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Gender differences in psychosocial function and self-reported health status in late-diagnosed autistic adults: results from the FACE-ASD national cohort

Published online by Cambridge University Press:  30 September 2022

Julien Dubreucq Open the ORCID record for Julien Dubreucq [Opens in a new window] ,
Romain Coutelle ,
Mohamed Lajnef ,
Ophélia Godin ,
Anouck Amestoy ,
Paola Atzori ,
Jean-Marc Baleyte ,
Olivier Bonnot ,
Manuel Bouvard  and
Nathalie Coulon
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Julien Dubreucq*
Affiliation:
Fondation FondaMental, Créteil, France Centre de Neurosciences Cognitive, UMR 5229, CNRS & Université Lyon, Lyon, France Centre Expert TSA-SDI, Centre Référent de Réhabilitation Psychosociale et de Remédiation Cognitive (C3R), CH Alpes Isère, Saint-Egrève, France
Romain Coutelle
Affiliation:
Fondation FondaMental, Créteil, France Service de Psychiatrie de l'Enfant et de l'Adolescent, Centre d'Excellence STRAS&ND, Centre Expert TSA-SDI, FHU NEUROGENΨCS, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, CNRS UPR 3212, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
Mohamed Lajnef
Affiliation:
Fondation FondaMental, Créteil, France Univ Paris Est Créteil, INSERM U955, IMRB, Translational Neuro-Psychiatry, F-94010 Créteil, France
Ophélia Godin
Affiliation:
Fondation FondaMental, Créteil, France Univ Paris Est Créteil, INSERM U955, IMRB, Translational Neuro-Psychiatry, F-94010 Créteil, France
Anouck Amestoy
Affiliation:
Fondation FondaMental, Créteil, France CRA Aquitaine, 121 Rue de la Béchade, 33016 Bordeaux cedex; INCIA, UMR 5287, Neuroimaging and Human Cognition Team, Bordeaux, France
Paola Atzori
Affiliation:
Fondation FondaMental, Créteil, France Unité de Psychopathologie de l'enfant et de l'adolescent, Hôpital Salvador, Assistance Public- Hopitaux de Marseille, Université Aix-Marseille II, 13009 Marseille, France
Jean-Marc Baleyte
Affiliation:
Service de Psychiatrie de l'Enfant et de l'Adolescent, Hôpital Intercommunal de Créteil, Créteil, France
Olivier Bonnot
Affiliation:
Fondation FondaMental, Créteil, France Psychiatrie de l'Enfant et de l'Adolescent, CHU & Universite de Nantes, LPPL EA 4638 Centre Ressource Autisme Pays de la Loire, Nantes, France
Manuel Bouvard
Affiliation:
Fondation FondaMental, Créteil, France CRA Aquitaine, 121 Rue de la Béchade, 33016 Bordeaux cedex; INCIA, UMR 5287, Neuroimaging and Human Cognition Team, Bordeaux, France
Nathalie Coulon
Affiliation:
Fondation FondaMental, Créteil, France Centre Expert TSA-SDI, Centre Référent de Réhabilitation Psychosociale et de Remédiation Cognitive (C3R), CH Alpes Isère, Saint-Egrève, France
David Da Fonseca
Affiliation:
Fondation FondaMental, Créteil, France Unité de Psychopathologie de l'enfant et de l'adolescent, Hôpital Salvador, Assistance Public- Hopitaux de Marseille, Université Aix-Marseille II, 13009 Marseille, France
Caroline Demily
Affiliation:
Fondation FondaMental, Créteil, France Centre de Neurosciences Cognitive, UMR 5229, CNRS & Université Lyon, Lyon, France Centre d'excellence I-Mind, Centre de référence maladies rares Génopsy, pôle ADIS, Centre hospitalier Le Vinatier, UMR 5229, CNRS & Université Lyon 1, Université de Lyon, Lyon, France
Richard Delorme
Affiliation:
Fondation FondaMental, Créteil, France Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Aur p-HP, Hôpitaux Universitaires Henri Mondor, Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT) F-94010, Créteil, France Hôpital Robert Debré, Centre d'Excellence InoVAND, Service de Psychiatrie de l'enfant, Centre Expert TSA-SDI Paris, Paris, France
Marine Fabrowski
Affiliation:
Fondation FondaMental, Créteil, France Centre de Neurosciences Cognitive, UMR 5229, CNRS & Université Lyon, Lyon, France Centre d'excellence I-Mind, Centre de référence maladies rares Génopsy, pôle ADIS, Centre hospitalier Le Vinatier, UMR 5229, CNRS & Université Lyon 1, Université de Lyon, Lyon, France
