BackgroundFetal alcohol spectrum disorders (FASD) are a global health concern. To further understand FASD in adulthood is a major public health interest.ObjectiveTo describe the clinical characteristics of young adults with FASD adopted from orphanages to a socially more favourable and stable rearing environment as children.DesignProspective observational cohort studySettingWestern SwedenParticipantsA population-based cohort of 37 adoptees diagnosed with FASD in childhood.Outcome measuresAssessment consisted of clinical evaluations of social, medical, psychiatric, neuropsychological, adaptive and ophthalmological status by a physician, ophthalmologist, orthoptist and psychologist.ResultsOut of 37 adoptees with FASD, 36 (15 females) were evaluated at a median age of 22 years (range 18–28) and a mean follow-up time of 15.5 years (range 13–17). Twenty (56%) were dependent on social support. Sexual victimisation was reported by nine (26%). In 21 individuals with fetal alcohol syndrome, growth restriction in height and head circumference of approximately −1.8 SD persisted into adulthood. Of 32 examined, 22 (69%) had gross motor coordination abnormalities. High blood pressure was measured in nine (28%). Ophthalmological abnormalities were found in 29 of 30 (97%). A median IQ of 86 in childhood had declined significantly to 71 by adulthood (mean difference: 15.5; 95% CI 9.5–21.4). Psychiatric disorders were diagnosed in 88%, most commonly attention deficit hyperactivity disorder (70%). Three or more disorders were diagnosed in 48%, and 21% had attempted suicide. The median Clinical Global Impression-Severity score was 6 = ‘severely ill’.ConclusionMajor cognitive impairments, psychiatric morbidity, facial dysmorphology, growth restriction and ophthalmological abnormalities accompanies FASD in adulthood. Recognition of FASD in childhood warrants habilitation across the lifespan.
Biomedical markers and psychiatric morbidity of neurasthenia spectrum disorders in four outpatient clinics in India
