Asperger's Disorder (Medical Psychiatry)

402 Pages·2008·3.76 MB·English

by  Jeffrey L. Rausch

40
Psychiatry
A
about the book…
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Today at least seven million children and adolescents are afflicted with developmental,
behavioral, or mental disorders such as Asperger’s Disorder. p
Examining the etiology, diagnosis and treatment of this condition, Asperger’s Disorder: e
• is filled with comprehensive treatments in Asperger’s Disorder, including diagnostic A ’
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tools, imaging techniques, case studies, etiology, treatments, and pharmacotherapies
sperger s
• gives necessary guidance to psychiatrists and neurologists to ensure that they can g
correctly diagnose Asperger’s Disorder from other neurodevelopmental disorders
• investigates prevalence of Asperger’s Disorder and presents individual case studies e
• devotes entire chapters to the individual subjects: diagnosis, biological treatment, D
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pharmacological treatment, and behavioral treatment
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about the editors... s
JEFFREY L. RAUSCH is Professor and Case Distinguished Chair in Psychiatry and Health
Behavior, The Medical College of Georgia, Augusta, Georgia, USA. He received his M.D. D
from the Medical College of Georgia, Augusta, Georgia, USA. Dr. Rausch is also a member
of over 15 professional organizations, including the American Psychiatric Association,
Society of Biological Psychiatry, and Psychiatric Research Society, of which he served as i
s
President in 2003. He has been named one of the Best Doctors in America from 1994
through 2008, and has been awarded both the Humanitarian Award and the creativity o
award from the Medical College of Georgia as well as the Distinguished Fellow award
from the American Psychiatric Association. In 2005, he was named one of the top One r
Hundred Health Professionals. Dr. Rausch’s specialty areas include psychiatric genetics,
neuroendocrinology, molecular neuroscience, and clinical psychopharmacology. D
Medical Psychiatry Series / 40
MARIA E. JOHNSON is Medicine-Psychiatry Consultation-Liaison at Gracewood Hospital e
for the Developmentally Disabled, Augusta, Georgia, USA. She obtained her M.D.,
r
completed training and psychopharmacology fellowship at the Medical College of
Georgia, Augusta, Georgia, USA. Dr. Johnson is a young investigator in the areas of
Asperger’s Disorder, Autism Spectrum Disorders, intellectual disability, and depression.
MANUEL F. CASANOVA is Professor of Psychiatry, University of Louisville, Louisville,
Kentucky, USA. Dr. Casanova received his M.D. from the University of Puerto Rico, San
Juan, Puerto Rico. Having helped establish two of the most successful brain banks in the
US, The Johns Hopkins Brain Resource Center and the Brain Bank Unit of the Clinical Rausch
Brains Disorders Branch at the National Institutes of Mental Health, Dr. Casanova was • Edited by
bestowed honorary appointments as a scientific expert for the Armed Forces Institute of
Johnson
Pathology and professorial lecturer for the Department of Forensic Science at George
•
Washington University. He is well published in a multitude of areas, including neuronal
Jeffrey L. Rausch
morphometry immunocytochemistry, neurochemistry, and autoradiography. Casanova
Printed in the United States of America DK8360 Maria E. Johnson
Manuel F. Casanova
PMS 225 PMS 287
A ’
sperger s
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MEDICAL PSYCHIATRY
Series Editor Emeritus
William A. Frosch, M.D.
Weill Medical College of Cornell University, New York, New York, U.S.A.
Advisory Board
JonathanE.Alpert, M.D.,Ph.D. SiegfriedKasper, M.D.
MassachusettsGeneral Hospitaland MedicalUniversity ofVienna
HarvardUniversitySchool ofMedicine Vienna,Austria
Boston,Massachusetts, U.S.A.
Mark H.Rapaport,M.D.
BennettLeventhal,M.D. Cedars-SinaiMedical Center
UniversityofChicagoSchoolofMedicine Los Angeles,California, U.S.A.
Chicago, Illinois,U.S.A.
1. Handbook of Depression and Anxiety: A Biological Approach, edited
by Johan A. den Boer and J. M. Ad Sitsen
2. Anticonvulsants in Mood Disorders, edited by Russell T. Joffe and
Joseph R. Calabrese
3. Serotonin in Antipsychotic Treatment: Mechanisms and Clinical
Practice, edited by John M. Kane, H.-J. Mo¨ller, and Frans Awouters
4. Handbook of Functional Gastrointestinal Disorders, edited by Kevin
W. Olden
5. Clinical Management of Anxiety, edited by Johan A. den Boer
6. Obsessive-CompulsiveDisorders:Diagnosis.Etiology.Treatment,
edited by Eric Hollander and Dan J. Stein
7. Bipolar Disorder: Biological Models and Their Clinical Application,
edited by L. Trevor Young and Russell T. Joffe
8. Dual Diagnosis and Treatment: Substance Abuse and Comorbid
Medical and Psychiatric
Disorders, edited by Henry R. Kranzler and Bruce J. Rounsaville
9. Geriatric Psychopharmacology, edited by J. Craig Nelson
10. Panic Disorder and Its Treatment, edited by Jerrold F. Rosenbaum
and Mark H. Pollack
11. Comorbidity in Affective Disorders, edited by Mauricio Tohen
12. Practical Management of the Side Effects of Psychotropic Drugs,
edited by Richard Balon
13. Psychiatric Treatment of the Medically III, edited by Robert G.
Robinson and William R. Yates
14. MedicalManagementoftheViolentPatient:ClinicalAssessmentand
Therapy, edited by Kenneth Tardiff
15. Bipolar Disorders: Basic Mechanisms and Therapeutic Implications,
edited by Jair C. Soares and Samuel Gershon
16. Schizophrenia: A New Guide for Clinicians, edited by John G.
Csernansky
17. Polypharmacy in Psychiatry, edited by S. Nassir Ghaemi
18. Pharmacotherapy for Child and Adolescent Psychiatric Disorders:
SecondEdition,RevisedandExpanded,DavidR.Rosenberg,Pablo
A. Davanzo, and Samuel Gershon
19. Brain Imaging In Affective Disorders, edited by Jair C. Soares
20. Handbook of Medical Psychiatry, edited by Jair C. Soares and Samuel
Gershon
21. Handbook of Depression and Anxiety: A Biological Approach,
Second Edition, edited by Siegfried Kasper, Johan A. den Boer,
and J. M. Ad Sitsen
22. Aggression: Psychiatric Assessment and Treatment, edited by Emil
Coccaro
23. Depression in Later Life: A Multidisciplinary Psychiatric Approach,
edited by James Ellison and Sumer Verma
24. Autism Spectrum Disorders, edited by Eric Hollander
25. Handbook of Chronic Depression: Diagnosis and Therapeutic
Management, edited by Jonathan E. Alpert and Maurizio Fava
26. Clinical Handbook of Eating Disorders: An Integrated Approach,
edited by Timothy D. Brewerton
27. Dual Diagnosis and Psychiatric Treatment: Substance Abuse and
Comorbid Disorders: Second Edition, edited by Henry R. Kranzler and
Joyce A. Tinsley
28. Atypical Antipsychotics: From Bench to Bedside, edited by John G.
Csernansky and John Lauriello
29. SocialAnxietyDisorder,editedbyBorwinBandelowandDanJ.Stein
30. Handbook of Sexual Dysfunction, edited by Richard Balon and R.
Taylor Segraves
31. Borderline Personality Disorder, edited by Mary C. Zanarini
32. Handbook of Bipolar Disorder: Diagnosis and Therapeutic
Approaches,editedbySiegfriedKasper andRobertM.A.Hirschfeld
33. ObesityandMentalDisorders,editedbySusanL.McElroy,DavidB.
Allison, and George A. Bray
34. Depression:TreatmentStrategiesandManagement,editedbyThomas
L. Schwartz and Timothy J. Petersen
35. Bipolar Disorders: Basic Mechanisms and Therapeutic Implications,
Second Edition, edited by Jair C. Soares and Allan H. Young
36. Neurogenetics of Psychiatric Disorders, edited by Akira Sawa and
Melvin G. Mclnnis
37. Attention Deficit Hyperactivity Disorder: Concepts, Controversies,
New Directions, edited by Keith McBurnett, Linda Pfiffner, Russell
Schachar, Glen Raymond Elliot, and Joel Nigg
38. InsulinResistanceSyndromeandNeuropsychiatricDisorders,edited
by Natalie L. Rasgon
39. AntiepilepticDrugstoTreatPsychiatricDisorders,editedbySusanL.
McElroy, Paul E. Keck, Jr., and Robert M. Post
40. Asperger’s Disorder,edited byJeffrey L.Rausch, MarieE.Johnson,
and Manuel F. Casanova
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Edited by
Jeffrey L. Rausch
The Medical College of Georgia
Augusta, Georgia, USA
Maria E. Johnson
Gracewood State School and Hospital
Gracewood, Georgia, USA
Manuel F. Casanova
University of Louisville
Louisville, Kentucky, USA
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ISBN-13:978-0-8493-8360-1(hardcover:alk.paper)
ISBN-10:0-8493-8360-9(hardcover:alk.paper)1. Asperger’ssyndrome.
I.Rausch,JeffreyL.II.Johnson,MariaE.III.Casanova,ManuelF.IV.Series.
[DNLM:1. AspergerSyndrome.2. CaseReports. W1ME421SMv.402008/
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To John, Gloria, and June; To Manuel Casanova and Elisa Soto de Casanova

