Revisión del alcance: las implicaciones del diagnóstico tardío de TEA en mujeres
DOI:
https://doi.org/10.34024/rnc.2023.v31.15662Palabras clave:
Autismo, DiagnósticoResumen
Introducción. Entre los trastornos del neurodesarrollo, el Trastorno del Espectro Autista (TEA) es uno de los que presenta mayor proporción entre hombres y mujeres, presentando puntuaciones 3,8 veces superiores para los niños que para las niñas, considerando la prevalencia en las regiones estudiadas. El TEA se divide en tres niveles, clasificados según la necesidad de apoyo del individuo considerando características como dificultad de expresión, baja capacidad de contacto visual, conductas repetitivas y mayor sensibilidad al entorno. Objetivo. Verificar los efectos del diagnóstico tardío del TEA en las mujeres, así como las principales aportaciones científicas para revertir esta situación. Método. Utilizando el protocolo PRISMA se realizó una revisión de alcance de los trabajos científicos presentes en las plataformas PubMed, Scielo, BVS, Cochrane y Capes. Resultados. El diagnóstico tardío del TEA tiene varias implicaciones y riesgos, incluidas las diferencias características, la influencia de los factores de género, la depresión y las conductas de autolesión en la adolescencia. Se destacan las dificultades para distinguir el TEA de otros trastornos, recalcando la necesidad de aumentar la conciencia y la comprensión del autismo, especialmente en grupos demográficos específicos. Conclusión. Diversos factores pueden explicar el alto índice de diagnósticos tardíos de mujeres adultas con TEA, principalmente enmascaramiento de los signos y síntomas. De tal forma, fue posible percibir diversas consecuencias que un subdiagnóstico del espectro puede causar, en especial en lo que respecta a enfermedades psicológicas, que se consideran, a menudo, experiencias traumáticas para este grupo de mujeres.
Métricas
Citas
Kanner L. Autistic disturbances of affective contact. Nervous Child 1943;2:217-50. https://psycnet.apa.org/record/1943-03624-001
Rutter M. Diagnosis and definition of childhood autism. J Autism Childhood Schizophr 1978;8:139-61. https://doi.org/10.1007/BF01537863
Dias S. Asperger e sua síndrome em 1944 e na atualidade. Rev Latinoam Psicopatol Fundamental 2015;18:307-13. https://doi.org/10.1590/1415-4714.2015v18n2p307.9
Wing L. Asperger’s syndrome: a clinical account. Psycholog Med 1981;11:115-29. https://doi.org/10.1017/s0033291700053332
Sandin S, Lichtenstein P, Kuja-Halkola R, Larsson H, Hultman CM, Reichenberg A. The Familial Risk of Autism. JAMA 2014;311:1770-7. https://doi.org/10.1001/jama.2014.4144
Gesi C, Migliarese G, Torriero S, Capellazzi M, Omboni AC, Cerveri G, et al. Gender Differences in Misdiagnosis and Delayed Diagnosis among Adults with Autism Spectrum Disorder with No Language or Intellectual Disability. Brain Sci 2021;11:912. https://doi.org/10.3390/brainsci11070912
Green RM, Travers AM, Howe Y, McDougle CJ. Women and Autism Spectrum Disorder: Diagnosis and Implications for Treatment of Adolescents and Adults. Curr Psychiatr Rep 2019;21:22. https://doi.org/10.1007/s11920-019-1006-3
Geelhand P, Bernard P, Klein O, van Tiel B, Kissine M. The role of gender in the perception of autism symptom severity and future behavioral development. Mol Autism 2019;10:16. https://doi.org/10.1186/s13229-019-0266-4
Budisteanu M, Linca F, Andrei L, Mateescu L, Glangher A, Ioana D, et al. Recognition of early warning signs and symptoms -the first steps on the road to Autism Spectrum Disorder diagnosis. Ann Ist Super Sanità 2022;58:183-91. https://doi.org/10.4415/ANN_22_03_07
Clarke E, Hull L, Loomes R, McCormick CEB, Sheinkopf SJ, Mandy W. Assessing gender differences in autism spectrum disorder using the Gendered Autism Behavioral Scale (GABS): An exploratory study. Res Autism Spectrum Dis 2021;88:101844. https://doi.org/10.1016/j.rasd.2021.101844
