Pharmacological Treatment of Autism Spectrum Disorder: Evidence and Clinical Decision Making in Practice

Abstract

In the diagnosis of autism spectrum disorder (ASD), in cases where there is no accompanying intellectual disability, it can be difficult to distinguish from typical development on the surface due to compensatory adaptation through high intellectual ability. In addition, the basic characteristics are often difficult to grasp due to changes in symptom expression depending on the developmental stage and the long-term compensatory adaptation in adulthood. In particular, in women, the acquisition of compensatory strategies in social imitation and interpersonal relationships tends to make it difficult to see the typical ASD characteristics. Furthermore, when comorbidities such as anxiety disorders and mood disorders come to the fore, it becomes difficult to assess the underlying ASD characteristics. For diagnosis, it is necessary to carefully observe the patient's behavior in multiple situations and to listen to a detailed developmental history. It is also essential to conduct a comprehensive evaluation that takes into account the differences in symptom expression due to developmental stage and gender differences, as well as the impact of comorbid conditions. In particular, it is necessary to pay attention to the difficulties that become apparent due to changes in the environment in high-functioning cases that show compensatory adaptation. It is hoped that this multifaceted evaluation will lead to more appropriate diagnosis and support.