Experts explain why autism is more often diagnosed in adults

The diagnosis of autism has become more common for adults, especially women, as the concepts and methods of diagnosis have changed. This was told by the experts interviewed by RBC.

The term autism was originally coined by Eigen Bleuler in 1911, when it was used to describe the symptoms of schizophrenia. For some time, autism was perceived as a feature of mental development in childhood, but later it became clear that it persists throughout life, noted a psychiatrist, MD, head of the medical and psychological center Solution Ivan Martynikhin.

Why do adults now receive this diagnosis? Because when they were small, they didn't have these concepts, they didn't diagnose them that way. This is <...> the process of the last 20 years, when modern diagnostics began, it is constantly expanding, adjusting, said Martynikhin.

Many people who were diagnosed with autism in their 30s and 40s had previously been treated for other disorders, including depression and anxiety. People who have lived with a diagnosis of schizophrenia for many years are sometimes also switched to autism.

“Now we look a little bit from a new angle and realize that it’s not actually schizophrenia in a narrow biological sense.” This may indeed be part of what we used to call schizophrenia, which is actually the same childhood autism as an adult. Therefore, in some people with schizophrenia, we change the diagnosis to autism, the expert explained.

Martynikhin stressed that earlier in the classification of diseases autism and mental retardation “always were on the margins”, but in the latest versions of documents, including in ICD-11, measures of mental development are in the first place.

He pointed out that thanks to the new diagnosis, many people who were previously considered incurable people with bad behavior can now receive medical care. The expert noted that with autism, the main thing is not drug therapy, but training in social skills.

“There are many advocates now who advocate for the recognition of people diagnosed with the autism spectrum. These are features of development, a significant part of which, a person can not change, not make him live according to the standards of an ordinary person, the doctor added.

According to Martynikhin, the number of people diagnosed with autism has increased by 600% since the registration of the diagnosis began in 2014. According to the expert, Russia is approaching international standards for the detection of autism in children, but in adults “it is very sad.”.

In adulthood, high-functioning forms that occur without intellectual and speech disorders are more often diagnosed, said psychiatrist, MD Anna Portnova. In this case, people often turn to psychologists because of social problems, and a specialist may suspect that they are caused by autistic traits.

“Quite often in women, because girls, because of their adaptability, are more likely to master social patterns ... and less likely to notice strange behaviors than boys, that is, they are better suited to the demands of their environment. They're not taken to specialists. When a person grows up, he realizes that something is wrong with him, and looks for the reasons for this, Portnova concluded.

Autism or autism spectrum disorders (ASD) is a violation of the development of the nervous system due to the peculiarities of the brain, which manifests itself in early childhood to three years. This condition is incurable. People with ASD often experience difficulties in social interaction, communication, unusual interests, and repetitive, stereotypical behaviors.

In 2024, according to Rosstat, 76,096 children with ASD and 5,059 adults with ASD were registered in Russia.

In the spring, the Russian Society of Psychiatrists developed clinical recommendations for autism spectrum disorders (ASD) in children. It proposed to expand the list of drugs for the relief of various associated ASD conditions. The document also indicated that one of the fundamental principles of management of patients with ASD is the integrated use of medical and non-drug treatment methods in combination with social work with the child's family.

At the same time, doctors and associations criticized the shift in focus on drug therapy. In particular, Evgenia Petelchuk, development director of the Anton Here Near Foundation, told RBC that working with children with ASD can be built as a comprehensive support system, and not as a set of medical appointments. According to her, the role of the doctor is not in the selection of the drug, but in the timely diagnosis and routing of the family further into the care system.