Marion Givaudan
Affiliation:
Fondation FondaMental, Créteil, France Unité de Psychopathologie de l'enfant et de l'adolescent, Hôpital Salvador, Assistance Public- Hopitaux de Marseille, Université Aix-Marseille II, 13009 Marseille, France
Fanny Gollier-Briant
Affiliation:
Fondation FondaMental, Créteil, France Psychiatrie de l'Enfant et de l'Adolescent, CHU & Universite de Nantes, LPPL EA 4638 Centre Ressource Autisme Pays de la Loire, Nantes, France
Fabian Guenolé
Affiliation:
Fondation FondaMental, Créteil, France Caen University Hospital – Head of the department of child and adolescent psychiatry, 14 Avenue Clemenceau CS 30001, 14033 Caen Cedex 9, France
Elise Humeau
Affiliation:
Fondation FondaMental, Créteil, France Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Aur p-HP, Hôpitaux Universitaires Henri Mondor, Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT) F-94010, Créteil, France Hôpital Robert Debré, Centre d'Excellence InoVAND, Service de Psychiatrie de l'enfant, Centre Expert TSA-SDI Paris, Paris, France
Sylvain Leignier
Affiliation:
Fondation FondaMental, Créteil, France Centre Expert TSA-SDI, Centre Référent de Réhabilitation Psychosociale et de Remédiation Cognitive (C3R), CH Alpes Isère, Saint-Egrève, France
Florian Lejuste
Affiliation:
Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Aur p-HP, Hôpitaux Universitaires Henri Mondor, Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT) F-94010, Créteil, France Hôpital Robert Debré, Centre d'Excellence InoVAND, Service de Psychiatrie de l'enfant, Centre Expert TSA-SDI Paris, Paris, France Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Versailles, France
Charlotte Levy
Affiliation:
Fondation FondaMental, Créteil, France CRA Aquitaine, 121 Rue de la Béchade, 33016 Bordeaux cedex; INCIA, UMR 5287, Neuroimaging and Human Cognition Team, Bordeaux, France
Juliette Rabot
Affiliation:
Fondation FondaMental, Créteil, France Service de Psychiatrie de l'Enfant et de l'Adolescent, Centre d'Excellence STRAS&ND, Centre Expert TSA-SDI, FHU NEUROGENΨCS, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, CNRS UPR 3212, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
Carmen M. Schröder
Affiliation:
Fondation FondaMental, Créteil, France Service de Psychiatrie de l'Enfant et de l'Adolescent, Centre d'Excellence STRAS&ND, Centre Expert TSA-SDI, FHU NEUROGENΨCS, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, CNRS UPR 3212, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
Marie Valette
Affiliation:
Fondation FondaMental, Créteil, France Service de Psychiatrie Infanto-Juvénile, Centre Hospitalier de Versailles – INSERM U669, UMR-S0669, Université Paris-Sud et Université Paris-Descartes, Paris, France
Marion Leboyer
Affiliation:
Fondation FondaMental, Créteil, France Univ Paris Est Créteil, INSERM U955, IMRB, Translational Neuro-Psychiatry, F-94010 Créteil, France Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Aur p-HP, Hôpitaux Universitaires Henri Mondor, Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT) F-94010, Créteil, France Hôpital Robert Debré, Centre d'Excellence InoVAND, Service de Psychiatrie de l'enfant, Centre Expert TSA-SDI Paris, Paris, France
Mario Speranza
Affiliation:
Fondation FondaMental, Créteil, France Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Versailles, France Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Centre Hospitalier de Versailles, Versailles, France
the FACE-ASD (FondaMental Advanced Centers of Expertise for Autism Spectrum Disorder) Groups
Affiliation:
Fondation FondaMental, Créteil, France
*
Author for correspondence: Julien Dubreucq, E-mail: [email protected]
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Abstract

