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Biomedical subjects

Eric Fombonne

Publications and source records attributed to Eric Fombonne.

33 records · Page 2Linked to original sources
PubMed2003

Epidemiologic data on Asperger disorder.

In 1944, Asperger described a syndrome that was subsequently given his name, although there is evidence from earlier European literature that clinical descriptions matching this disorder were available in the 1920s. Asperger's work was largely ignored until the seminal article by Wing, however, which led to a resurgence of interest in this diagnostic concept. Asperger disorder (AD) was only introduced as a separate diagnostic category in the latest revisions of ICD-10 and DSM-IV. Epidemiologic research on this disorder has only started in recent years and therefore data are still scarce on the prevalence of this syndrome. This article reviews available epidemiologic surveys that have shed light on the prevalence of AD.

Adolescent↗
PubMed2003

Epidemiological surveys of autism and other pervasive developmental disorders: an update.

This paper was commissioned by the committee on the Effectiveness of Early Education in Autism of the National Research Council (NRC). It provides a review of epidemiological studies of pervasive developmental disorders (PDD) which updates a previously published article (The epidemiology of autism: a review. Psychological Medicine 1999; 29: 769-786). The design, sample characteristics of 32 surveys published between 1966 and 2001 are described. Recent surveys suggest that the rate for all forms of PDDs are around 30/10,000 but more recent surveys suggest that the estimate might be as high as 60/10,000. The rate for Asperger disorder is not well established, and a conservative figure is 2.5/10,000. Childhood disintegrative disorder is extremely rare with a pooled estimate across studies of 0.2/10,000. A detailed discussion of the possible interpretations of trends over time in prevalence rates is provided. There is evidence that changes in case definition and improved awareness explain much of the upward trend of rates in recent decades. However, available epidemiological surveys do not provide an adequate test of the hypothesis of a changing incidence of PDDs.

Adolescent↗
PubMed2003

Measuring the parental, service and cost impacts of children with autistic spectrum disorder: a pilot study.

The aim of this study was to carry out a preliminary examination of a research instrument developed specifically to collect cost information for individuals with autistic spectrum disorder. There is very little cost information on children or adults with autism or autism-related disorder, and no study appears to have carried out a specific cost collection in this area. Although some global cost estimates can be made, little is known about the cost implications of parental burden. By using different techniques to collect indirect costs, the study outlines a functional methodology. Results from this small pilot study point to considerable economic burden for parents and give some indication of the associated costs of autistic spectrum disorder.

Adult↗
PubMed2003

Autism spectrum disorders: early detection, intervention, education, and psychopharmacological management.

Our understanding and treatment of children with autism have changed dramatically since Leo Kanner first formally documented the disorder in 1943. With reference to the historical context, this paper reviews recent research addressing 4 major issues: early detection, intervention, education, and psychopharmacological management of children with autism and related (autistic) spectrum disorders (hereafter, "autism"). We conclude from our review of the evidence that, in the absence of additional, more compelling data, the clinical usefulness of existing screening instruments remains questionable. However, the potential importance of such research is underscored by the clear benefits of early behavioural intervention: despite differences in orientation, outcomes for children with autism can be significantly enhanced with early intensive intervention. Although many questions remain (notably, What are the critical therapeutic components? For whom? For what domains of development? For what level of intensity and duration?), interventions shown to be effective are all carefully planned, engineered, monitored, and designed to target specific skill domains. Including children with autism in regular classes within the public school system poses several challenges, the most pressing of which is the large number of school personnel who need to be trained in evidence-based teaching and behavioural management practices. Finally, psychotropic drugs may help to reduce some symptoms, but they are neither curative nor a substitute for other forms of support and intervention.

Adolescent↗
PubMed2002

Evaluation of adverse effects of vaccines: the case-control approach.

When the hypothesis of a link between vaccination and a possible adverse outcome arises, further investigation is required to confirm or refute the suspicion. Given the rarity of most serious adverse effects, a case-control approach will often be chosen. This paper discusses aspects of the design, analysis and interpretation of case-control studies to evaluate vaccine adverse effects. Potential biases (and how to minimise such biases) in the selection of cases and assessment of vaccine exposure and the potential for confounding are discussed. Finally the increasing use of electronic databases in the evaluation of vaccine adverse effects is considered.

Case-Control Studies↗
PubMed2002

Differences in early childhood risk factors for juvenile-onset and adult-onset depression.

