Autism Spectrum Disorder in 2023: Understanding the Challenge

An update on Autism Spectrum Disorder (ASD) covers its escalating prevalence (epidemiology) and the search for a definitive etiology, which largely remains unknown despite an enormous increase in cases over recent decades. This surge has driven a search for environmental factors that combine with genetic predisposition. While a single cause is rare, several pathogenetic mechanisms are hypothesized, including oxidative stress, mitochondrial dysfunction, altered gut microbiota, immune dysregulation, and neuroinflammation, all of which could alter gene expression. The condition’s defining feature is its clinical heterogeneity, reflecting the spectrum in its name and frequent comorbidity. Early diagnosis and psychoeducational treatment are critical for a better prognosis, with pediatricians playing a key referral role. Although advanced cognitive-behavioral techniques have improved outcomes, only a minority of affected individuals fully leave the spectrum.

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