The epidemiology of autism: a review
The epidemiology of autism: a review
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DOI：
10.1017/s0033291799008508
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发表时间：
1999-07-01
影响因子：
6.9
通讯作者：
Fombonne, E
中科院分区：
文献类型：
--
作者：
Fombonne, E
背景有一些关于自闭症的比率和相关性的不确定性。本文回顾了1966年至1998年间发表的23篇英文版孤独症流行病学调查报告。超过400万名受试者接受了调查; 1533名自闭症受试者被确定。总结了每项研究的方法学特征，包括病例定义、病例发现程序、参与率和达到的精确度。在所有调查中，患病率估计中位数为5.2 / 10000。一半的调查有95%的置信区间与人口估计值5.4-5.5/10000一致。患病率显着增加与出版年，反映了变化的情况下定义和提高认识，中位数率为7.2/10000自1989年以来进行的11次调查。男女比例平均为3.8：1，根据是否存在智力迟钝而有所不同。据报道，约20%的受试者的智力功能在正常范围内。平均而言，在6%的自闭症受试者中发现了具有潜在因果意义的医学状况，结节性硬化症与自闭症有着一贯的强关联。社会阶层和移民身份似乎与自闭症无关。没有证据表明自闭症的发病率长期增加。在八项调查中，其他形式的广泛性发育障碍的发病率比自闭症高出两到三倍。根据最近的调查，所有形式的广泛性发育障碍的最低估计为18.7/10000，这概述了一个大的儿童群体的特殊服务的需求。
Background. There is some uncertainty about the rate and correlates of autism.Method. Twenty-three epidemiological surveys of autism published in the English language between 1966 and 1998 were reviewed.Results. Over 4 million subjects were surveyed; 1533 subjects with autism were identified. The methodological characteristics of each study are summarized, including case definition, case-finding procedures, participation rates and precision achieved. Across surveys, the median prevalence estimate was 5.2 / 10000. Half the surveys had 95 % confidence intervals consistent with population estimates of 5.4-5.5/10000. Prevalence rates significantly increased with publication year, reflecting changes in case definition and improved recognition; the median rate was 7.2/10000 for 11 surveys conducted since 1989. The average male/female ratio was 3.8:1, varying according to the absence or presence of mental retardation. Intellectual functioning within the normal range was reported in about 20 % of subjects. On average, medical conditions of potential causal significance were found in 6 % of subjects with autism, with tuberous sclerosis having a consistently strong association with autism. Social class and immigrant status did not appear to be associated with autism. There was no evidence for a secular increase in the incidence of autism. In eight surveys, rates for other forms of pervasive developmental disorders were two to three times higher than the rate for autism.Conclusion. Based on recent surveys, a minimum estimate of 18.7/10000 for all forms of pervasive developmental disorders was derived, which outlines the needs in special services for a large group of children.