Symptom profiles and correlates of anxiety and depression among parents of autistic girls and boys

Focusing on autism symptoms masks sex-specific needs of autistic children: An example from the Sydney Child Neurodevelopment Research Registry

Studies have shown that there are differences between the presentations of males and females diagnosed with autism. There remains a developing understanding about how the presentation of autism differs between boys (hereafter referred to as 'assigned males at birth') and girls (assigned females at birth). This study sought to investigate the presence of sex differences in autistic children. Participants (1.11-17.97 years) attended an assessment clinic and participated in measures of intelligence/development, social/communication skills and behaviour. Adaptive skills were evaluated using a range of standardised measures, and other clinical and demographic variables were collected (e.g. age, intelligence quotient, ratio of male to female). Assigned males at birth displayed more autism characteristics and greater symptom autism severity than assigned females at birth. No significant differences were found between assigned males at birth and assigned females at birth on any measure of intelligence. Children assigned males at birth received assessments 6 months earlier than children assigned females at birth on average. Externalising behaviour problems were more evident in assigned males at birth, but statistically significant differences in adaptive skills were not apparent between assigned males at birth and assigned females at birth. This study showed assigned females at birth and assigned males at birth differ in autism symptoms and severity and age at diagnosis based on a real-world sample. It highlights the importance of balancing assessments of symptoms with assessment of adaptive function.Lay abstractStudies have shown that there is a difference between biological sex at birth in autism spectrum disorder. There remains a lack of understanding about how the symptoms of autism differ between assigned males at birth and assigned females at birth. We looked at the presence of sex differences in a large group of autistic toddlers, children and adolescents, who were seen in a large diagnosis and assessment clinic. They participated in measures of intelligence/development, social/communication skills and behaviour. Their adaptive skills were evaluated and other clinical and information were collected. Assigned males at birth displayed more autism characteristics and greater symptom autism severity than assigned females at birth. There were no statistically significant differences between assigned males at birth and assigned females at birth on any measure of intellectual assessment. Assigned females at birth showed better nonverbal performance than assigned males at birth on formal developmental assessments. Children assigned males at birth received assessments 6 months earlier than children assigned females at birth. Externalising behaviour problems were more evident in assigned males at birth. This study provides evidence to show that autistic children assigned females at birth and assigned males at birth differ in terms of autism symptoms and severity and age at diagnosis based on a sample recruited in a real-world clinic. It highlights the importance of the growing debate between balancing assessments of symptoms with assessment of adaptive function.

A study on differences about the influencing factors of depressive symptoms between medical staff and residents during 2022 city-wide temporary static management period to fighting against COVID-19 pandemic in Shanghai

Objectives

Our study aimed to identify the latent class of depressive symptoms in the Shanghai population during the city-wide temporary static management period and compare differences in the factors influencing depressive symptoms between medical staff and residents.

Methods

An online cross-sectional survey was conducted with 840 participants using questionnaires, including Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Pittsburgh Sleep Quality Index (PSQI), and self-compiled questionnaire (demographic characteristics and internet usage time). Latent class analysis (LCA) was performed based on participants' depressive symptoms. The latent class subgroups were compared using the chi-square test and t-test. Logistic regression was used in our study to analyze the factors influencing depressive symptoms within the medical staff group and residents group and then compare their differences.

Results

Two distinct subgroups were identified based on the LCA: the group with low-depressive symptoms and the group with high-depressive symptoms. There were significant differences between the two groups (P < 0.05) on age, education level, marital status, internet usage time, identity characteristics (medical staff or residents), family income level, living style, overall quality of sleep, and anxiety levels. Furthermore, logistic regression analysis results showed that compared with the residents group, the participants in the group of medical staff with "increasing internet usage time" and the "daytime dysfunction" would have nearly two times the possibility of getting serious depressive symptoms.

Conclusions

There are differences in the factors influencing depression symptoms between medical staff and residents during the 2022 city-wide temporary static management period to fighting against the COVID-19 pandemic in Shanghai. We should pay special attention to those with increasing internet usage time and daytime dysfunction in medical staff working in a special environment such as the COVID-19 pandemic.

A qualitative study exploring experiences and support needs of parents of children with autism spectrum disorder in Singapore

AIMS AND OBJECTIVE

To explore the experiences and support needs of parents of children with recently diagnosed autism spectrum disorder (ASD) in Singapore.

BACKGROUND

Raising a child with ASD is challenging for parents, especially in the initial period following the diagnosis. Limited studies have focused on parents' perspectives.

DESIGN

A qualitative descriptive design study.

METHODS

Thirteen parents were recruited from a developmental and behavioural paediatric outpatient clinic of a tertiary hospital in Singapore from October-December 2018. Adult parents, who were primary caregivers of 2-10-year-old children diagnosed with ASD in the preceding 3 months to 2 years, were recruited. Semi-structured individual face-to-face interviews were conducted based on an interview guide. Thematic analysis was used to analyse the data. Consolidated Criteria for Reporting Qualitative Studies (COREQ) checklist was used for reporting.

RESULTS

Common themes were analysed using constant comparative method to generate results. Four themes emerged after 13 interviews: (1) adjusting psychologically, (2) changing lifestyle, (3) contending with hurdles to services and (4) needing informational, tangible and emotional support.

CONCLUSIONS

Findings suggested a need for more formal support networks, targeted resource platforms and accessibility of services to help support parents better after receiving a diagnosis of ASD in their child.

RELEVANCE TO CLINICAL PRACTICE

Enhancing current healthcare and social policies to improve the provision of standardised and targeted information to parents, establishing formal support networks, facilitating access to childcare services, and involving domestic helpers/nannies as dedicated caregivers and trainers could better support parents.