Comments of the current study on the etiology of autism spectrum disorders

Abstract

Autism spectrum disorder (ASD) was proposed in the Diagnostic and Statistical Manual of Mental Disorders version 5 (DSM-5), released May 2013. The new diagnosis encompasses previous diagnoses of autistic disorder, Asperger's syndrome, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified (PDD-NOS). So ASD is a group of developmental disabilities that can cause significant social, communication and behavioral challenges. To estimate a prevalence is 0.1%-1%. The importance of lifelong influence and social burden has attracted extensive attention and focus of research. Searching for the cause of ASD is the hotspot of medical study in China and all of the world recently. Many etiologic researches focus on genetics, brain imaging, nerve biochemistry, infection and immunity, nutrition and intestinal cerebral circulation, and neuropsychology. Obviously, many researchers and clinical experts explore the etiology of ASD from different levels and different point of view on the pathogenesis and clinical manifestation of ASD and aim to put forward effective prevention and treatment of ASD. However, it is also far away from making the etiological diagnosis and treatment of ASD. Although there were a large number of scholars and the influx of funds, a little success was achieved. There is no breakthrough discovery, and some results have been found conflicting. Especially it is lack of distinctive and specific results. In fact, it is obvious that the some current researches were fallen in many misunderstandings, the separation of clinical and basic research; no match in phenotype and genotype; no clear for single disease or composite disorders. These have seriously affected etiological research. From the fundamental analysis, the search for ASD, the biggest difficulty is the heterogeneity of the phenotype and genotype of ASD. There are many problems to determine the ASD phenotype. Most of power basic research groups are not necessarily strong in clinical diagnosis and evaluation and in contrast some power clinical research units are not relatively good in basic research. Although it is the use of both basic and clinical methods, our child psychiatrist team is weak, and the lack of strict admittance system of professional child psychiatrist. Many autism rehabilitation center established quickly in our country are lack of professional diagnosis and screening system. So the clinical cases not be standardized is the inevitable problems. In fact, the state has promulgated the guidelines for the diagnosis and treatment of autism, more accurate diagnosis and clinical phenotype determination are feasible. The key is to cooperation between basic and clinical research groups, to carry out joint research and development of specialized institutions. The etiological study of ASD is more suitable to research autistic disorder, Asperger's syndrome, childhood disintegrative disorder, and PDD-NOS respectively. Therefore, precise clinical phenotype, strict classification and diagnosis, to avoid the blindness and repetition of research are imperative. Out of misunderstanding, joint research are direction in future etiological research.