Psychiatric services for adolescents and adults with Asperger syndrome and other autistic-spectrum disorders
May 16, 2006 - 1:35:37 AM

The Royal College of Psychiatrists has published a new report entitled Psychiatric services for adolescents and adults with Asperger syndrome and other autistic-spectrum disorders.

It is a consensus view of a working party of experts convened by the College to address the complex issues facing professionals and patients with these disorders.

The report is aimed at psychiatrists, stakeholders in the development of autistic-spectrum disorders services, and commissioners of adolescent and adult services, across all the psychiatric specialties.

Autistic spectrum disorders are a complex group of developmental disorders, affecting a wide range of physiological systems and with a variety of symptoms. Possible signs of the disorders include difficulties with personal relationships (social isolation), problems in communication, and absorbing or narrow interests
which begins in childhood and is lifelong.

These disorders often require psychiatric involvement in their diagnosis, and need to be addressed by all the psychiatric specialties. However, psychiatric services are only one component of the wider provision needed by people with autistic-spectrum disorders.

Treatment requires a flexible approach from a multidisciplinary, multi-agency range of services that is comprehensive enough to encompass the complex needs of people with the disorders. This wider service is the subject of a proposed strategy by the National Autistic Society, as well as of Health and Social Service planning in Wales, Scotland and Northern Ireland.

The report describes the syndrome, other problems associated with it, and its epidemiology. Diagnosis is distinguished from broader, multidisciplinary assessment. The report addresses the problem of people with the disorders who are too old for adolescent services, and too able for learning disability services.

Psychiatric provision needs to bridge this gap with a combination of training, better liaison between its specialties, and the development of specialist and tertiary services. As psychiatric services are overstretched, any improvement requires service commissioners to recognise the shortfall, encourage change and support further developments.

The report includes sections on how autistic-spectrum disorders are diagnosed and who should be responsible. Psychiatric management and drug treatments are discussed, as are psychiatric services in the community, psychiatric treatment units and psychiatric specialties, and recommendations made.

The report stresses the need for psychiatrists to work together with both the statutory and the independent sectors to ensure adequate psychiatric input into autistic-spectrum services.

For those cases where diagnosis is less straightforward, or where clinical management is more complex, there also needs to be access to local specialist expertise and, where necessary, to tertiary specialist services.

The report encourages research into the impact of autistic-spectrum disorders on adolescence and adulthood as it affects clinical psychiatry.

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