Autism symptoms

Symptoms cannot be better explained by another mental disorder (e.g., autism). 

Autism (Pervasive Development Disorder). The association between schizophrenia and autism is of particular historic significance. Bleuler, who coined the term schizophrenia, included autism as one of his four As among the symptoms of schizophrenia, the others being affect, ambivalence, and association. By autism, Bleuler meant the indifference to and separation from normal social interaction that is characteristic of schizophrenia. 

Symptoms of Fragile X syndrome include cognitive impairment, autism, seizures, and hyperactivity. 

Dysfunction of the dopamine system has been implicated in autism. Abnormalities have been observed in levels of whole blood, urinary and CSF dopamine and HVA. Also dopamine antagonists alleviate some autistic symptoms. It is thought that the levels of the HVA in the CSF reflect central... 

The conventional antipsychotics have little effect on the negative psychotic symptoms such as autism, stupor and emotional withdrawal. The so-called atypical antipsychotics, or second-generation antipsychotics, like the heterocyclic compound risperidone, the benzamide sulpiride and several diben-zepines of which clozapine is the best known, have a broader spectrum which means that they also have an effect on the negative psychotic symptoms. Most share a common attribute of working on serotonin receptors as well as dopamine receptors. They have a low risk of extrapyramidal side effects. 

Preliminary studies on pharmacological manipulation of the serotonergic system in autism suggest that acute depletion of the 5-HT precursor tryptophan can exacerbate many behavioral symptoms of autistic disorder (McDougle et ah, 1996). McBride et al. (1989) showed decreased central 5-HT responsiveness in autistic adults via blunted prolactin response to fenfluramine, a 5-HT-releasing agent. 

Bouvard, M.P., Leboyer, M., Launay, J.M., Recasens, C., Plumet, M.H., Waller-Perotte, D., Tabuteau, F., Bondoux, D., Dugas, M., Lensing, P., et al. (1995) Low-dose naltrexone effects on plasma chemistries and clinical symptoms in autism a douhle-hlind, placebo-controlled study. Psychiatry Res 58 191-201. 

Language and speech. Speech spontaneity, articulation, vocabulary, and prosody should be noted. Pedantic speech may be a symptom of Asperger s disorder or of a nonverbal learning disorder. Diminished speech may be the result of depression or autism. Excessive speech may be the result of anxiety, ADHD, or hypo-mania. Unusual speech may be an early sign of neu-rodevelopmental vulnerability to psychosis. Slurred speech may be evidence of a neurologic abnormality or a medication side effect. 

Freeman, B.J., Ritvo, E.R., Yokota, A., and Ritvo, A. (1985) A scale of rating symptoms of patients with the syndrome of autism in real life settings. / Am Acad Child Adolesc Psychiatry 25 130-136. 

Positive symptoms may develop (DSM-IV does not exclude a diagnosis of schizophrenia in cases of PDD/autism as long as prominent delusions or hallucinations are present for a month)... 

To more rigorously address the pharmacotherapy of symptoms of hyperactivity and inattention in PDD, the NIMH-sponsored RUPP Autism Network is conducting a controlled investigation of methylphenidate versus placebo in children and adolescents with PDDs. Nonresponders to methylphenidate will have the opportunity to enter a prospective, open-label trial of guanfacine. 

Anderson, L.T., Campbell, M., Adams, P., Small, A.M., Perry, R., and Shell, J. (1989) The effects of haloperidol on discrimination learning and behavioral symptoms in autistic children. J Autism Dev Disord 19 227-239. 

Handen, B.L., Johnson, C.R., and Lubetsky, M. (2000) Efficacy of methylphenidate among childten with autism and symptoms of attention-deficit hypetactivity disotdet. J Autism Dev Disord 30 245-255. 

Sovner et al. (1998) have done an excellent job summarizing the data on antidepressants in patients with developmental disabilities. There have been nine reports of antidepressant use in adults with depression and MR and three reports of antidepressant use in children and adolescents. Eight of nine reports in adults were positive. The drugs studied included nialimide (n = 27), fluoxetine (9), imipramine (6), amoxapine (2), and nortriptyline (1) (total n = 45). In addition, Sovner et al. identified four reports of antidepressant use in children. One involved successful treatment with fluoxetine in an adolescent, another indicated efficacy with imipramine and amitriptyline in 9 of 12 children (Do-sen, 1982), and a third showed successful management in 3 of 4 children treated with imipramine or tryptophan plus nicotinamide (Dosen, 1990). One study of fluoxetine in depressed children with autism and MR witnessed improvement in depression but not in compulsive symptoms (Ghaziuddin and Tsai, 1991). 

In the Zito et al. study (2000), antidepressants were the second most commonly prescribed psychotropic medication. There are a total of 10 studies or case reports in the literature examining antidepressant use in preschool children (Table 49.4). None of the 10 studies are randomized, double-blind, or placebo-controlled trials. The ten uncontrolled studies looked at a total of 37 preschool children. Six of the studies looked at a total of 29 preschoolers with autism or childhood schizophrenia (Campbell et ah, 1971a Petti and Campbell, 1975 Holttum et ah, 1994 Sanchez et ah, 1996 DeLong et ah, 1998 Hollander et ah, 2000). While these six studies are difficult to compare, given the small sample sizes and the different treatment medications, these open-label studies suggest that clomipramine, venlafaxine, and fluoxetine may be helpful to reduce some psychiatric symptoms found in autistic... 

There are a number of uncontrolled studies that indicate that clonidine may be effective in reducing aggression (Comings et al., 1990 Kemph et al., 1993 Schvehla et al., 1994). Transdermal clonidine decreased hyperarousal in nine children with autism in an uncontrolled study (Frankhauser et al., 1982). In a doubleblind study of eight FDD children with ADHD-like symptoms, Jaselski et al. (1992) reported that clonidine had nonsignificant overall effects compared to placebo, however, some of the ratings of aberrant (by teacher) and oppositional (by parent) behavior decreased. 

To attempt to obtain a claim for a nonspecific symptom in a single disease model would, by definition, be pseudospecific, since such a claim would give the impression that the symptom is specific to that disease. For example, if there were agreement that psychomotor agitation could be considered a nonspecific psychiatric symptom, it would be important to study a drug treatment proposed for this symptom in several different disease models, such as schizophrenia, autism, and mental retardation. 

GAMT deficiency has been known for more than 10 years now and several affected patients have been reported [6]. The severity of clinical symptoms varies widely. Affected patients show developmental delay with absence of active speech and, in older patients, autism with self injury. More severely affected patients present with severe extrapyramidal symptoms and intractable epilepsy. Biochemical diagnosis can be made by analysis of GA in the plasma or urine. 

FIGURE 10—4. Cognitive symptoms are not just associated with schizophrenia, but also with several other disorders, including autism, Alzheimer s disease, and conditions following cerebrovascular accidents (poststroke). 

Neuroleptics are used primarily in managing the symptoms of schizophrenia, although they are also used to treat a variety of conditions, including autism, attention deficit hyperactivity disorder (ADHD), bipolar disorder, and even to alleviate severe pain. 

Correlates of Psychomotor Symptoms in Autism Laura Stoppelbein, Sara Sytsma-Jordan, and Leilani Greening... 

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