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Autism
30/07/2009

The Dysfunction of the Ways of Expression of Pain as a Cause of Problem Behaviours in Patients with Autism

The literature shows a high prevalence of problem behaviours in the population with Pervasive Development Disorders. Some recent studies have looked at the pathogenic contribution of organic conditions, including pain. People with Pervasive Development Disorder present a difficulty in the functional expression of pain and tend to convert to abnormal behaviors.
Although this dynamic is not completely clear, evidence indicates pain as an important variable, which is instead largely neglected in the psychiatric evaluation procedures of people with Pervasive Development Disorders. CREA (Research Center and Evolution AMG) and the Psychiatric Unit of Mental Development of the HUG of Ginevra have collaborated to revise the literature and produce an article on this topic. The article, being published in the Italian Journal of Psychopathology, describes the clinical history of three people with Autism and one with Pervasive Development Disorder hospitalized in a psychiatric ward for problem behaviours, the causes of which were instead linked to the behavioral manifestation of pain derived from physical ailments. A frontal glioma, an auditory hyperesthesia, lobar pneumonia, and a coprostasis.
The survey of pain should be considered a fundamental moment in the psychiatric practice of a person with Pervasive Development Disorders or other intellectual disabilities.

REFERENCES
- Deb S., Salvador-Carulla L., Bertelli M., Barnhill J., Torr J., Bradley E., Kwok H., and Bouras N. Problem Behaviour in Adults with Intellectual Disabilities: International Guide for Using Medication. The World Psychiatric Association (WPA) Section on Psychiatry of Intellectual Disability, WPA, Ginevra, in press.
- Matson J., Cooper C., Malone C.J., Moskow S.L. The relationship of self-injurious behavior and other maladaptive behaviors among individuals with severe and profound intellectual disability. Research in Developmental Disabilities, 2008;29: 141-148.
- Van Dijk M., Valkenburg A., Boerlage A.A., Tibboel D., Veerkamp J.S. Children with intellectual disabilities and pain perception: A review and suggestions for future assessment protocols. European Archives of Paediatric Dentistry, 2009 Jun;10(2): 57-60.

Marco Bertelli, Annamaria Bianco