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Autism spectrum disorder (ASD) is often overlooked or misdiagnosed in adult patients especially in those with other psychiatric comorbidities. Several reasons possibly account for this fact, for example, difficulty in obtaining accurate developmental history from a patient, insufficient experience among psychiatrists detecting ASD in adult patients, and mild/atypical autistic traits in contrast to prominent symptoms of psychiatric comorbidities. We conducted a search of databases (PubMed, PsycINFO, and ERIC) for relevant articles published from January 2000 to May 2015 and summarized unrecognized or misdiagnosed cases as well as major psychiatric comorbidities among adults with ASD from previous reports. Five disorders, (i.e., schizophrenia, psychotic disorder, bipolar disorder, major depressive disorder, and personality disorder) were specifically highlighted as misdiagnosed psychiatric diseases or comorbidities responsible for unrecognized ASD. This review also proposes plausible pathways for patterns of maladjustment and processes leading to misdiagnosis among adults with ASD, together with necessary approaches to support their goals of a requisite social life. In conclusion, clinicians should be more concerned with correct diagnosis of ASD as well as treatments of psychiatric comorbidities and need perspective of management for better mental health and social adjustment in ASD patients.

How and Why is Autism Spectrum Disorder Misdiagnosed in Adult Patients? - From Diagnostic Problem to Management for Adjustment -