Thursday, September 24, 2009

British study finds no evidence of autism surge in children

Autism is as common among adults as it is among children, a study has found, dispelling fears of a link between the MMR vaccine and the condition. A study of rates of autism spectrum disorder among adults suggests that one in every 100 people over the age of 18 has the condition — broadly the same as that cited for children.

The data, collected by the NHS Information Centre, is the first to show how autism affects people over the course of a lifetime, concluding that it is similar across all ages.

People in more than 4,000 households in England were asked a series of questions aimed at assessing their psychiatric health. The results were used to identify adults with an autism spectrum disorder, including Asperger’s syndrome.

The centre said that the study found no evidence to support claims of a link between the MMR jab given to children and the development of autism: if the vaccine was to blame, autism rates among children should be higher because the MMR has been available only since the early 1990s.

The study — the Adult Psychiatric Morbidity Survey 2007 — was funded by the Department of Health. It found that rates of autism were higher among men (1.8 per cent) than among women (0.2 per cent). This reflects studies in children, which have shown higher rates among boys than girls.

The report also found higher rates of autism among single people, among men with no university degree and among men who rent their homes rather than those in other types of housing. [The poor have worse health: The old, old finding]

Tim Straughan, chief executive of the NHS Information Centre, said: “This landmark report is the first major study into the prevalence of autism spectrum disorders among adults to be carried out anywhere in the world. “The findings do not support suggestions of a link between the MMR vaccine and the development of this condition.” Mr Straughan said that while the sample size was small and any conclusions needed to be treated with caution, the report suggested that, despite popular perceptions, rates of autism were not increasing.

The MMR jab was first introduced in the UK in 1988. Concerns over the vaccine were sparked by a paper published in The Lancet in 1998 by Dr Andrew Wakefield. The research has since been discredited.

Mr Straughan said that the findings backed those from the National Audit Office (NAO) that more was required to support people with autism through adulthood. The NAO found there was very little recognition and service provision by local authorities or the NHS for adults with autism spectrum disorder.

The NHS Information Centre report found that people with autism do not access support services for mental or emotional problems in any greater numbers than the general population. “This does beg some questions about whether services, as currently configured, are meeting the needs of this group of people,” Mr Straughan said.

Mark Lever, chief executive of the National Autistic Society (NAS), said that his organisation had long campaigned about awareness of “woefully inadequate” services and support for adults with autism. “Nearly two-thirds of adults with autism told us they do not have enough support to meet their needs. “Many thousands feel isolated and ignored and are often completely dependent on their families. This study gives us further evidence to demand that more vital support is put in place.” Mr Lever said that the report was the first part of a much more detailed research project into the prevalence of autism in the UK. “While we welcome this initial report, it only underlines the scale of the task that lies ahead and the importance of the forthcoming adult autism strategy in tackling the devastating lack of support and services,” he said.


Bashed your head? You needed a stiff drink

Crazy as it sounds, alcohol may one day be given to people with brain injuries to help them recover. The idea has arisen from a study of 38,000 people with head injuries, which found that those with alcohol in their blood were more likely to survive. For every 100 people who died when stone-cold sober, only 88 died with ethanol – the kind of alcohol in drinks – in their veins. "The finding raises the intriguing possibility that administering ethanol to patients with brain injuries may improve outcome," conclude the investigators.

Lead researcher Ali Salim of the Cedars-Sinai Medical Center in Los Angeles said he hoped a trial could be mounted, but more information is needed first. "We need a better understanding of the exact mechanism, the appropriate dose and specific timing of treatment before we can embark on clinical trials," he told New Scientist.

Salim said that several previous studies have found similar beneficial effects – although others do not. Animal experiments, meanwhile, suggest that relatively low doses of alcohol protect the brain from injury, but high doses increase the risk of death. More research is also needed to establish how alcohol protects the brain, but Salim says it may work by blunting the amount of adrenalin reaching the brain, which reduces inflammation.

Despite alcohol's potential for helping patients survive brain injury, Salim stressed that it is to blame for half of all injury cases. "Alcohol is and will always continue to be bad, since it contributes to over 40 per cent of traffic-related fatalities," he says.

The study also found that drinkers suffered more complications and more severe injuries than non-drinkers, even though the overall survival rate was higher.

David Hovda, director of the Brain Injury Research Center at the University of California at Los Angeles, agreed that more research is needed before a clinical trial could take place. "One would have to know the therapeutic time window and, of course, the dose," he says. "But the mechanisms of action involving the neurobiology of traumatic brain injury have different timeframes and regional profiles which would make ethanol therapy difficult to manage correctly."

Hovda also points out that brain injuries can be very diverse, so ethanol might work for some but not others. "Severity and type really make a difference when deciding on therapeutic options," he says.

Journal reference: Archives of Surgery, vol 144, p 865


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