The situationally independent triad of manifestations of attention deficit—hyperactivity disorder ADHD consists of lack of attention, lack of impulse control, and increased motor activity, with resulting impairment of social-cognitive performance. The manifestations are thought to persist into adulthood in half of all cases e The problems of attention in Asperger syndrome include increased distractability by external stimuli and intolerance to stress.
Impulsive behavior may arise if the rigid behavior patterns and rituals are interrupted. Impaired motor coordination, bizarre body language, and fleeting eye contact can also be features of either condition. Conflict of interest statement.
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Gawronski have had meeting participation fees reimbursed by the Volkswagen Foundation. Schilbach received financial support from the Volkswagen Foundation for an interdisciplinary research project on social cognition. Vogeley has received payment for medicolegal work involving autism. He has received reimbursement of meeting participation fees as well as financial research support from the Volkswagen Foundation.
Kockler state that they have no conflict of interest.
National Center for Biotechnology Information , U. Journal List Dtsch Arztebl Int v. Published online Nov 8. Fritz-Georg Lehnhardt , Dr. Psych, 1 Kathleen Pfeiffer , Dipl. Psych, 1 Hanna Kockler , Dr. Author information Article notes Copyright and License information Disclaimer.
Received Nov 2; Accepted Jun This article has been cited by other articles in PMC. Abstract Background As a result of the increased public interest in autism spectrum disorders ASD , certain core manifestations of ASD—impaired social interaction and communication, bizarre interests—are now commonly recognized as being typical of autism, not only in children, but in adults as well. Conclusion The diagnostic assessment of autism in adults requires knowledge of the core and accompanying manifestations of autism and of their differential diagnoses.
Learning objectives Our goals in writing this article are to: Methods We selectively searched the PubMed database for relevant original articles and reviews, using the following search terms: Restricted, repetitive, and stereotyped patterns of behavior and interests at least 3 of 5 areas: Qualitative impairments of verbal and non-verbal communication at least 3 of 5 areas: Disturbance of social interaction The main feature is a lack of intuitive understanding of the rules of interpersonal relations.
Impaired communication There is a marked impairment in the perception, interpretation, and implementation of mutually modulated, context-driven nonverbal communication, e. Open in a separate window.
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Screening instruments Only a few specific screening instruments have been developed to date for the initial diagnostic assessment of AS in adulthood. Confirming a suspected diagnosis The diagnosis of AS in adulthood requires time, resources, and clinical experience 4.
In the United Kingdom, the National Assessment Service for Adults with Autism, confronted with a fivefold increase in referrals over the period —, established a diagnostic process in three steps 10 , which is shown in modified form in the Figure: Table 3 Synopsis of the diagnostic assessment of Asperger syndrome AS in adults. Psychiatric comorbidity or differential diagnosis? Table 4 Phenomenological overlap of relevant differential diagnoses of AS that involve abnormal social interaction. Social anxiety disorders The category of social anxiety disorders contains social phobia and avoidant personality disorder e5.
Compulsive anankastic personality disorder The manifestations of compulsive personality disorder consist of an intense preoccupation with order, lists, and formalities and an emphasis on peripheral details at the expense of flexibility and openness. Attention deficit—hyperactivity disorder The situationally independent triad of manifestations of attention deficit—hyperactivity disorder ADHD consists of lack of attention, lack of impulse control, and increased motor activity, with resulting impairment of social-cognitive performance. Persons with AS are often highly educated and capable of living independently, yet half are unemployed and have a low socioeconomic status.
The main clinical features are a poor ability to assume the emotional perspectives of others, impaired social-communicative behavior, unusual interests, and restrictive behavior patterns. These manifestations are already present in early childhood and persist thereafter. The differential diagnosis of AS includes schizoid, obsessive-compulsive, and avoidant personality disorders. Its common psychiatric comorbidities include anxiety disorders, obsessive-compulsive disorders, and attention deficit—hyperactivity disorder.
