한빛사논문
Marco Solmi1,2,3,4,5,51, Minjin Song6,51, Dong Keon Yon7,8,51, Seung Won Lee9,10,51, Eric Fombonne11,12, Min Seo Kim13, Seoyeon Park6, Min Ho Lee6, Jimin Hwang14, Roberto Keller15, Ai Koyanagi16,17, Louis Jacob16,18, Elena Dragioti19,20, Lee Smith21, Christoph U. Correll22,23,24,25, Paolo Fusar-Poli4,26,27,28, Giovanni Croatto29, Andre F. Carvalho30, Jae Won Oh31, San Lee31,32, Corentin J. Gosling5,33,34, Keun-Ah Cheon35, Dimitris Mavridis36,37, Che-Sheng Chu38,39,40, Chih-Sung Liang41,42, Joaquim Radua4,43,44, Laurent Boyer45, Guillaume Fond45, Jae Il Shin46,* and Samuele Cortese5,47,48,49,50
1Department of Psychiatry, University of Ottawa, Ontario, ON, Canada. 2Department of Mental Health, The Ottawa Hospital, Ontario, ON, Canada. 3Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program University of Ottawa, Ottawa, ON, Canada. 4Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology, King’s College London, London, UK. 5Centre for Innovation in Mental Health (CIMH), School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK. 6Yonsei University College of Medicine, Seoul, Republic of Korea. 7Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, Republic of Korea. 8Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Republic of Korea. 9Department of Data Science, Sejong University College of Software Convergence, Seoul, South Korea. 10Sungkyunkwan University School of Medicine, Suwon, Republic of Korea. 11Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA. 12Department of Pediatrics, Oregon Health & Science University, Portland, OR, USA. 13Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea. 14Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. 15Adult Autism Center, Mental Health Department, Health Unit ASL Città di Torino, 10138 Turin, Italy. 16Parc Sanitari Sant Joan de Déu/CIBERSAM/ISCIII, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, 08830 Barcelona, Spain. 17ICREA, Pg. Lluis Companys 23, Barcelona, Spain. 18Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux 78180, France. 19Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linkoping University, SE-581 85 Linkoping, Sweden. 20Research Laboratory Psychology of Patients, Families & Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina 45500, Greece. 21Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge CB1 1PT, UK. 22Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, New York City, NY, USA. 23Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA. 24Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY, USA. 25Department of Child and Adolescent Psychiatry, Charité-Universitätsmedizin Berlin, Berlin, Germany. 26Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy. 27OASIS service, South London and Maudsley NHS Foundation Trust, London, UK. 28National Institute for Health Research, Maudsley Biomedical Research Centre, London, UK. 29Department of mental health, AULSS3 Serenissima, Veneto, Italy. 30IMPACT (Innovation in Mental and Physical Health and Clinical Treatment) Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia. 31Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea. 32Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. 33DysCo Lab, Paris Nanterre University, Nanterre, France. 34Laboratoire de Psychopathologie et Processus de Santé, Université de Paris, Paris, France. 35Division of Child and Adolescent Psychiatry, Department of Psychiatry, Severance Hospital, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea. 36Department of Primary Education, Evidence Synthesis Methods Team, University of Ioannina, Ioannina, Greece. 37Faculté de Médecine, Paris Descartes University, Sorbonne Paris Cité, Paris, France. 38Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan. 39Center for Geriatric and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan. 40Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan. 41Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan. 42Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 11490, Taiwan. 43Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain. 44Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Stockholm, Sweden. 45AP-HM, Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, Fondation FondaMental, Marseille, France. 46Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea. 47Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK. 48Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK. 49Hassenfeld Children’s Hospital at NYU Langone, New York University Child Study Center, New York City, NY, USA. 50Solent NHS Trust, Child and Adolescent Mental Health Service (CAMHS), Southampton, UK. 51These authors contributed equally: Marco Solmi, Minjin Song, Dong Keon Yon, Seung Won Lee.
*Corresponding author.
Abstract
Autism spectrum disorder (ASD) substantially contributes to the burden of mental disorders. Improved awareness and changes in diagnostic criteria of ASD may have influenced the diagnostic rates of ASD. However, while data on trends in diagnostic rates in some individual countries have been published, updated estimates of diagnostic rate trends and ASD-related disability at the global level are lacking. Here, we used the Global Burden of Diseases, Injuries, and Risk Factors Study data to address this gap, focusing on changes in prevalence, incidence, and disability-adjusted life years (DALYs) of ASD across the world. From 1990 to 2019, overall age-standardized estimates remained stable globally. Both prevalence and DALYs increased in countries with high socio-demographic index (SDI). However, the age-standardized incidence decreased in some low SDI countries, indicating a need to improve awareness. The male/female ratio decreased between 1990 and 2019, possibly accounted for by increasing clinical attention to ASD in females. Our results suggest that ASD detection in low SDI countries is suboptimal, and that ASD prevention/treatment in countries with high SDI should be improved, considering the increasing prevalence of the disorder. Additionally, growing attention is being paid to ASD diagnosis in females, who might have been left behind by ASD epidemiologic and clinical research previously. ASD burden estimates are underestimated as GBD does not account for mortality in ASD.
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