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Advisor(s)
Abstract(s)
Introdução: De acordo com o Diagnostic and Statistical Manual of Mental Disorders
(DSM-5), a Perturbação do Espetro do Autismo (PEA) é definida por défices persistentes,
em vários contextos, na interação social e comunicação. Tem vindo a reconhecer-se que
algumas pessoas com PEA, nomeadamente do género feminino, conseguem disfarçar os
seus sintomas, quer seja escamoteando-os, quer seja fazendo apelo a comportamentos
compensatórios, com o intuito de diminuir os problemas ou desafios sociais e de
comunicação. Este tipo de situação poderá estar a contribuir para um subdiagnóstico da
doença a nível global ou até mesmo para um diagnóstico incorreto.
Objetivo: Esta dissertação visa caracterizar a situação do diagnóstico de PEA
(Perturbação do Espetro do Autismo) no género feminino. Para além disso, pretende
averiguar as implicações que estas diferenças de género no diagnóstico têm na revisão
dos critérios de diagnóstico, de modo a diminuir o subdiagnóstico de PEA nas raparigas.
Método: Foi realizada uma revisão sistemática da literatura, com base nas diretrizes do
Preferred Reporting Items for Systematic Reviews and Meta-Analyses - PRISMA. A
pesquisa foi realizada nas bases de dados Pubmed e Elsevier Scopus, considerando o
intervalo temporal 2000-2022 (março) e os critérios de elegibilidade previamente
definidos.
Resultados: Dos 32 artigos inicialmente apurados, foram selecionados 9 artigos (7
estudos quantitativos e 2 estudos qualitativos) para leitura integral, tendo sido excluídos
todos aqueles que não satisfizeram os critérios de elegibilidade. Não se apurou um
número muito alargado de artigos que considerassem as palavras-chave pretendidas na
sua totalidade, contudo esses mesmos artigos obtidos foram realizados em vários países
diferentes, o que conferiu alguma representatividade geográfica a este estudo. Em
termos gerais, os estudos apresentaram consenso a nível das conclusões obtidas,
nomeadamente no que diz respeito às diferenças de género e subdiagnóstico.
Conclusões: Os estudos analisados suportam a existência de um subdiagnóstico de PEA,
mais manifesto e tardio no género feminino, resultado tanto de uma avaliação
inadequada dos traços clínicos mais característicos do fenótipo feminino, como da
perceção desajustada dos cuidadores, e ainda da existência de um “fenómeno de
camuflagem” de sinais e sintomas por parte das raparigas com PEA.
Introduction: According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Autism Spectrum Disorder (ASD) is defined by persistent deficits, in various contexts, in social interaction and communication. It has been recognized that some people with ASD, particularly females, manage to disguise their symptoms, either by hiding them or by resorting to compensatory behaviors in order to reduce social and communication problems or challenges. This type of situation may be contributing to a global underdiagnosis of the disease or even to an incorrect diagnosis. Objective: This dissertation aims to characterize the situation of ASD (Autism Spectrum Disorder) diagnosis in females. More specifically, it aims to investigate the implications that these gender differences in diagnosis have for the revision of diagnostic criteria in order to reduce the underdiagnosis of ASD in girls. Methods: A systematic literature review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses - PRISMA guidelines. The search was conducted in the Pubmed and Elsevier Scopus databases, considering the time interval 2000-2022 (March) and the previously defined eligibility criteria. Results: Of the 32 articles initially ascertained, 9 articles (7 quantitative studies and 2 qualitative studies) were selected for full reading, and all those that did not meet the eligibility criteria were excluded. We did not find a large number of articles that considered the intended keywords in their entirety; however, these same articles were obtained from several different countries, which gave some geographical representativeness to this study. In general terms, the studies showed consensus in terms of the conclusions obtained, namely regarding gender differences and underdiagnosis. Conclusions: The studies analyzed support the existence of an ASD underdiagnosis, more evident and delayed in females, resulting both from an inadequate assessment of the clinical features more characteristic of the female phenotype and from the inadequate perception of caregivers, as well as the existence of a "camouflage phenomenon" of signs and symptoms in girls with ASD.
Introduction: According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Autism Spectrum Disorder (ASD) is defined by persistent deficits, in various contexts, in social interaction and communication. It has been recognized that some people with ASD, particularly females, manage to disguise their symptoms, either by hiding them or by resorting to compensatory behaviors in order to reduce social and communication problems or challenges. This type of situation may be contributing to a global underdiagnosis of the disease or even to an incorrect diagnosis. Objective: This dissertation aims to characterize the situation of ASD (Autism Spectrum Disorder) diagnosis in females. More specifically, it aims to investigate the implications that these gender differences in diagnosis have for the revision of diagnostic criteria in order to reduce the underdiagnosis of ASD in girls. Methods: A systematic literature review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses - PRISMA guidelines. The search was conducted in the Pubmed and Elsevier Scopus databases, considering the time interval 2000-2022 (March) and the previously defined eligibility criteria. Results: Of the 32 articles initially ascertained, 9 articles (7 quantitative studies and 2 qualitative studies) were selected for full reading, and all those that did not meet the eligibility criteria were excluded. We did not find a large number of articles that considered the intended keywords in their entirety; however, these same articles were obtained from several different countries, which gave some geographical representativeness to this study. In general terms, the studies showed consensus in terms of the conclusions obtained, namely regarding gender differences and underdiagnosis. Conclusions: The studies analyzed support the existence of an ASD underdiagnosis, more evident and delayed in females, resulting both from an inadequate assessment of the clinical features more characteristic of the female phenotype and from the inadequate perception of caregivers, as well as the existence of a "camouflage phenomenon" of signs and symptoms in girls with ASD.
Description
Keywords
Diagnóstico Diferenças de Género Género Feminino Perturbação do Espetro do Autismo (Pea)