Foreword
For me, the opportunity to practice in academic medicine has been one of the
finest rewards of a medical career. It has given me the privilege to teach, to
interact with great minds, and to meet so many fine people. As Ralph Waldo
Emersonstated,“achiefeventoflifeisthedayinwhichwehaveencountereda
mind that startled us.”
Hans Asperger described his childhood cases as “little professors,” so
maybe it’s fitting to describe the professorial phenotype, at least the academic
medicine version, because in academic medicine you’ll meet all kinds: the
pedanticstuffedshirts,rigid,poker-faced,retentiveofdivulginganyunnecessary
information, the hypercritical, the critically minded, and sometimes even the
rather uncritical (usually constrained to the youngsters, one would hope). There
are the social climbers, the snobs, the one-upmanship types, the regular guys
(“guys” includes the gals here), the salt of the earth types, transparent, genuine,
unassuming, the phonies, the posers, the cavalier, the fearful, the timid, the
worriers,theself-effacing,thehighlydedicated,thosededicatedtotheirpatients,
theircareers,thosededicatedtotheadvancementoftheir fields,theadventurers
who take thrill in the discovery of new knowledge, the mensches on the high
road you can always count on, as well as the meshuggeners, the just plain
crazies,theparanoid,andthegrandiose,aswellasthefamilytypes,theperennial
student types, the spiritual, the devout, the atheistic, the agnostic, the over-
whelmed, the underwhelmed, the introverted, the extroverted, the geniuses
(a few), the brilliant, the bright, the outstanding, the remarkable, the not-so-
remarkable,andthegifted.Somearedrivenbyneurosis,andsomearedrivenby
love; all are driven by hope.
Mostofusconstitutesomecombinationoftheabove,butdon’tgettheidea
that I’ve got everyone pegged; it’s in the perception of the beholder, and both
v