Male to female ratios in autism spectrum disorders by age, intellectual disability and attention-deficit/hyperactivity disorder
Male to female ratios in autism spectrum disorders by age, intellectual disability and attention-deficit/hyperactivity disorder
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DOI：
10.1111/acps.13368
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发表时间：
2021-09-20
影响因子：
6.7
通讯作者：
Klungsoyr, Kari
中科院分区：
文献类型：
--
作者：
Posserud, Maj-Britt;Solberg, Berit Skretting;Klungsoyr, Kari
目的比较成人和儿童ASD的性别分布，以及智力残疾（ID）和注意缺陷多动障碍（ADHD）共病对男女比例（MFR）的影响。方法我们使用挪威医学出生登记处估计成人和儿童ASD的MFR和男性患病率（PR），包括1967-2011年出生的所有个体。我们检查了2008-2015年期间挪威患者登记处诊断和/或ADHD药物处方中定义的年龄，共病ID和ADHD的变化。结果共调查成人1,701,206人，儿童804,146人，其中儿童8995人（0.5%）成人和8，056（1.0%）自闭症儿童，53，822人（3.2%）成人和26，967（3.4%）ADHD儿童和9，178（0.5%）成人和5，038 ASD的MFR在儿童中为3.67，在成人中为2.57，对应于ASD中的男性PR分别为1.54（95%CI 1.53-1.56）和1.41（1.39-1.24）。共病ID降低了MFR和男性PR在成人和儿童，而共病ADHD显着增加男性PR在儿童。从儿童到年轻人，再到老年人，自闭症、多动症和ID的MFR和人群患病率都有所下降。结论成年男性的MFR和PR低于儿童。研究结果表明，在ASD的儿童/临床研究中看到的男性优势在成人样本中减少，可能反映了非病因因素的影响，如女性的后期诊断，诊断偏差和诊断趋势。
Objective To examine the gender distribution in ASD in adults compared with children and the impact of comorbid intellectual disability (ID) and attention-deficit/hyperactivity disorder (ADHD) on the male to female ratio (MFR). Methods We estimated the MFR and the male prevalence ratio (PR) for ASD in adults and children using the Medical Birth Registry of Norway, including all individuals born during 1967-2011. We examined variation with age, comorbid ID and ADHD as defined by diagnoses in the Norwegian Patient Registry during 2008-2015 and/or a dispensed prescription for ADHD medication. Results The sample included 1,701,206 adults and 804,146 children, including 8,995 (0.5%) adults and 8,056 (1.0%) children with ASD, 53,822 (3.2%) adults and 26,967 (3.4%) children with ADHD and 9,178 (0.5%) adults and 5,038 (0.6%) children with ID. The MFR for ASD was 3.67 in children and 2.57 in adults, corresponding to a male PR in ASD of 1.54 (95% CI 1.53-1.56) and 1.41 (1.39-1.24), respectively. Comorbid ID decreased the MFR and the male PR in both adults and children, whereas comorbid ADHD significantly increased the male PR in children. The MFR and the population prevalence of ASD, ADHD and ID decreased from children to younger adults and yet further to older adults. Conclusion We found a lower MFR and male PR in adults than in children. Findings suggest the strong male predominance seen in childhood/clinical studies of ASD diminishes in adult samples, possibly reflecting the influence of non-aetiological factors such as later diagnosis in females, diagnostic biases and diagnostic trends.