagnosis of atypical autism tended to be diagnosed with autism at follow-up. The correspondence between clinical diagnoses and DISCO algorithm diagnoses was very good. The level of ...