Davidovitch M, Gazit S, Patalon T, Leitner Y, Rotem RS. Late diagnosis of autism spectrum disorder—Journey, parents’ concerns, and sex influences. Autism Res 2022;16:294-301. https://doi.org/10.1002/aur.2869
Demulier D, Mousset E, Kurzeja N, Evrard S, Wintgens A. Signes cliniques précoces chez les enfants porteurs d’un TSA léger: description et effet de genre. Neuropsychiatr Enfance Adoles 2023;71:186-93. https://doi.org/10.1016/j.neurenf.2023.03.006
Eriksson MA, Westerlund J, Anderlid BM, Gillberg C, Fernell E. First-degree relatives of young children with autism spectrum disorders: Some gender aspects. Res Develop Disabil 2012;33:1642-8. https://doi.org/10.1016/j.ridd.2012.03.025
Goodwin A, Matthews NL, Smith CJ. Parent-reported early symptoms of autism spectrum disorder in children without intellectual disability who were diagnosed at school age. Autism 2018;23:136236131877724. https://doi.org/10.1177/1362361318777243
Remnélius KL, Bölte S. Camouflaging in Autism: Age Effects and Cross-Cultural Validation of the Camouflaging Autistic Traits Questionnaire (CAT-Q). J Autism Develop Dis 2023;15:1-16. https://doi.org/10.1007/s10803-023-05909-8
Oswald TM, Winter-Messiers MA, Gibson B, Schmidt AM, Herr CM, Solomon M. Sex Differences in Internalizing Problems During Adolescence in Autism Spectrum Disorder. J Autism Develop Dis 2015;46:624-36. https://doi.org/10.1007/s10803-015-2608-1
Penner M, Dupuis A, Arnold P, Ayub M, Crosbie J, Georgiades S, et al. Pubertal stage, sex and behaviour in neurodevelopmental disorders versus typical development: a cross-sectional study. BMJ Paed Open 2022;6:e001469. https://doi.org/10.1136/bmjpo-2022-001469
Seers K, Hogg R. “Fake it ‘till you make it”: Authenticity and wellbeing in late diagnosed autistic women. Fem Psychol 2022;33:23-41. https://doi.org/10.1177/09593535221101455
Leedham A, Thompson AR, Smith R, Freeth M. “I was exhausted trying to figure it out”: The experiences of females receiving an autism diagnosis in middle to late adulthood. Autism 2019;24:135-46. https://doi.org/10.1177/1362361319853442
Sivadasan A, Christie LG. Gender Differences in Autism: TED Talks as Inclusive Spaces for Co-creation of Collective Memories. Stud Media Commun 2023;11:153-9. https://doi.org/10.1371/journal.pone.0287808
Mandy W, Midouhas E, Hosozawa M, Cable N, Sacker A, Flouri E. Mental health and social difficulties of late‐diagnosed autistic children, across childhood and adolescence. J Child Psychol Psychiatr 2022;63:1405-14. https://doi.org/10.1111/jcpp.13587
Malwane MI, Nguyen EB, Trejo S, Kim EY, Cucalón-Calderón JR. A Delayed Diagnosis of Autism Spectrum Disorder in the Setting of Complex Attention Deficit Hyperactivity Disorder. Cureus 2022;14:e25825. https://doi.org/10.7759/cureus.25825
Lee JK, Andrews DS, Ozonoff S, Solomon M, Rogers S, Amaral DG, et al. Longitudinal Evaluation of Cerebral Growth Across Childhood in Boys and Girls With Autism Spectrum Disorder. Biolog Psychiatr 2020;90:286-94. https://doi.org/10.1016/j.biopsych.2020.10.014
Melancia F, Schiavi S, Servadio M, Cartocci V, Campolongo P, Palmery M, et al. Sex-specific autistic endophenotypes induced by prenatal exposure to valproic acid involve anandamide signalling. Bri J Pharmacol 2018;175:3699-712. https://doi.org/10.1111/bph.14435
Milner V, Colvert E, Mandy W, Happé F. A comparison of self‐report and discrepancy measures of camouflaging: Exploring sex differences in diagnosed autistic versus high autistic trait young adults. Autism Res 2022;16:580-90. https://doi.org/10.1002/aur.2873
Mitroulaki S, Serdari A, Tripsianis G, Gundelfinger R, Arvaniti A, Vorvolakos T, et al. First Alarm and Time of Diagnosis in Autism Spectrum Disorders. Compr Child Adoles Nurs 2020;45:1-17. https://doi.org/10.1080/24694193.2020.1834013
