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Autism study downplays genetics as primary cause

Environmental factors may be more important than previously thought in determining whether a child develops autism, says a study of twins published online in July by the Archives of General Psychiatry. The findings shake up prior assumptions that genetics were largely the culprit behind the neurodevelopmental disorder, now estimated to affect 1% of the population. The study, believed to be the largest of its kind, looked at 192 pairs of identical and fraternal twins, in which at least one child in each pair had strict autism or a milder autism spectrum disorder. Researchers drew on records from the California Dept. of Developmental Services. They found that shared environmental factors -- prenatal and early postnatal experiences common to both twins, such as parental age, low birth weight or multiple births -- accounted for 55% of strict autism and 58% of more broadly defined ASD cases. Genetic heritability accounted for 37% of autism and 38% of ASD cases. By contrast, earl ...

California budget includes Medicaid doctor pay cut and patient co-pays

California lawmakers adopted an annual budget by the June deadline for the first time in five years, but they will have to amend it if judges or federal officials reject a 10% Medicaid physician pay cut in the budget, among other policy changes that require federal approval. California Gov. Jerry Brown, who signed the $88 billion fiscal 2012 budget on June 30, said the measure reduces the state's general fund spending to its lowest level as a percentage of state economic growth since 1973. "This is a huge step forward. But California's long-term stability depends on our willingness to continue to pay down debt and live within our means." California physicians opposed the Medicaid rate and access reductions in the budget, according to the California Medical Assn. These include a double-digit Medicaid pay cut in a state that already has one of the five-lowest Medicaid pay rates in the country, according to Lisa Folberg, vice president of medical and regulatory policy for the associ ...

Personality disorder criteria revised in new diagnosis manual

Draft criteria for identifying and diagnosing personality disorders in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders simplifies the number of conditions and allows for a greater variety of impairment levels. The proposed recommendations follow the receipt of more than 8,000 public comments on the DSM-5 in 2010. The comments concerned all aspects of the DSM-5, not just personality disorders. Comments relevant to issues managed by the 11-member Personality and Personality Disorders Work Group led it to return narcissistic personality disorder to the list of disorder types after removing it in an earlier draft. The group also simplified and streamlined the process of assessing personality disorders. The goal of the new criteria is to maximize their utility to clinicians and benefit to patients, according to the American Psychiatric Assn. "Our proposed criteria get away from the idea that personality pathology is just a group of disorders," said ...