In the study titled "Missed Diagnoses and Misdiagnoses of Adults with Autism Spectrum Disorder," researchers evaluated the psychiatric history of adults who received their first diagnosis of autism spectrum disorder (ASD) at two Italian university centers. The study aimed to understand the characteristics and diagnostic journeys of these individuals, focusing on the prevalence of missed or incorrect diagnoses before receiving an ASD diagnosis.
The sample consisted of 161 participants, with a median age of 23 years at the time of diagnosis. The majority of participants were male (79.5%), and the median IQ was 100. The first evaluation by a mental health professional occurred at a median age of 13 years, with an 11-year gap between the first evaluation and the diagnosis of ASD. Notably, 33.5% of participants had never received a psychiatric diagnosis before their ASD diagnosis, while the rest had received one or more diagnoses different from ASD. The most common past diagnoses included intellectual disability, psychoses, personality disorders, and depression.
The study found significant sex differences in the age of diagnosis and ADOS-2 scores. Women were diagnosed later than men and had lower scores in social interaction and communication domains. The results highlight the challenges in diagnosing ASD in adulthood, particularly for women, and the importance of considering ASD in differential diagnoses due to its overlap with other psychiatric conditions.
The findings emphasize the need for clinicians to be aware of the possibility of ASD in adults presenting with various psychiatric symptoms and to use standardized tools for accurate diagnosis. The study also underscores the importance of early intervention and appropriate support for individuals with ASD to improve their long-term outcomes.
Fusar-Poli, L., Brondino, N., Politi, P., & Aguglia, E. (2022). Missed diagnoses and misdiagnoses of adults with autism spectrum disorder. European Archives of Psychiatry and Clinical Neuroscience, 272(187-198).