Christopher Gillberg

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Christopher Gillberg
Born (1950-04-19) 19 April 1950 (age 74)
Gothenburg, Sweden
NationalitySwedish
OccupationProfessor
Known for

Lars Christopher Gillberg (born 19 April 1950) is a professor of child and adolescent psychiatry at Gothenburg University in Gothenburg, Sweden. He has been a visiting professor at the universities of Bergen, New York, Odense, St George's (University of London), San Francisco, and Glasgow and Strathclyde. [1] [2] Gillberg is the founding editor of the journal European Child & Adolescent Psychiatry.

Contents

Autism research

In the early 1980s, the concept of an 'autism spectrum' was introduced by Lorna Wing and Gillberg. [3] Gillberg has done extensive research into autism throughout his academic career. In 2003, a French and Swedish research team at the Institut Pasteur and the psychiatry departments at Gothenburg University and University of Paris, led by Thomas Bourgeron, Marion Leboyer and Gillberg, discovered the first precisely identified genetic mutations in individuals with autism. [4] The team identified mutations altering two genes on the X chromosome which seem to be implicated in the formation of synapses (communication spaces between neurons), in two families where several members are affected. Previous studies, such as the Paris Autism Research International Sib-Pair Study (PARIS), coordinated by Gillberg and Marion Leboyer, have more generally associated the X-chromosome regions with autism. The 2003 breakthrough indicated the location of the mutation to be on the NLGN4 gene and the NGLN3 gene. The mutation prevents a complete protein from forming and is inherited from the mother. [5]

Beginning in 2006, Gillberg is involved in a cross-disciplinary project titled "Autism spectrum conditions: the Gothenburg collaborative studies", funded by the Swedish Research Council (Vetenskapsrådet). [6] The project is a collaboration between scientists specialized in child and youth psychiatry, molecular biology and neuroscience and involves a genetic part with an international study team of French, British and U.S. researchers examining various aspects autism. Some of the results were published during 2007. [7] [8] The project also includes a genetic study on the Faroe Islands. [6] [9]

DAMP, MBD, and ADHD

In the 1970s, Gillberg and co-workers developed the concept Deficits in Attention, Motor control and Perception (DAMP), which was primarily used in Scandinavia. [10] [11] The DAMP concept as used in more recent publications, refers to Attention-deficit hyperactivity disorder (ADHD) in combination with Developmental Coordination Disorder (DCD). According to Gillberg, it constitutes a "subgroup of the diagnostic category of ADHD, conceptually similar – but not clinically identical – to the WHO concept of HKD (hyperkinetic disorder)" and is diagnosed on the basis of "concomitant attention deficit/hyperactivity disorder and developmental coordination disorder in children who do not have severe learning disability or cerebral palsy". [12]

Some scholars disagree with the lumping of ADHD and DCD, arguing that they are unrelated. [13] Gillberg stated in 2003 that, although he opines that there is a "very real issue of how to deal with the conflict between splitting (ADHD plus developmental coordination disorder (DCD)) and lumping (DAMP)", he nevertheless feels that "the DAMP construct has been helpful in identifying a group of children with ADHD and multiple needs that will not be self evident if the diagnosis is just ADHD or just DCD." [12] Before the Scandinavian studies, recognition that individuals with attention problems may also have difficulties with movement, perception, and memory had received little attention in studies. [13] According to various studies, half of the children with ADHD also have DCD. [14]

With the development of the ADHD concept, the previous, less precise, category of Minimal Brain Dysfunction (MBD), "a term almost universally employed in child psychiatry and developmental paediatrics from the 1950s to the early 1980s" [12] was replaced. Gillberg began to study DAMP in the late 1970s, when ADHD was still called MBD and the DAMP concept has been adjusted as the term ADHD was introduced and became internationally used. Around 1990, DAMP had become a generally accepted diagnostic concept in two Nordic countries, [15] but when the DSM-IV appeared in 1994, DAMP became considered a redundant term in many countries, since DAMP is essentially equivalent to ADHD in combination with DCD as defined by DSM-IV. [12] [16] Gillberg's four criteria for DAMP are:

