Asperger syndrome (AS) is still misdiagnosed. It has also not many papers devoted to its course and outcomes.

To investigate the course of AS in different ages as well as identify the predictors of poor prognosis.

We have sorted out 87 outpatients (78 males and 9 females) with the diagnosis of “Asperger syndrome” according to the DSM-IV. The research was naturalistic. We have also used the following rating scales: Asperger syndrom diagnostic interview (ASDI), a screening questionnaire of autism spectrum disorders (ASDASQ), Adult ADHD Self- Report Scale (ASRS) Symptom Checklist.

We have identified two groups of patients with AS. One group (55 persons) was characterized by predominance of different conduct disorders in their childhood. The symptoms of AS overlapped with ADHD signs. Most patients were treated then with psychotropic medicines as well as more than one third (35%) have been hospitalized. During adolescence a lot of symptoms were gradually decreasing except mild neurotic signs that did not lead to either inpatient or outpatient psychiatric service.

Another group (32 persons) was characterized in the childhood by only separate symptoms of attention deficit syndrome without taking any psychiatric drugs. However, in adolescence some affective and neurotic disorders have been exacerbated. Most individuals took psychotropic drugs (81%) and/or being hospitalized (38%). Symptoms of AS had declined that was accompanied with better prognosis.

Course of AS mainly depends on the age of individual and comorbid psychiatric disorders.