Simple screening measures by the primary-care physician, followed by further assessment of the suspected diagnosis of AS by a mental health care specialist, are resource-efficient initial diagnostic steps before the patient with suspected AS is referred to a dedicated outpatient clinic for patients with this disorder. Footnotes Conflict of interest statement Dr. Prevalence of autism spectrum disorders—autism and developmental disabilities monitoring Network, 14 sites. Centers for Disease Control and Prevention; pp. Prevalence of autism-spectrum conditions: UK school-based population study.
Epidemiology of autism spectrum disorders in adults in the community in England. Recognition, referral, diagnosis, and management of adults with autism: Psychiatric comorbidity in young adults with a clinical diagnosis of Asperger syndrome. Psychiatric and psychosocial problems in adults with normal-intelligence autism spectrum disorders. Autistic disorders - the state of the art and recent findings: Z Kinder Jugendpsychiatr Psychother.
Evaluation of diagnostic and therapeutic services in German university hospitals for adults with autism spectrum disorder ASD Fortschr Neurol Psychiatr. New biologicial findings and their translational implications to the cost of clinical services. Verlag Hans Huber; J Autism Dev Disord. The weak coherence account: Theory of mind in adults with HFA and Asperger syndrome. Adult outcome for children with autism. J Child Psychol Psychiatry. Finally, the the proper diagnosis of BPD can help us to inform and educate patients and their families.
National Center for Biotechnology Information , U. Journal List Psychiatry Edgmont v. Joel Paris , MD.
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- The Investigation and Differential Diagnosis of Asperger Syndrome in Adults;
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- Why Psychiatrists are Reluctant to Diagnose.
Abstract Clinicians can be reluctant to make a diagnosis of borderline personality disorder BPD. What is Borderline Personality Disorder? BPD and Psychosis The original concept of BPD as lying on a border between neurosis and psychosis found a parallel in the diagnostic term pseudoneurotic schizophrenia.
Assessment and Management of Personality Disorders
BPD and the Bipolar Spectrum It has been proposed that borderline pathology falls within the spectrum of bipolar illness, 22 based on a wish to expand the narrower diagnostic construct of bipolar disorder into a much broader range of conditions termed the bipolar spectrum. Psychoanalytic investigation of and therapy in the borderline group of neuroses. Cognitive features of borderline personality disorder. The nature of borderline personality disorder: Multiple symptoms, multiple dimensions, but one category. History of multiple suicide attempts as a behavioral marker of severe psychopathology.
Factors associated with multiple hospitalizations of patients with borderline personality disorder. Zimmerman M, Mattia JI. Differences between clinical and research practices in diagnosing borderline personality disorder.
The Investigation and Differential Diagnosis of Asperger Syndrome in Adults
Lewis L, Appleby L. The patients psychiatrists dislike. Recent advances in the treatment of borderline personality disorder. Axis I comorbidity of borderline personality disorder. Mutually exclusive versus co-occurring diagnostic categories: The challenge of diagnostic comorbidity. Diagnosis and definition of treatment-resistant depression. Discriminating features of borderline patients. The revised diagnostic interview for borderlines: Discriminating borderline personality disorder from other Axis II disorders.
The course and outcome of pseudoneurotic schizophrenia. Crossing the border into borderline personality disorder.
Why Psychiatrists are Reluctant to Diagnose
Family studies of borderline personality disorder: An adjective in search of a noun. A current view of the interface between borderline personality disorder and depression. Misdiagnosis, antidepressant use, and a proposed definition for bipolar spectrum disorder. Affective instability and impulsivity in borderline personality and bipolar II disorders: The interface between borderline personality disorder and bipolar spectrum disorder.
Herman J, van der Kolk B. Traumatic antecedents of borderline personality disorder. American Psychiatric Press, Inc. Does childhood trauma cause personality disorders? For instance, such patients may try to manipulate others to gratify them and thus alleviate their distress.
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They achieve such manipulative outcome by threatening, cajoling, seducing, tempting, or co-opting their "sources of supply". Patients with personality disorders also lack self-awareness and are ego-syntonic. They do not find themselves, their conduct, traits, or the lives they lead to be objectionable, unacceptable or alien to their true self.
They are mostly happy-go-lucky people. Consequently, they rarely assume responsibility for the consequences of their actions. This is further compounded, in some personality disorders, by a startling absence of empathy and scruples conscience. The lives of personality disordered subjects are chaotic.