A systematic review Ewelina Rydzewska Kirsty Dunn Christopher Gillberg Sally Ann Cooper University of Glasgow Institute of Health and Wellbeing ewelinarydzewskaglasgowacuk wwwsldoacuk ID: 815196
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Systematic reviews and meta-analyses of evidence on comorbid health conditions in people with autism spectrum disorder:
A systematic review
Ewelina Rydzewska, Kirsty Dunn, Christopher Gillberg, Sally-Ann Cooper University of Glasgow, Institute of Health and Wellbeingewelina.rydzewska@glasgow.ac.ukwww.sldo.ac.uk
Introduction
People with
autism spectrum
disorder (ASD) experience
a wide range of
comorbid health problems, some of which may have different
prevalence compared with the general population.Since health problems can significantly affect quality of life, it is important to know how common they are in people with ASD.
Methods
PsycINFO
, Scopus, CINAHL, Medline and Cochrane were searchedlimited to sources published in English between January 2005 and July 2016search terms: ‘autis*’ OR ‘pervasive developmental disorder’ OR ‘Asperger*’ OR ‘ASD’animal, brain-imaging or genetic studies and reviews of intervention and treatment studies on the core symptoms of autism or comorbid health conditions were excludedquality of all included papers reviewed using a tool for Assessing the Methodological Quality of Systematic Reviews (AMSTAR)
Aim
The aim
was to identify and systematically review existing systematic reviews and meta-analyses of evidence
on co-occurring health conditions.
Research
questions
How common are co-occurring health needs of people with ASD?
Are specific co-occurring health needs in people with
ASD more prevalent than in the general population?Are there gaps in the evidence base on co-occurring health needs in people with ASD?
Results
Conclusions
prevalence
of some mental (e.g. mood and anxiety disorders) and physical health conditions (e.g. epilepsy and gastrointestinal problems) seems to be higher
in people with
ASD
heterogeneous methodological approaches and sample characteristic often preclude meaningful pooling of findingsthere is a need for more robust research to draw comparisons between specific health needs of people with and without ASD
Limitations of literature
Lack of
information on:assessment and operationalisation of ASD and comorbiditiessamples recruitmentInconsistent results reported due to:varying study designsdifferent source populationsparticipant characteristicssmall or highly selective samples
Flow chart of reviewed articles
References
(full list available on request): Amiet et al. 2008; Bartolomé-Villar et al. 2016; Beers et al. 2014; Billeci et al. 2015; Catala-Lopez et al. 2014; Elrod and Hood 2015; Galling et al. 2016; Hannon and Taylor 2013; Huke et al. 2013; McElhanon et al. 2014; Padgett et al. 2010; Perkins and Berkman 2012; Reilly et al. 2013; Rubenstein et al. 2015; Segers and Rawana 2014; Skokauska and Gallagher 2009; Spain et al. 2016; Stewart et al. 2006; Su et al. 2016; van de Wouw et al. 2012; Vannucchi et al. 2014; van Steensel et al. 2011; White et al. 2009; Woolfenden et al. 2012.
Physical healthstandardised mortality rate is reported as 2.8; higher SMR for females and learning disabilities or epilepsy related deaths, and accidental deaths from drowning, suffocation, cancer, respiratory, nervous, sensory, and circulatory diseaseslife expectancy at 65 is >3 years shorter than the general population epilepsy is much more common than for the general population, especially in groups with additional learning disabilities, and for womensleep disorders are reported in 45% of adultsType II diabetes risk is higher for antipsychotic-exposed youth, but lower in antipsychotic-exposed youth with ASDgastrointestinal problems, including general symptoms, diarrhoea, constipation and abdominal pain seem to be more common than for comparison groups of typically developing children and youthinconclusive findings on peripheral hearing loss, oral health and canceratopy, such as dermatitis, allergic rhinitis, and asthma may be more commonMental healthdepression (4-34%), bipolar disorder (6-21%) and suicidal ideation (31-50%) appear to be more common than in the general populationanxiety appears to occur more commonly than expected, and may be more common in girls than boysfindings on schizophrenia are inconclusivefindings regarding ASD prevalence in eating disorders are inconclusive