Autism spectrum disorders (ASD) are a heterogeneous group of neurodevelopmental disabilities with various etiologies, but with a heritability estimate of more than 90%. Although the strong correlation between autism and genetic factors has been long established, the exact genetic background of ASD remains unclear. A number of genetic syndromes manifest ASD at higher than expected frequencies compared to the general population. These syndromes account for more than 10% of all ASD cases and include tuberous sclerosis, fragile X, Down, neurofibromatosis, Angelman, Prader-Willi, Williams, Duchenne, etc. Clinicians are increasingly required to recognize genetic disorders in individuals with ASD, in terms of providing proper care and prognosis to the patient, as well as genetic counseling to the family. Vice versa, it is equally essential to identify ASD in patients with genetic syndromes, in order to ensure correct management and appropriate educational placement. During investigation of genetic syndromes, a number of issues emerge: impact of intellectual disability in ASD diagnoses, identification of autistic subphenotypes and differences from idiopathic autism, validity of assessment tools designed for idiopathic autism, possible mechanisms for the association with ASD, etc. Findings from the study of genetic syndromes are incorporated into the ongoing research on autism etiology and pathogenesis; different syndromes converge upon common biological backgrounds (such as disrupted molecular pathways and brain circuitries), which probably account for their comorbidity with autism. This review paper critically examines the prevalence and characteristics of the main genetic syndromes, as well as the possible mechanisms for their association with ASD.
Methods: We present data from the first 40 adolescents who attended our service. Demographics and PC / Internet usage statistics are presented along with final diagnosis and treatment where it was deemed appropriate, both for Internet addiction disorder but also any co-morbid psychiatric disorder. We describe the diagnostic tests that are employed and their appropriateness for this goal and the therapeutic methods including psychotherapy (a sixteen session CBT protocol) and pharmacotherapy. Recommendations for effectively setting up similar services are given. Results: All cases involved teenage boys (mean age 15 yrs) who abused the Internet primarily to play on-line games. In all cases it was the parents who initiated contact with our Unit. In 75% of the cases the primary concern was addiction to the Internet per se while in 25% of the cases it was the drop in school achievement that prompted the parents to seek a possible explanation in excessive Internet use. Conclusions: During the first year of operations the Unit has treated with success a variety of cases of Internet addiction disorder and made an effort to alert the public to the new phenomenon. A need for similar services is becoming evident throughout Europe as they have already proliferated in Asia.
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