Greta Thunberg has recently turned 18 and has also become an adult with Asperger syndrome, an autistic spectrum disorder (it concerns about 1% of the population) which can go through for a long time, thus causing a diagnosis often more late than that of other forms of autism.
She discovered him at 13, but many others coexist all our life without knowing it, however suffering because of their emotional difficulties, of feeling different and unable to establish relationships with others.
The same happens to those who have the Attention deficit disorder and hyperactivity (ADHD), which is estimated to concern 2% of the population in Italy, about one million adults. But he is aware of it less than one in five.
These are people who struggle in everyday life because they are too much impulsive and disorganizedunable to focus or manage stress and emotions. A more serene life thanks to targeted interventions is also possible in adults, but the first step is to get to the correct diagnosis quickly.
Neurosviluppo disorders
THE Neurosviluppo disorders They manifest themselves in the early years of age, therefore they fall within the work of childhood neuropsychiatrists, which historically, first recognized and studied them.
Also still the focus of research is mainly centered on this age group, but we know well that these disorders also persist in adulthood; In fact, even if their manifestations change in relation to the development of each individual, the most characteristic aspects of neurosviluppo disorders are usually maintained, so as to compromise the well -being of those who are affected in every phase of life.
Unfortunately, as reported above, cases in which the symptoms remain without diagnosis well beyond eighteen years are not rare: in fact in fact the adultADHD and autistic spectrum disorders (especially in the most attenuated forms, the Asperger syndrome can be masked by other psychopathological conditions that often determine precisely because the adaptation strategies implemented by the subjects who are affected often are insufficient to maintain a good functioning in work, in the study, in relationships, effectively exposing the patient to continuous stress and psychological trauma.
Before analyzing these evolutionary phenomena more in depth, a reference to the fundamental diagnostic criteria that identify these two pathologies is appropriate.
Diagnostic criteria
The fundamental characteristics of Autistic spectrum disorder I am:
- Deficit of social interaction, which is expressed with the inability to maintain the normal reciprocity of the conversation, with a reduced sharing of interests, emotions or feelings, in the absence of empathy towards peers;
- Deficit of non -verbal communication behavior, such as anomalies of visual contact and body language, deficit of understanding and using gestures; up to a total lack of facial expressiveness;
- presence of repetitive interests, movements or eloquils, with adherence to routine without flexibility (e.g., extreme discomfort in front of small changes, rigid thought patterns, ritual greetings, need to travel the same road or eat the same food every day);
- Hyper or hypeactivity in response to sensory stimuli, or incongruous interests towards sensory aspects of the environment with reaction of aversion to sounds or light sources.
We then report the constitutive elements of the attention deficit and/or hyperactivity (English acronym ADHD) which affects between 5 and 7% of school age subjects.
The inattention deficit and hyperactivity (ADHD)
The child with hyperactivity:
- struggles to stand still or sitting, it takes on twisted positions
- puts in place a series of absolutely Afinal motor activities
- Play in a noisy and disorganized way
- It has excessive verbalizations.
Attentive deficit is manifested by:
- attentive lability
- interruption and difficulty following the speeches of others
- inconstancy in following the rules
- difficulty in organizing
- Loss of objects
- great ease to distract themselves with any stimulus present in the environment
- problems in carrying out or completing trivial tasks or routine activities
Finally, impulsiveness is expressed as:
- inability to reflect
- difficulty waiting or respecting your turn
- struggles to predict the consequences of an action, with the result of often exposing themselves to dangerous situations
- tendency to provide uncontrolled responses, to disturb and interrupt others, to express themselves with an excessive eloquium and not modifiable from the limitations of the social context.
Neurosviluppo disorders in adults
For a long time it was considered that neurosviluppo disorders could occur almost exclusively in the evolutionary agewith a subsequent tendency to the mitigation of the symptoms, so as to remain in an under -rough dimension, therefore unknown and, consequently, not adequately treated, because it is without adequate recognition in the context of adult mental health services.
Instead, it was clear that often adhds and autism can remain in adulthoodmodifying the methods of expression according to age.
The reasons of the metamorphosis syndromic of these pathologies from childhood to adulthood are at least two:
- An adult who has lived with the disorder for years may have learned compensatory strategies to reduce their impact on global operation;
- Some symptoms change spontaneously: for example, hyperactivity decreases with age in each individual, while other symptoms, although not increasing in intensity, become more evident for the different impact on the style and quality of life of the adult.
Autism and Adhd: how to recognize them in adulthood
The first step to get to the diagnosis is to recognize the alarm bells of neuro development disorders in the adult.
Indicative elements of autism in adulthood
- scarce capacity for interaction and social communication
- low self -esteem
- limited interest and, at times, obsessive, with a great need for fixed routine
- Wide range of confined and very particular behaviors and interests
- lack of flexibility of thought
- poor ability of autonomy in life choices
- considerable difficulties in facing changes within their environment
- lack of spontaneity and initiative
- Possible presence of aggressive behaviors (direct or straight cars)
- Routine attachment as a safety valve to maintain predictability and control in one’s life.
Indicative elements of ADHD in adulthood
Scope
- Persistent motor hyperactivity with behaviors not adequate to an adult
- Attention deficit
- Affective lability, frequent changes in mood and substance abuse
- Poor self -control and tolerance of frustrations, impulsiveness, easy irritability and recourse to violence
- Inadequate response to stress
- Inadequate social skills
- Low self -esteem
- Increase in road accidents for increased risk of exceeding speed limits
Workplace
- Inability to give priorities to plan and complete a task, with the consequence of frequent work failures and repeated changes of work
- Less reliability
- Frequent absences
- Conflicts with superiors and colleagues
- Decrease in productivity
- Lower salary
Family
- Relational difficulties
- Tendency to stop affective relationships
- Risk of intra -family violence
- Greater propensity to divorces and separations
- Frequent change of home
- Stronger rivalry between brothers
It should therefore be remembered that neurosviluppo disorders, despite progress in knowledge, diagnosis and early interventions, typically Lifetime pathology remain: i Children with autism or ADHD almost always become autistic adults or with ADHDbecause the diagnosis, during the course of life, has very strong stability.
This obviously does not mean that nothing silent. Let alone that there is nothing to do to treat these situations.
Pharmacological treatments
Unlike what happens in children, drugs are the first choice in adults.
For the ADHD, the most used drug is Metilfenida, which however cannot be prescribed in our country after 18 years.
One aspect that strongly limits its use, which is why in Italy the only drug approved for the adult with ADHD is atomoxetine, which leads to a remission of the disorder 60-70% of the patients treated, acting mainly on the frontal cortex.
Unfortunately, despite the therapeutic possibilities, it is estimated that still 10% of adults with ADHD is still treated.
As for autism, there are no specific drugs to improve the central aspects of this pathology, but the simultaneous presence of other psychiatric diseases (depression, anxiety, obsessive-compulsive disorder and bipolar disorder) commonly associated, means that a treatment of these pathological forms can still improve the general psychic framework.
In the face of this picture, it is difficult to think that adult psychiatry can continue to ignore this problem, but the question requires collaboration between the area of infantile mental health and that of adulthood, also to create information campaigns aimed at spreading awareness of the need to deal with people with neurosviluppo diseases throughout their life.