BACKGROUND: Family and twin studies suggest that juvenile-onset major depressive disorder (MDD) may be etiologically distinct from adult-onset MDD. This study is the first to distinguish prospectively between juvenile- and adult-onset cases of MDD in a representative birth cohort followed up from childhood into adulthood. METHOD: The study followed a representative birth cohort prospectively from birth to age 26 years. Early childhood risk factors covered the period from birth to age 9 years. Diagnoses of MDD were made according to DSM criteria at 3 points prior to adulthood (ages 11, 13, and 15 years) and 3 points during adulthood (ages 18, 21, and 26 years). Four groups were defined as (1) individuals first diagnosed as having MDD in childhood, but not in adulthood (n = 21); (2) individuals first diagnosed as having MDD in adulthood (n = 314); (3) individuals first diagnosed in childhood whose depression recurred in adulthood by age 26 years (n = 34); and (4) never-depressed individuals (n = 629). RESULTS: The 2 juvenile-onset groups had similar high-risk profiles on the childhood measures. Compared with the adult-depressed group, the juvenile-onset groups experienced more perinatal insults and motor skill deficits, caretaker instability, criminality, and psychopathology in their family-of-origin, and behavioral and socioemotional problems. The adult-onset group's risk profile was similar to that of the never-depressed group with the exception of elevated childhood sexual abuse. CONCLUSIONS: Heterogeneity within groups of psychiatric patients poses problems for theory, research, and treatment. The present study illustrates that the distinction between juvenile vs adult-onset MDD is important for understanding heterogeneity within depression.

Adolescent↗
PubMed2002

Emergency presentations to an inner-city adolescent psychiatric service.

There is little research into emergency presentations in child and adolescent mental health. The purpose of this study was to obtain an overview of number and types of presentations to a inner London child and adolescent mental health emergency service and to determine immediate and longer-term service demands. All available data on 107 consecutive child and adolescent emergency attenders were gathered using a structured data collection sheet. Half of those who presented following an episode of deliberate self-harm were considered to have no mental health disorder though a significant minority of emergency attenders had serious mental health problems. Most attenders were already known to child psychiatry or social services. Prospective study of young people who are already linked in with child mental health and/or social services but who require emergency assessments and interventions is warranted. An understanding of what breaks down in the routine care of these young people would facilitate earlier identification and more effective prevention or early intervention for these vulnerable children and adolescents.

Adolescent↗
PubMed2002

Are impaired childhood motor skills a risk factor for adolescent anxiety? Results from the 1958 U.K. birth cohort and the National Child Development Study.

OBJECTIVE: Neurodevelopmental impairments have been associated with early-onset schizophrenia, early-onset bipolar disorder, and childhood-onset affective disorder. The authors investigated whether delayed childhood motor skills predicted persistent anxiety in adolescence among 6,850 subjects from a national 1958 U.K. birth cohort. METHOD: This historic cohort study used data from the National Child Development Study that was collected when its subjects were 7, 11, and 16 years old. RESULTS: Boys with poor motor skills had more than threefold the odds of maternally rated anxiety at the ages of 11 and 16, but no effect was observed for girls. CONCLUSIONS: Childhood motor impairment was strongly associated with persistent anxiety among male, but not among female, adolescents. The effect modification by sex was greater than expected, as was the effect size for boys. Both findings warrant replication and further examination.

Adolescent↗
PubMed2002

The Maudsley long-term follow-up of child and adolescent depression: 3. Impact of comorbid conduct disorder on service use and costs in adulthood.

BACKGROUND: Depression in childhood or adolescence often has morbidity implications continuing into adulthood, generating needs for specialist services and support. AIMS: To estimate the patterns of service use and costs in adulthood of former patients. METHOD: Service use and other cost-related data were collected from former patients. Comparisons were made between those people with and without comorbid conduct disorder in childhood and with data for the general population. RESULTS: Data on 91 people with depression (only) and 49 with comorbid conduct disorder revealed high adulthood service utilisation rates and costs. Inpatient care and criminal justice services were used more frequently by the comorbid group and total costs were significantly higher. There were also indications of higher service use by the comorbid group than the general adult population. CONCLUSIONS: The high and enduring long-term costs associated with childhood depression and conduct disorder give further reason for early and effective intervention.

Adolescent↗
PubMedDate not supplied

MMR vaccination and pervasive developmental disorders: a case-control study.

BACKGROUND: Concern that measles-mumps-rubella (MMR) vaccination might cause autism has led to a fall in vaccine coverage. We investigated whether MMR vaccination is associated with an increased risk of autism or other pervasive developmental disorders. METHODS: We did a matched case-control study using the UK General Practice Research Database. Cases were people born in 1973 or later who had first recorded diagnosis of pervasive developmental disorder while registered with a contributing general practice between 1987 and 2001. Controls were matched on age, sex, and general practice. FINDINGS: 1294 cases and 4469 controls were included. 1010 cases (78.1%) had MMR vaccination recorded before diagnosis, compared with 3671 controls (82.1%) before the age at which their matched case was diagnosed. After adjustment for age at joining the database, the odds ratio for association between MMR and pervasive developmental disorder was 0.86 (95% CI 0.68-1.09). Findings were similar when restricted to children with a diagnosis of autism, to those vaccinated with MMR before the third birthday, or to the period before media coverage of the hypothesis linking MMR with autism. INTERPRETATION: Our findings suggest that MMR vaccination is not associated with an increased risk of pervasive developmental disorders.

Asperger Syndrome↗