Background

While adult outcome in autism spectrum disorder (ASD) is generally measured using socially valued roles, it could also be understood in terms of aspects related to health status – an approach that could inform on potential gender differences.

Methods

We investigated gender differences in two aspects of outcome related to health-status, i.e. general functioning and self-perceived health status, and co-occurring health conditions in a large multi-center sample of autistic adults. Three hundred and eighty-three participants were consecutively recruited from the FondaMental Advanced Centers of Expertise for ASD cohort (a French network of seven expert centers) between 2013 and 2020. Evaluation included a medical interview, standardized scales for autism diagnosis, clinical and functional outcomes, self-perceived health status and verbal ability. Psychosocial function was measured using the Global Assessment of Functioning scale.

Results

While autistic women in this study were more likely than men to have socially valued roles, female gender was associated with poorer physical and mental health (e.g. a 7-fold risk for having three or more co-occurring physical health conditions) and a poorer self-perceived health status. Psychosocial function was negatively associated with depression and impairment in social communication. Half of the sample had multiple co-occurring health conditions but more than 70% reported that their visit at the Expert Center was their first contact with mental health services.

Conclusions

To improve objective and subjective aspects of health outcome, gender differences and a wide range of co-occurring health conditions should be taken into account when designing healthcare provision for autistic adults.

Keywords

Autism spectrum disorderco-occurring health conditionsgender differencesgeneral functioningquality of life
Type
Original Article
Information
Psychological Medicine , Volume 53 , Issue 12 , September 2023 , pp. 5674 - 5684
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Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press

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Footnotes

*

List of FondaMental Advanced Center of Expertise (FACE-ASD) collaborators:

FACE-ASD Clinical Coordinating Center (Fondation FondaMental); R. Coutelle, M. Speranza, M. Leboyer and PM Llorca;

FACE-SZ Data Coordinating Center (Fondation FondaMental); V. Barteau, S. Bensalem, O. Godin, H. Laouamri and K. Souryis;

FACE-ASD Clinical Sites and Principal Collaborators in France;

AP-HP, INSERM U955, Translational Psychiatry Team, Centre Expert TSA-SDI, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires Henri Mondor, Paris Est University, 40 rue de Mesly, 94000 Créteil, France: M. Leboyer, F. Lejuste; Centre Excellence InoVAND, Service de Psychiatrie de l'enfant, Centre Expert TSA-SDI Paris, France: R. Delorme, E. Humeau, A. Cartigny; Service de psychiatrie de l'enfant et de l'adolescent, CHI Créteil: J. M Baylete; CRA Aquitaine, 121 Rue de la Béchade, 33016 Bordeaux cedex: A. Amestoy, M. Bouvard, C. Levy; Centre Expert TSA-SDI/Centre Référent de Réhabilitation Psychosociale; CH Alpes Isère: N. Coulon, S. Leignier, CC Périer; Service de Psychiatrie Infanto-Juvénile, Centre Hospitalier de Versailles: M. Speranza, M. Valette; Service de Psychiatrie de l'Enfant et de l'Adolescent, Centre d'Excellence STRAS&ND, Centre Expert TSA-SDI, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg: C. Schroder, R. Coutelle, J. Rabot; Centre d'excellence I-Mind, Centre de référence maladies rares Génopsy, pôle ADIS, Centre hospitalier Le Vinatier: C.Demily; M. Fabrowski; Marseille: D. Da Fonseca, M. Givaudan et P. Atzori

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