Asperger's syndrome does not only occur in children and adolescents, but is also diagnosed in adults. Mandy Roy from the Hannover University Medical School and her colleagues explain the clinical picture in the new edition of Deutsches Ärzteblatt International (Dtsch Arztebl Int 2009; 106: 59??).
The causes of Asperger's syndrome have not yet been fully clarified, although a genetic component is likely. To make the diagnosis, tests are performed to assess social ability, fluctuations in attention, attention to detail, communication, and fantasy. It is also sensible to ask children or siblings about unusual features of the patient's childhood. Typical behavioral patterns are evident in the clinical examination. Facial expressions and intonation are monotonous, although verbal expression can appear to be highly sophisticated. What is typical is narration with a great attention to detail. Patients usually avoid direct eye contact. There is often no response if the doctor smiles or makes a joke. Moreover, the patients feel diminished empathy for others. Many adult patients with Asperger's syndrome live a withdrawn life and experience difficulties in partnership. They may appear to be egotistical or cold. However, their overall cognitive abilities would appear to favor realization of their professional or private objectives. It is not necessary to treat every individual with Asperger's syndrome. A combination of drug treatment and psychotherapy can be used for more severe cases.