O contexto do diagnóstico da síndrome de Asperger

Abstract

Pervasive developmental disorders (PDDs) have symptomatic heterogeneity and a little known etiology, with the involvement of genetic and environmental factors. They are part of a group of five disorders, including Asperger syndrome (AS), which has the greatest diagnostic difficulty, because of the symptoms similar to other psychiatric conditions and also because of the lack of clarity with regard to diagnostic criteria included in the official classifications. This study evaluated the diagnostic context of AS. Forty-five individuals were investigated, 39 men and 06 women (6,5:1) with conclusive diagnosis of AS, confirmed by using a standard instrument. Parents or caretakers were interviewed according to a questionnaire designed by the author. On average, at the age of 3,3 symptomatic perception was observed by the parents (55%) but the first physical examination of children was only performed at the average age of 5,3.The time interval between symptomatic perception and conclusive diagnosis was 8,5 years, on average. The attention deficit disorder and hyperactivity (TDA/H-33,3%) was the most common diagnosis before obtaining a diagnosis of AS, in isolation or in combination with other diagnoses. The psychiatrist was responsible for the conclusive diagnosis in 77,8% of cases, on average, at the age of 11,8. The recommendations given by professionals who concluded the diagnosis of AS were: regular attendance to school (68,9%), considering seeing a psychologist (57,8%), making use of medicines (57,8%), considering seeing a speech-language pathologist (37,8%) and carrying out genetic evaluation (35,6%). The results revealed that: 1) symptoms of AS are usually noticed first by parents; 2) after considering the symptoms the first clinical examination of children is generally carried out at late age; 3) TDA/H in isolation or in combination with other diagnoses is the most frequent and mistakenly given to patients before the conclusion of AS, which is drawn late and is most frequently accomplished by a psychiatrist. In addition, the recommendations to instruct parents after the diagnosis of AS are unsatisfactory. Therefore, the diagnostic context of Asperger syndrome is complex and difficult, probably worsened by the lack of preparation of health professionals to detect the symptoms, aggravated by the lack of experts in the disorder or by the difficulties in the accessibility to specialized health professionals.