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Aetiology of autism: findings and questions.

Rutter M

SGDP Centre, Institute of Psychiatry, Denmark Hill, London, UK. j.wickham@iop.kcl.ac.uk

BACKGROUND: Although there is good evidence that autism is a multifactorial disorder, an adequate understanding of the genetic and non-genetic causes has yet to be achieved. METHODS: Empirical research findings and conceptual reviews are reviewed with respect to evidence on possible causal influences. RESULTS: Much the strongest evidence concerns the importance of susceptibility genes, but such genes have yet to be identified. Specific somatic conditions (such as tuberous sclerosis and the fragile X anomaly) account for a small proportion of cases. Over recent decades there has been a major rise in the rate of diagnosed autism. The main explanation for this rise is to be found in better ascertainment and a broadening of the diagnostic concept. Nevertheless, some degree of true rise cannot be firmly excluded. However, the epidemiological evidence on the main hypothesized environmental explanation, namely the measles-mumps-rubella vaccine, is consistently negative. CONCLUSION: Progress on the elucidation of the causes of autism will be crucially dependent on the combination of epidemiology with more basic science laboratory studies.

Published 8 April 2005 in J Intellect Disabil Res, 49: 231-8.
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