| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 504.94 KB | Adobe PDF |
Authors
Advisor(s)
Abstract(s)
Introdução: As diferenças de género na expressão dos sinais/sintomas associados à
Perturbação do Espetro do Autismo (PEA) são um tópico crescente na comunidade
científica, nomeadamente pelo que implicam a nível do diagnóstico. Dada a diferença de
prevalência da doença nos géneros, com a maioria masculina, e a forma distinta como
esta se manifesta em doentes do sexo masculino e do sexo feminino, tem vindo a ser
debatida a possibilidade de os métodos de diagnóstico utilizados terem um viés
masculino, contribuindo para o possível subdiagnóstico feminino da PEA.
Objetivo: Análise das discrepâncias de género a nível de apresentação clínica na PEA,
investigação de possível subdiagnóstico no sexo feminino e exploração da relação entre
género e processo de diagnóstico.
Métodos: Adoção do método PEO (People, Exposure, Outcomes) para a definição da
pergunta de investigação, do modelo PRISMA (Preferred Reporting Items for
Systematic Reviews and Meta-Analyses) para orientação da revisão e utilização da base
de dados PubMed para pesquisa. Foram incluídos estudos que investigaram diferenças
de sexo/género da PEA em crianças, adolescentes e jovens adultos, com foco nas
implicações diagnósticas e aplicados critérios rigorosos de inclusão e exclusão para a
seleção dos artigos.
Resultados: Os principais resultados desta revisão revelam uma predominância
masculina nas amostras dos estudos, assim como a maioria dos estudos se focou em
crianças até aos 18 anos. Relataram-se diferenças significativas de sexo/género na
apresentação da PEA na maioria dos estudos, com o sexo feminino exibindo maior
prática de camuflagem social. As participantes femininas demonstraram, também,
maiores défices de competências sociais e o sexo masculino apresentou uma maior
associação a comportamentos restritivos e repetitivos. Em relação a idades de
diagnóstico, estas tendem a ser mais tardias no sexo feminino. Adicionalmente, as
metodologias variaram, mas a observação direta, a utilização de relatos dos
pais/cuidadores e a equiparação das amostras segundo o nível cognitivo foram pontos
comuns.
Conclusões: A revisão destaca a evidência de diferenças de género na PEA, tanto a nível
da apresentação como de idade diagnóstica. Destaca-se a possibilidade de viés de género
nos métodos de diagnóstico e defendem-se intervenções personalizadas e formação
profissional para uma abordagem mais equitativa na identificação e apoio da PEA.
Introduction: Gender differences in the expression of signs/symptoms associated with Autism Spectrum Disorder (ASD) are a growing topic in the scientific community, particularly due to their implications for diagnosis. Given the gender prevalence difference in ASD, with the majority being male, and the distinct manifestation in males and females, the possibility of diagnostic bias towards males has been debated, potentially contributing to underdiagnosis of ASD in females. Objective: To analyze gender discrepancies in clinical presentation in ASD, investigate possible underdiagnosis in females and explore the relationship between gender and diagnostic process. Methods: Adoption of the PEO (People, Exposure, Outcomes) method to define the research question, use of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) model for review guidance and use of the PubMed database for research. Studies investigating gender differences in ASD in children, adolescents, and young adults, with a focus on diagnostic implications, were included. Rigorous inclusion and exclusion criteria were applied for article selection. Results: The main findings of this review reveal a male predominance in study samples, with most studies focusing on children up to 18 years old. Significant gender differences in ASD presentation were reported in most studies, with females exhibiting greater practice of social camouflage. Female participants also demonstrated greater deficits in social skills, while males showed a stronger association with restrictive and repetitive behaviors. Regarding age of diagnosis, females tend to be diagnosed later. Additionally, methodologies varied, but direct observation, parent/caregiver reports, and matching samples based on cognitive level were common points. Conclusions: The review highlights evidence of gender differences in ASD, both in presentation and age of diagnosis. The possibility of gender bias in diagnostic methods is emphasized, and personalized interventions and professional training are advocated for a more equitable approach to ASD identification and support.
Introduction: Gender differences in the expression of signs/symptoms associated with Autism Spectrum Disorder (ASD) are a growing topic in the scientific community, particularly due to their implications for diagnosis. Given the gender prevalence difference in ASD, with the majority being male, and the distinct manifestation in males and females, the possibility of diagnostic bias towards males has been debated, potentially contributing to underdiagnosis of ASD in females. Objective: To analyze gender discrepancies in clinical presentation in ASD, investigate possible underdiagnosis in females and explore the relationship between gender and diagnostic process. Methods: Adoption of the PEO (People, Exposure, Outcomes) method to define the research question, use of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) model for review guidance and use of the PubMed database for research. Studies investigating gender differences in ASD in children, adolescents, and young adults, with a focus on diagnostic implications, were included. Rigorous inclusion and exclusion criteria were applied for article selection. Results: The main findings of this review reveal a male predominance in study samples, with most studies focusing on children up to 18 years old. Significant gender differences in ASD presentation were reported in most studies, with females exhibiting greater practice of social camouflage. Female participants also demonstrated greater deficits in social skills, while males showed a stronger association with restrictive and repetitive behaviors. Regarding age of diagnosis, females tend to be diagnosed later. Additionally, methodologies varied, but direct observation, parent/caregiver reports, and matching samples based on cognitive level were common points. Conclusions: The review highlights evidence of gender differences in ASD, both in presentation and age of diagnosis. The possibility of gender bias in diagnostic methods is emphasized, and personalized interventions and professional training are advocated for a more equitable approach to ASD identification and support.
Description
Keywords
Autismo Diagnóstico Diferenças de Género Diferenças de Sexo