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Monday, February 17, 2014

What is causing the drop in the prevalence of Autism?

The prevalence of Autism is expected to decline up to 20% in the coming year or so. That's a substantial and abrupt decline. 

This projected decline in Autism is caused by the same problem that caused the dramatic increase of Autism since 1986 - a change in the definition of Autism.

Both issues, the dramatic increase and dramatic decrease in Autism diagnosis reflect a very serious problem with psychiatric "diagnosis." 

In psychiatry, a diagnosis is just a label; 
it doesn't reflect a true disease with a specific 
known cause or specific treatments.

Vaccines are safe enough and worth the risk
given the very low incidence of problems.
The risk for infection and serious injury or death
from not getting vaccinated is much, much greater.

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     The problem with the public perception that Autism was spiraling out of control lead to a slew of simplistic ideas of cause-and-effect, most popular was the allegation that Autism was caused by chemicals in the MMR vaccine. This idea gained momentum when, in 1998, physician Andrew Wakefiled, was able to get a study published in the prestigious British Medical Journal demonstrating a link between Autism and vaccination. However, it was later discovered that he "misrepresented or altered the medical histories of all 12 of the patients" in his study.  The study was retracted and Dr. Wakefiled later lost his medical license as a consequence of the fraud. (

Over 30,000 cases of Autism are
directly related Fragile X syndrome
which inhibits the ability to learn.

      The idea that vaccinations were causing Autism is still creating problems around the world with breakouts of measles, mumps, rubella, whooping cough, and other once mostly eradicated illnesses. Great Britain continues to experience major outbreaks of measles. This remains a very serious problem because measles can leave children deaf; it can also cause severe pneumonia and death in more vulnerable children, but that's just measles; there are other diseases making a comeback.
      The number of children who have come down with Whooping cough (pertussis) in the United States is the highest since 1959. Pertussis can lead to pneumonia, encephalopathy (swelling in the brain), ear aches, and seizures; children with asthma or younger children are at much higher risk of death. Permanent brain damage, such as mental retardation, can result from the secondary problems from pertussis.

       The spurious Autism-vaccine link was promoted by celebs like Jenny McCarthy. It's questionable whether or not her son actually suffered from Autism. It was very irresponsible for major networks to continue to air celebrity stories and at the same time, disregard subsequent research indicating that there was no Autism-vaccine link; but, the media does not understand the scientific process, and it is reflected in their abysmal reporting on it. 

      The idea that you can protect your child from developing Autism by avoiding vaccines is incorrect and dangerous. Not vaccinating children older than age 5 is ridiculous because Autism does not develop past that age anyway, internet-anecdotes notwithstanding. The cause of Autism is probably a complicated interaction between environment and genetics with many factors, some seem more significant than others; one important factor is the age of the parents; there probably are environmental factors (i.e., pollutants, pesticides) but vaccines are not one of those factors. 
     The most shocking study that I have come across is the substantial increase in autism for mothers who took SSRI Anti-Depressants; the closer birth that they took the drug, the greater the chance of having a child with Autism. Moreover, Serotonin was found to be a significant factor in the development of Autism prior to this study. It has been known that psychotropic drugs promote neuro-genesis and that many children with Autism seem to have excessive neuronal growth; perhaps there's a connection here.

     We need to be careful when we hear stories that a disease is becoming more prevalent. Rates of breast cancer are another example of over-blown incidence. Breast cancer rates increased for quite a while in the 1990's and 2000's, but plateaued and recently declined. The increase was almost entirely due to what is called "lead time bias." Lead time bias means that doctors are able to make a diagnosis of breast cancer much sooner than in the past, due to advances in diagnostics methods. Moreover, breast cancer screening recommendations changed, so, many more women received regular mammograms. Unfortunately, recent reviews of the benefits of breast cancer screenings has found that they have done more harm than good and not saved any additional lives. This last finding is a travesty
     One scientific review from 2013 found that:

"During the study period, screening detected tumors in more than 1 million US women that would have not resulted in clinical symptoms. In 2008, it is estimated that breast cancer was over-diagnosed in more than 70,000 women, accounting for 31% of all breast cancers detected."

It turns out that breast cancer rates were not increasing and that
early and frequent screenings for breast cancer have not saved
lives and surprisingly caused more harm than good.

     Another significant problem with breast cancer screening is that it involves radiation into breast tissue. Ionizing radiation can cause cancer, and it will increase the general risk of cancer in a person's lifetime. It is impossible, regardless of what any doctor tells their patient, to predict how radiation exposure will affect any specific person with regards to cancer risk. Dr. Oz was correct (if anyone recalls his controversial show on the issue, he was actually a little ahead of his time on it, perhaps he had some insider information).

     Back to Autism. Another concerning issue is the variety of "treatments" for Autism that have gained popularity but have no scientific basis. Currently, there are no known effective therapies or treatments for Autism. 

If you picked two children with Autism and 
provided one with all the available treatments
and another with no treatments, each would have 
an equal chance of the same degree of progress 
in 5 and 10 years from the start of treatment. 

Regardless, as parents, we do what we can, assuming that doing something is better than doing nothing, and we are prone to believing the anecdotes that sell the treatments.

     Major Depression is another disorder where we will probably see changes in the incidence and prevalence as it has undergone changes in its criteria, too. Major Depression used to exclude bereavement, however, that exclusion has been changed, probably at the request of pharmaceutical companies, so that more medications can be prescribed to individuals suffering from the loss of a loved one. This is the latest example of how non-scientific psychiatry remains as well as how influenced it is by the pharmaceutical industry. This comes at the start of a new period of psychotropic drugs for depression, and it's not a coincidence. Pharmaceutical companies have been heavily manipulating the field of psychiatry since the 1980's by promoting diagnosis like ADHD, OCD, Depression, Social Anxiety, and in the last 15 years, Bipolar disorder. There are many good books on the issue, but here is one of my favorite, and here.

     If you'd like to read more about the history of psychiatry, you can try this, a fantastic and very interesting book. So, be wary of news reports that have anything to do with science; chances are that they are either wrong or not covering the whole story. Also, watch out for the latest and greatest depression treatments that will be promoted by pharmaceutical corporations. Soon they'll probably be prescribed Ketamine and Ecstasy (seriously) in a pill; it probably won't work any better than a placebo and will have bad long-term side effects just like all the others, because that's what happens when you mess your brain's natural chemistry.

Mental Health Advice Disclaimer: The information included in this post and blog are for educational purposes only. It is not intended nor implied to be a substitute for professional mental health treatment or medical advice. The reader should always consult his or her mental health provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a mental health or medical condition or treatment plan. Reading the information on this website does not create a therapist-patient relationship.

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