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Social Media is No Substitute for Clinical Expertise

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TikTok is overtaking the internet and many are using this platform to learn about a variety of psychiatric illnesses and psychological problems. But how accurate are these videos in sharing medical information? Could they be causing things like tics? Do they influence individuals to self-diagnose and cause mis-diagnosis? There is a new phenomenon labeled “munchausen by internet”, and while some of the videos might be helpful in raising awareness, others are just spreading lies and causing psychiatric problems. In other words: be careful about TikTok. If a social media platform shares videos that tell you to eat laundry detergent, maybe you should not listen to everything they say.

https://journals.sagepub.com/doi/full/10.1177/07067437221082854

https://pubmed.ncbi.nlm.nih.gov/35473358/

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Genetic confounding plus organoids

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You heard it in the news this week, and we discuss it on this week’s ASF podcast. Can you make little brains in a dish then make them better by providing them a real structured live neural environment? Can these organoids integrate with a live brain and be functional in vivo? The answers are: yes! Learn more from a new study published this week. Also, what the h**l is genetic confounding and how can it address many of the controversies of genetic vs. the environment? Sometimes genes that predispose to a disorder also predispose to environmental factors leading to that disorder. There is always room for both. Here are the links I promised:

https://www.fhi.no/en/studies/moba/

https://pubmed.ncbi.nlm.nih.gov/35793100/

https://www.nature.com/articles/s41586-022-05277-w

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You asked, we listened: what is the link between ASD and ADHD?

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This week’s ASF podcast topic comes from the listeners: what is the link between ASD and ADHD? Do parents diagnosed with ADHD have a greater chance of having a child with ASD? What are the similarities and differences? And what do families need to know? We interviewed Dr. Meghan Miller from the University of California Davis, who is one of the most prolific academics (and trusted psychologist to families) in this area. Want to read some of her research? Here you go:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6439602/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7891894/

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“ASADHD” – where does ASD and ADHD join together, and go their separate ways?

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One the surface, symptoms of ADHD and ASD may seem very similar.  However, they come from very different places.  The genetic and behavioral makeup may be on the same spectrum across the two disorders, but they are actually farther apart than you might think.  Dr. Meghan Miller from UC Davis MIND Institute who studies both ADHD and ASD and people with ADHD and ASD explains what those differences and similarities are, how to make the right diagnosis, and what’s on the horizon for treatments for ADHD in people with ASD.

 

https://www.ncbi.nlm.nih.gov/pubmed/31974800

https://www.ncbi.nlm.nih.gov/pubmed/30535156

https://www.ncbi.nlm.nih.gov/pubmed/30658861

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#thisisanautismmentalhealthcrisis

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Mental health disorders are a serious problem across the lifespan in people with autism.  This has been shown by over 2 decades of research and further proven by a new meta analysis and a systematic review of the last 25 years of data.  What is the result of these mental health disorder co-morbidities?  Many times, these mental health disorders trigger a crisis situation: the police are called, someone goes to the hospital, may end up hospitalized, and family members are traumatized.  This week’s podcast summarizes the evidence and provides recommendations from scientists to help those with autism and possibly prevent crises from occurring.

https://www.ncbi.nlm.nih.gov/pubmed/31447415 

https://www.ncbi.nlm.nih.gov/pubmed/31652032

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Autism spectrum disorders underneath a bigger umbrella: more data from the brain

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There is demonstrated genetic overlap between many neurodevelopment disorders including  ASD, ADHD, and schizophrenia, and now there is data showing similarities in the structure and size of the brains in people with autism and those with ADHD.  These differences depend on how severe social difficulties are, but the similarities are seen with ASD and ADHD, but not OCD.   In addition, this week there are new depressing results from the Interactive Autism Network on unemployment and females with ASD.  The results may not surprise you, but they will upset you.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6361977/

https://www.ncbi.nlm.nih.gov/pubmed/30729799

 

 

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The 2018 Year in Review: A spectrum within a spectrum

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There were a number of exciting advances in scientific understanding autism in 2018.  These include things that we know to be true, and know to be not true.  Researchers made progress in identifying subgroups of ASD, defining biological markers, and developing  interventions. There were also research that demonstrates that while autism is a spectrum itself, it is also part of a bigger spectrum of neurodevelopmental disorders from anxiety to ADHD to OCD.  Therefore, the approaches to these other conditions may be applicable to ASD. In addition, there may be more similarities than differences in the biological features of these conditions.

This is just a sampling of the exciting research presented on this year’s Year in Review.  You can also read the full summary, complete with references, HERE.

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Lordy Lordy it’s One in Forty

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This week’s headlines were focused on the new prevalence numbers of 1:40.  They were not calculated using the same method as the 1:59 number, so should not be  compared.  In addition to looking at just prevalence, this survey identified a major problem for families, which is unmet mental health needs.  Those with autism have higher unmet mental health needs than those with  ADHD, anxiety or depression.  Again, there is something unique about an autism diagnosis which poses a challenge to accessing care.  In addition, a new summary paper outlined what needs to be done to better study  regression in autism.  The rate may be higher than you think if a new definition of regression is used.

 

https://www.ncbi.nlm.nih.gov/pubmed/30478241

https://www.ncbi.nlm.nih.gov/pubmed/30475449

 

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From cells to anxiety

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Thanks to brain tissue research, scientists now know how cells in the amygdala form, connect, and how this changes with age.  But does that explain behavioral or neurological features in autism?  Last week, Dr. Inna Fishman from SDSU examined connections in and out of the amygdala in children and adolescents in autism, in a different study but the same age range as when cellular changes in the amygdala are seen.  Strikingly, the brain connections to regions outside the amygdala follow a similar pattern at a similar time, which may explain functioning, autism severity and anxiety in adolescents with autism.   Also this week, while autism is a spectrum, it’s on a spectrum with other neurodevelopmental disorders like ADHD.  Just like in autism, there are individuals who are not diagnosed with ADHD until adulthood.  But these adults show signs of autism as children.  This is similar to autism, where symptoms are there but may not manifest until later in life.

 

https://www.ncbi.nlm.nih.gov/pubmed/30274651

https://www.ncbi.nlm.nih.gov/pubmed/30338854

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The Final Word on Antidepressants and Autism Risk???

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Every time you turn around there is another study contradicting the last on antidepressant use and autism risk.  An answer on why there are differences across different studies may be found in a new analysis published by University of Washington and SSM Dean Medical Group in Wisconsin this week.  They showed that autism severity (not risk) is increased only with both a likely gene disruption AND following antidepressant exposure in pregnancy together.  This suggests a double hit model similar to other complex neuropsychiatric disorders like depression.  It also suggests that findings from other chemicals, like PBDE’s, may be dependent on gene / environment interactions too.  After all, a new systematic review showed PBDE’s during pregnancy are bad for the IQ of the child.  This provides insight on ASD risk and subtype given the multitude of possible genetic / environmental combinations out there.