Morton C. Not Like All the Other Horses: Neurodiversity and the Case of Rose Williams. Tenn Williams Ann Rev 2012;13:3-18. https://doi.org/10.2307/45344159
Obaydi H, Puri B. Prevalence of Premenstrual Syndrome in Autism: A Prospective Observer-rated Study. J Inter Med Res 2008;36:268-72. https://doi.org/10.1177/147323000803600208
Wigham S, Ingham B, Le Couteur A, Wilson C, Ensum I, Parr JR. A survey of autistic adults, relatives and clinical teams in the United Kingdom: And Delphi process consensus statements on optimal autism diagnostic assessment for adults. Autism 2022;26:1959-72. https://doi.org/10.1177/13623613211073020
Sochacka AJ. Rewriting Normal: A Discourse Analysis of TEDx Speeches on Neurodiversity and Autism. Nord J Eng Stu 2022;21:166-94. https://doi.org/10.35360/njes.780
Sweetmore V. Mental health nursing and autism: I am a mental health nurse so why did it take me so long to realize I’m autistic? J Psychiatr Mental Health Nurs 2022;29:770-3. https://doi.org/10.1111/jpm.12762
Tsompanidis A, Blanken L, Broere-Brown ZA, van Rijn BB, Baron-Cohen S, Tiemeier H. Sex differences in placenta-derived markers and later autistic traits in children. Translat Psychiatr 2023;13:256. https://doi.org/10.1038/s41398-023-02552-w
Bradley L, Shaw R, Cohen SB, Cassidy S. Autistic Adults’ Experiences of Camouflaging and Its Perceived Impact on Mental Health. Autism Adulth 2021;3:320-9. https://doi.org/10.1089/aut.2020.0071
Belcher HL, Zamir SM, Stagg SD, Ford RM. Shining a Light on a Hidden Population: Social Functioning and Mental Health in Women Reporting Autistic Traits But Lacking Diagnosis. J Autism Develop Dis 2023;53:3118-32. https://doi.org/10.1007/s10803-022-05583-2
Bargiela S, Steward R, Mandy W. The Experiences of Late-diagnosed Women with Autism Spectrum Conditions: An Investigation of the Female Autism Phenotype. J Autism Develop Dis 2016;46:3281-94. https://doi.org/10.1007/s10803-016-2872-8
Halvorsen M, Mathiassen B, Myrbakk E, Brøndbo PH, Sætrum A, Steinsvik OO, et al. Neurodevelopmental correlates of behavioural and emotional problems in a neuropaediatric sample. Res Develop Disabil 2019;85:217-28. https://doi.org/10.1016/j.ridd.2018.11.005
Hamdani Y, Kassee C, Walker M, Lunsky Y, Gladstone B, Sawyer A, et al. Roadblocks and detours on pathways to a clinical diagnosis of autism for girls and women: A qualitative secondary analysis. Womens Health 2023;19:174550572311637. https://doi.org/10.1177/17455057231163761
Hosozawa M, Sacker A, Mandy W, Midouhas E, Flouri E, Cable N. Determinants of an autism spectrum disorder diagnosis in childhood and adolescence: Evidence from the UK Millennium Cohort Study. Autism 2020;24:1557-65. https://doi.org/10.1177/1362361320913671
Hosozawa M, Sacker A, Cable N. Timing of diagnosis, depression and self-harm in adolescents with autism spectrum disorder. Autism 2021;25:70-8. https://doi.org/10.1177/1362361320945540
Kentrou V, Veld DM, Mataw KJ, Begeer S. Delayed autism spectrum disorder recognition in children and adolescents previously diagnosed with attention-deficit/hyperactivity disorder. Autism 2019;23:1065-72. https://doi.org/10.1177/1362361318785171
Descargas
Publicado
Cómo citar
Número
Sección
Licencia
Derechos de autor 2023 André Gonçalves Vasconcelos Soares, Hellen Carvalho da Silva, Leonardo Aquino Vidal, Maria Altina de Andrade Bonilla, Maria Eduarda Magalhães Tôrres, Maria Júlia Nascimento de Lima, Marina Alves de Santana, Mylena Etelvina de Macedo Alves, Uandra Ellen Santana Paz, Hugo Rafael de Souza e Silva
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
##plugins.generic.dates.accepted## 2023-10-30
##plugins.generic.dates.published## 2023-11-22
Português
English
Español