According to Gillberg, clinically severe form DAMP (or ADHD+DCD) affects about 1.5% of the general population of school age children; another few per cent are affected by more moderate variants. Boys are overrepresented; girls are currently probably underdiagnosed. There are many overlapping conditions, including conduct disorder, depression/anxiety, and academic failure. There is a strong link with autism spectrum disorders in severe DAMP. Familial factors and pre- and perinatal risk factors account for much of the variance. Psychosocial risk factors appear to increase the risk of marked psychiatric abnormality in DAMP. Outcome in early adult age was psychosocially poor in one study in almost 60% of unmedicated cases. About half of all cases with ADHD have DCD, and conversely, ADHD occurs in about half of all cases of DCD. [12]

As of December 2024, Gillberg has published 780 papers (listed at PubMed) on DAMP, ADHD and related conditions. [12]

Gillberg's criteria for Asperger syndrome

In 1989, Gillberg became instrumental in the publication of the first diagnostic criteria for Asperger syndrome. [17] They are applied in clinical practice due to the adhesion to the original description of Hans Asperger. [18] All of the following six criteria must be met for confirmation of diagnosis: [19]

  1. Severe impairment in reciprocal social interaction (at least two of the following)
    1. inability to interact with peers
    2. lack of desire to interact with peers
    3. lack of appreciation of social cues
    4. socially and emotionally inappropriate behavior
  2. All-absorbing narrow interest (at least one of the following)
    1. exclusion of other activities
    2. repetitive adherence
    3. more rote than meaning
  3. Imposition of routines and interests (at least one of the following)
    1. on self, in aspects of life
    2. on others
  4. Speech and language problems (at least three of the following)
    1. delayed development
    2. superficially perfect expressive language
    3. formal, pedantic language
    4. odd prosody, peculiar voice characteristics
    5. impairment of comprehension including misinterpretations of literal/implied meanings
  5. Non-verbal communication problems (at least one of the following)
    1. limited use of gestures
    2. clumsy/gauche body language
    3. limited facial expression
    4. inappropriate expression
    5. peculiar, stiff gaze
  6. Motor clumsiness: poor performance on neurodevelopmental examination

Gillberg's criteria differ from those given in the DSM-IV-TR. Some scholars have therefore criticized them for "making it difficult to compare with other studies." [20] It has been argued that the failure of some research groups to replicate some of Gillberg's findings "may relate primarily to fundamental differences in diagnostic approach". [20]

Awards

Gillberg has received several awards for his research, including:

