A follow-up survey was conducted on 201 young adults with autism who were 18 or older (mean age, 21.5). All had participated previously in intensive therapeutic camping or had therapeutic involvement at medical consultation agencies to evaluate their outcome. Their social outcome was better than that previously reported in Japan. Although 31.5% had shown marked deterioration during adolescence, 43.2% had shown marked improvement during that period. Possible factors contributing to these results are discussed.
From among the subjects of a follow-up study on cases of autism conducted by the authors in 1990, 179 cases for which precise records were available on the infancy period were selected for evaluation of the relationship between the occurrence of setback phenomenon in infancy and long-term prognosis. The following results were obtained: (i) a significantly higher rate of epilepsy among the setback group compared to the non-setback group; and (ii) a significantly lower level of language development among the setback group upon entering elementary school compared to the non-setback group, although the difference between the present levels of adaptation of the two groups was not significant. Factors determining the long-term prognosis of the setback group are discussed.
Key wordsA survey was conducted on the present behavioral characteristics of 187 cases of adult autism in patients over 18 years of age employing Achenbach's Child Behavior Checklist (CBCL), When their behavioral characteristics were evaluated in relation to Present Language Developmental Level (PLDL) and Present Adaptive Level (PAL), it was seen that greater variation in behavior characteristics was seen among those exhibiting increasingly lower PLDL and PAL scores, Behavior characteristics reminiscent of depression were noted even among those exhibiting high PLDL Behavior pointing to obsession was found in common among almost all cases of autism irrespective ofPLDL or PAL Psychotic symptoms such as hallucinations and delusions were absent in most cases, The results of the present study were indicative not only of the significance of obsessive behavior in autism, but also its significance in terms of delving further into the psychopathology of the disorder.Achenbach's Child Behavior Checklist (CBCL), autism in adults, depression, obsession, schizophrenia, INTRODUCTION Today, it is well known that autism is not a disorder restricted to infancy, but a disorder in which impairn1ent of some sort will persist throughout life. The results oflong-tern1 follow-up study on autism have mostly been pessimistic,I-:; although recent results indicate considerable improvement in the prog-. . 6 nostlc pIcture. Because autism is a syndrome defined by characteristics of behavior, there is considerable range in the level of mental development involved. In particular, the behavioral characteristics of autism upon reaching adulthood are quite varied, reflecting this dispariry in mental development. For this reason, any attempt to capture a comprehensive pathological picture of autism in adulthood invariably incurs great difficulry. Apart from the follow-up studies, there have been a number of reports to date on the behavioral characteristics of subjects with autism in adulthood 7 Despite improvement in the overall prognosis for autism, the studies demonstrate that conduct disorders and ego disturbances remain quite severe in such patients.In comparative studies on behavior characteristics in tern1S of difference in the level of intellectual development,S.9 a high incidence of self-injurious behavior and stereorypic behavior is reported for groups exhibiting low levels of development. sHowever, such studies rarely address the behavior characteristics in adulthood. Previous reports on behavior characteristics in adulthood have been insufficient for comprehensive clarification due to limitations in the number of subjects, or great deviation among the object group. Furthermore, many points remain unclear COITespondt"IlCl' address: Ryuji Kobayashi. MD, I'hD, Tokai University School of Health Sciences. Bohseidai. he-hara. Kallagawa 25Y-tl 43. Japan.
Abstract.e d fi-oin Through the daily treatment ofdepressive adolescents we have come to feel that such cases present with a coninion specific state at onset that includes hypersensitivity and a tendency to neuroticism.This state is reminiscent of the introverted character of children reported by Shimoda in 1929 and of immodithyniic character that he later proposed as the pre-pathological character of bipolar disorders. In contrast, we supposed that it might be important to evaluate these adolescents from the low self-worth theory and to compare adolescent psychopathology between the USA and Japan. In order to ascertain these issues, we performed a clinical survey of tlie junior and high school students who came to outpatient clinics, and thereby demonstrated the necessity of understanding the depressive adolescents froni tlie standpoint of character theory and self-worth theory.We then attempted some field work with ordinary junior high school children as object using Harter's self-perception profile and Kovac's CDI.The results showed that depressive tendencies and self-worth differed greatly among Japanese junior high school children and American counterparts. We have used these findings to discuss the psychopathology of depressive tendencies in Japanese adolescents. DEPRESSIVE CONDITION DURING ADOLESCENCE IN JAPAN
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