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Out and About

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It’s always good to get out into the real world, to share my ideas face to face. I was fortunate enough to be invited to give a presentation this past week at the Autism Society of America’s annual national convention: (Mental Illness in ASD – The Elephant in the Room  ). It was hard trying to squeeze six hours of material into a 75 minute session, but I managed to cover the key points:
  • The bright line between ASD and “mental illness” is a myth.
  • DSM-5 perpetuates the “gumball model” of psychiatric diagnosis: A given patient may have one or more discrete disorders, that happen to co-exist. “Co-Morbidity” is the necessary fiction on which this model rests. In reality, disorders shade into one another along a continuum, or undergo metamorphosis over time.
  • ASD, Schizophrenia, ADD, Bipolar Disorder, Generalized Anxiety Disorder and Depression have shared biological roots. A given genetic defect can give rise to disorders that “look different” on the surface (pleiotropy). Conversely, disorders that look the same on the surface may actually be due to very different underlying genetic mechanisms (phenocopies).

Myth and Reality in the etiology and classification of ASD and mental illness.

 (Click on graph to enlarge.)


Myth and Reality in the etiology and classification of ASD and mental illness

  • The overall prevalence of criminal behavior in persons with ASD is unknown. More relevant that the average risk, however, is the importance of identifying persons with ASD who may be at increased risk, and taking preventive action to avert future tragedies such as Newtown.
  • The combination of untreated mental health issues in a parent, plus ASD (with or without additional mental health issues), may be a key risk factor (My personal experience; not bolstered by data as yet).
  • Improving long-term outcome for persons with ASD will hinge, in part, upon the willingness of the autism community to make common cause with the mental health community, with respect to advocating for preventive and supportive mental health services for children and adults.

I haven’t gotten the audience reviews back yet, but the people who came up to me after the session — including parents, professionals, and adults on the spectrum – were all appreciative, despite the difficult nature of the material itself.

Next week we shall return to our regular programming.



Making Sense of Autistic Spectrum Disorder




James Coplan, MD is an Internationally recognized clinician, author, and public speaker in the fields of early child development, early language development and autistic spectrum disorders. Stay connected, join Dr. Coplan on Facebook and Twitter.





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