See also

Notes

  1. ↑ Munk-Jørgensen, P. (2003). "Biographies". Acta Psychiatrica Scandinavica . 108 (2): 160. doi:10.1034/j.1600-0447.2003.00154.x. S2CID   221438541.
  2. ↑ Modern Approaches in Learning Disabilities Conference Archived 3 December 2008 at the Wayback Machine . Developmental Disabilities Research Group (DDREG) 2005 annual conference, South West Centre for Education, Research & Development. Retrieved 23 May 2008.
  3. ↑ Gillberg, C. (2006) "Autism Spectrum Disorders". A Clinician's Handbook of Child and Adolescent. Eds. Christopher Gillberg, Richard Harrington and Hans-Christoph Steinhausen. Cambridge University Press, 2006. ISBN   0-521-81936-9, p. 447.
  4. ↑ Gosline, Anna. "Roadmap to unravelling autism revealed". New Scientist, 28 June 2005. Retrieved 20 August 2006.
  5. ↑ Betancur, Catalina; et al. (2003). "Mutations of the X-linked genes encoding neuroligins NLGN3 and NLGN4 are associated with autism". Nature Genetics. 34 (1): 27–29. doi:10.1038/ng1136. PMC   1925054 . PMID   12669065. Press release: "Two genes associated with autism" Archived 12 September 2006 at the Wayback Machine . Press Office, Institut Pasteur, University of Paris. 31 March 2003. Retrieved 20 August 2006.
  6. 1 2 Vetenskapsrådet. Detaljerad information för diarienr 2006–3449 Archived 24 May 2010 at the Wayback Machine : Gillberg, Christopher "Psychiatric diseases". 8 November 2006 (in Swedish). Retrieved 6 May 2008.
  7. ↑ Christopher Gillberg Archived 9 February 2012 at the Wayback Machine . Scientific Commons. Retrieved 6 May 2008.
  8. ↑ Buxbaum JD, Cai G, Nygren G, et al. (2007). "Mutation analysis of the NSD1 gene in patients with autism spectrum disorders and macrocephaly". BMC Med. Genet. 8: 68. doi: 10.1186/1471-2350-8-68 . PMC   2248565 . PMID   18001468.
  9. ↑ Ellefsen, Asa et al. (2008). "Autism in the Faroe Islands. An Epidemiological Study". Journal of Autism and Developmental Disorders, 37-3 (March 2007), pp. 437–444.
  10. ↑ Gillberg, C. (2003). "Deficits in attention, motor control, and perception: A brief review". Archives of Disease in Childhood. London: Oct 2003. Vol. 88, Iss. 10; p. 904: "In Scandinavia, the DAMP (deficits in attention, motor control, perception) concept was developed in the 1970s, in an attempt to operationalise the syndrome of MBD, long before the publication of the DSM-III-R (in which ADHD appeared in a formalised fashion for the first time)."
  11. ↑ Tervo, Raymond C. et al. (2002)."Children with ADHD and motor dysfunction compared with children with ADHD only". Developmental Medicine & Child Neurology 2002; 44, p. 383: "Establishing a diagnosis is often difficult because separately identified disorders such as DCD and attention-deficit-hyperactivity disorder (ADHD) have a substantial overlap (Bax 1999). A child who has problems of attention may have difficulties with movement, perception, and memory (Gillberg and Rasmussen 1982a,b). In Scandinavia these overlapping symptoms and signs are labeled as deficits in attention, motor control, and perception (DAMP)".
  12. 1 2 3 4 5 6 Gillberg, Christopher (2003). "Deficits in attention, motor control, and perception: a brief review". Archives of Disease in Childhood. 88 (10): 904–910. doi:10.1136/adc.88.10.904. PMC   1719331 . PMID   14500312.
  13. 1 2 Tervo Raymond C.; et al. (2002). "Children with ADHD and motor dysfunction compared with children with ADHD only". Developmental Medicine & Child Neurology. 2002 (44): 383–390. doi:10.1111/j.1469-8749.2002.tb00832.x.
  14. ↑ Martin, Neilson C.; Piek Jan P; Hay, David (February 2006). "DCD and ADHD: A genetic study of their shared aetiology". Human Movement Science. 25 (1). The Association for Child Psychology and Psychiatry: 110–124. doi:10.1016/j.humov.2005.10.006. ISSN   0167-9457. PMID   16442650.
  15. ↑ Airaksinen E; Bille B; Carlström G; Diderichsen J; Ehlers S; Gillberg C; et al. (1991). "Barn och ungdomar med DAMP/MBD". Läkartidningen. 88: 714.
  16. ↑ Gillberg, Christopher (1999). "Nordisk enighet om DAMP/ADHD – Aktuellt dokument sammanfattar dagens kunskap". Läkartidningen . 96: 3330–3331.
  17. ↑ Attwood, Tony (2006). The Complete Guide to Asperger's Syndrome. Jessica Kingsley Publishers, 2006. ISBN   1-84310-495-4, p.36: "One of the results of the discussions [at a small international conference about Asperger's syndrome in London in 1988] was the publication of the first diagnostic criteria in 1989, revised in 1991 (Gillberg 1991; Gillberg and Gillberg 1989)".
  18. ↑ Attwood, Tony (2006). The Complete Guide to Asperger's Syndrome. Jessica Kingsley Publishers, 2006. ISBN   1-84310-495-4, p.36: "the criteria of Christopher Gillberg, who is based in Sweden and London, remain those that most closely resemble the original descriptions of Asperger. Thus, these are the criteria of first choice for me and many experienced clinicians."
  19. ↑ Gillberg IC, Gillberg C (July 1989). "Asperger syndrome—some epidemiological considerations: a research note". J Child Psychol Psychiatry. 30 (4): 631–638. doi:10.1111/j.1469-7610.1989.tb00275.x. PMID   2670981.
  20. 1 2 Klin Ami; Pauls, David; Schultz, Robert; Volkmar, Fred (2005). "Three Diagnostic Approaches to Asperger Syndrome: Implications for Research". Journal of Autism and Developmental Disorders. 35 (2): 221–234. doi:10.1007/s10803-004-2001-y. PMID   15909408. S2CID   19076633.
  21. ↑ Staff list. ICH, Academic units, Neurosciences. Retrieved 23 May 2008.
  22. ↑ Professor Christopher Gillberg awarded H.M. The King's Medal Archived 24 February 2012 at the Wayback Machine . University of Gothenburg, 30 January 2009. Retrieved 16 June 2009.

Selected publications by Gillberg

Journal articles

Selected books

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