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      The ‘insanity’ of Lady Durham

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          Abstract

          This essay draws on evidence in a late nineteenth-century court case and surviving medical notes to provide a case study of a hitherto unidentified case of Autism Spectrum Disorder. The case is particularly interesting in that it not only appears to be the first identification of historical ASD in a female, but also because the patient subsequently developed symptoms of psychosis suggestive of schizophrenia or schizoaffective disorder. The unusual survival of detailed medical notes also throws light on the ways in which a difficult patient was treated by supposedly enlightened pioneers of psychiatry.

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          Psychiatric disorders in children with autism spectrum disorders: prevalence, comorbidity, and associated factors in a population-derived sample.

          Emily Simonoff, Andrew Pickles, Tony Charman … (2008)
          Autism spectrum disorders are now recognized to occur in up to 1% of the population and to be a major public health concern because of their early onset, lifelong persistence, and high levels of associated impairment. Little is known about the associated psychiatric disorders that may contribute to impairment. We identify the rates and type of psychiatric comorbidity associated with ASDs and explore the associations with variables identified as risk factors for child psychiatric disorders. A subgroup of 112 ten- to 14-year old children from a population-derived cohort was assessed for other child psychiatric disorders (3 months' prevalence) through parent interview using the Child and Adolescent Psychiatric Assessment. DSM-IV diagnoses for childhood anxiety disorders, depressive disorders, oppositional defiant and conduct disorders, attention-deficit/hyperactivity disorder, tic disorders, trichotillomania, enuresis, and encopresis were identified. Seventy percent of participants had at least one comorbid disorder and 41% had two or more. The most common diagnoses were social anxiety disorder (29.2%, 95% confidence interval [CI)] 13.2-45.1), attention-deficit/hyperactivity disorder (28.2%, 95% CI 13.3-43.0), and oppositional defiant disorder (28.1%, 95% CI 13.9-42.2). Of those with attention-deficit/hyperactivity disorder, 84% received a second comorbid diagnosis. There were few associations between putative risk factors and psychiatric disorder. Psychiatric disorders are common and frequently multiple in children with autism spectrum disorders. They may provide targets for intervention and should be routinely evaluated in the clinical assessment of this group.
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            Autistic disturbances of affective contact

            L. KANNER, A. Kanner, L Kanner (1943)
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              The Changing Epidemiology of Autism Spectrum Disorders

              Kristen Lyall, Lisa A Croen, Julie T. Daniels … (2017)
              Autism spectrum disorder (ASD) is a complex neurodevelopmental condition with lifelong impacts. Genetic and environmental factors contribute to ASD etiology, which remains incompletely understood. Research on ASD epidemiology has made significant advances in the past decade. Current prevalence is estimated to be at least 1.5% in developed countries, with recent increases primarily among those without comorbid intellectual disability. Genetic studies have identified a number of rare de novo mutations and gained footing in the areas of polygenic risk, epigenetics, and gene-by-environment interaction. Epidemiologic investigations focused on nongenetic factors have established advanced parental age and preterm birth as ASD risk factors, indicated that prenatal exposure to air pollution and short interpregnancy interval are potential risk factors, and suggested the need for further exploration of certain prenatal nutrients, metabolic conditions, and exposure to endocrine-disrupting chemicals. We discuss future challenges and goals for ASD epidemiology as well as public health implications.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Hist Psychiatry
                Journal ID (iso-abbrev): Hist Psychiatry
                Journal ID (publisher-id): HPY
                Journal ID (hwp): sphpy
                Title: History of Psychiatry
                Publisher: SAGE Publications (Sage UK: London, England )
                ISSN (Print): 0957-154X
                ISSN (Electronic): 1740-2360
                Publication date (Electronic): 19 May 2022
                Publication date (Print): June 2022
                Volume: 33
                Issue: 2
                Pages: 217-229
                Affiliations
                [1-0957154X211064952]Visiting Fellow, Oxford Brookes University, UK
                Author notes
                [*]Ruth Paley, Oxford Brookes University, Harcourt Hill Campus, Oxford OX2 9AT, UK. Email: p0090687@ 123456brookes.ac.uk
                Article
                Publisher ID: 10.1177_0957154X211064952
                DOI: 10.1177/0957154X211064952
                PMC ID: 9121518
                PubMed ID: 35588213
                SO-VID: 5a396acd-66f5-4e48-b1dc-85f0a07e57fb
                Copyright © © The Author(s) 2022
                License:

                This article is distributed under the terms of the Creative Commons Attribution 4.0 License ( https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

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                Subject: Articles
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                Keywords: autism,autism spectrum disorder,schizoaffective disorder,schizophrenia,ticehurst hospital,19th century
                Data availability:
                Keywords: autism, autism spectrum disorder, schizoaffective disorder, schizophrenia, ticehurst hospital, 19th century

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