A case report and literature review of autism and attention deficit hyperactivity disorder in paediatric chronic pain

Lipsker, Camilla Wiwe; Heijne, Margareta von; Bölte, Sven; Wicksell, Rikard K.

doi:10.1111/apa.14220

Cited by 15 publications

(20 citation statements)

References 27 publications

(30 reference statements)

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“…Recently, Lipsker et al (11) described the case of a 6-years-old girl with severe chronic pain since very early age (headaches, joint and muscle pain), and comorbid ASD and attention deficit/hyperactivity disorder (ADHD). The authors also describe JH and fatigue in this patient, as well as antecedents of chronic pain in her relatives.…”

Section: Ehlers-danlos Syndromes (Eds) and Autismmentioning

confidence: 99%

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Autism, Joint Hypermobility-Related Disorders and Pain

et al. 2018

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Autism Spectrum Disorder (ASD) and Joint Hypermobility-Related Disorders are blanket terms for two etiologically and clinically heterogeneous groups of pathologies that usually appears in childhood. These conditions are seen by different medical fields, such as psychiatry in the case of ASD, and musculoskeletal disciplines and genetics in the case of hypermobility-related disorders. Thus, a link between them is rarely established in clinical setting, despite a scarce but growing body of research suggesting that both conditions co-occur more often than expected by chance. Hypermobility is a frequent sign of hereditary disorders of connective tissue (e.g., Ehlers-Danlos syndromes, Marfan syndrome), in which the main characteristic is the multisystem fragility that prone to proprioceptive and motor coordination dysfunction and hence to trauma and chronic pain. Considering the high probability that pain remains disregarded and untreated in people with ASD due to communication and methodological difficulties, increasing awareness about the interconnection between ASD and hypermobility-related disorders is relevant, since it may help identify those ASD patients susceptible to chronic pain.

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Section: Ehlers-danlos Syndromes (Eds) and Autismmentioning

confidence: 99%

“…Although the magnitude of the co-occurrence between chronic pain and neurodevelopmental disorders such as ASD remains unknown (11), some data suggest that chronic pain is frequent among the ASD population. Bursch et al (12) reported that more than 20% of pediatric patients in a pain clinic in US presented with ASD traits.…”

Section: Introductionmentioning

confidence: 99%

Autism, Joint Hypermobility-Related Disorders and Pain

et al. 2018

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“…Taken together, existing research suggests that children with chronic pain conditions may be at risk of having an undetected neurodevelopmental disorder, and due to such comorbidity display more functional impairments 38 , 48 and respond less well to treatment. Thus, there is an urgent need to scientifically evaluate the co-occurrence of ASD, ADHD, and pediatric chronic pain, and potential relations to pain and demographic factors.…”

Section: Introductionmentioning

confidence: 97%

Prevalence of autism traits and attention-deficit hyperactivity disorder symptoms in a clinical sample of children and adolescents with chronic pain

Lipsker

Bölte

Hirvikoski

et al. 2018

JPR

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PurposeRecent research has suggested that autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) may be comorbid to pediatric chronic pain, but the empirical support is yet scarce. Therefore, the current study aimed to investigate the occurrence of traits and symptoms consistent with clinically significant ASD and ADHD in a group of children and adolescents with chronic debilitating pain and examine potential differences in pain and demographic variables between children with and without clinically significant traits and symptoms of ASD and ADHD.Patients and methodsThis cross-sectional study included 146 parent–child dyads (102 girls, 111 mothers, children 8–17 years) consecutively referred to a tertiary pain clinic. Parents completed the Social Responsiveness Scale to assess autistic traits, and Conners-3 to measure symptoms of ADHD in their children. Children completed the Lübeck Pain Questionnaire to evaluate experienced pain.ResultsAmong children, 20 (13.7%) received scores consistent with clinically significant ASD and 29 (19.9%) received scores consistent with clinically significant ADHD, with a combined prevalence of clinically significant ASD/ADHD traits and symptoms of 26% of the total sample. Only 4.8% of children were previously diagnosed with either disorder. Among children with clinically significant ASD traits, girls were more prevalent, parents reported lower health, and the pain was more likely triggered by being in school. Among children with clinically significant ADHD symptoms, there were no gender differences and pain was more likely triggered by the family situation and new situations. No differences regarding pain intensity, duration, or frequency were found between children with and without clinically significant ASD traits or ADHD symptoms.ConclusionChildren with debilitating chronic pain, particularly girls, may present with an elevated risk of having a comorbid, possibly high-functioning, neurodevelopmental disorder. Results suggest that clinical assessment of pediatric chronic pain should include screening for neurodevelopmental disorders.

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“…We read with interest the paper ‘A case report and literature review of autism and attention deficit hyperactivity disorder in paediatric chronic pain' by Wiwe Lipsker et al. in Acta Paediatrica and would like to add some further paediatric aspects. The authors discussed the importance of adopting a broad paediatric and neuropsychiatric perspective and screening for neurodevelopmental comorbidities in children with chronic pain without any identified cause.…”

mentioning

confidence: 99%

“…However, the case description provides another important medical aspect that may be of clinical relevance for the child′s chronic pain.…”

mentioning

confidence: 99%

A possible connection between childhood pain, joint hypermobility and Neurodevelopmental disorders

Fernell

Ronge

2018

Acta Paediatrica

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A case report and literature review of autism and attention deficit hyperactivity disorder in paediatric chronic pain

Abstract: The inclusion of behavioural assessment and screening for neurodevelopmental comorbidity may be essential in addressing complex paediatric chronic pain.

Cited by 15 publications

References 27 publications

Autism, Joint Hypermobility-Related Disorders and Pain

Autism, Joint Hypermobility-Related Disorders and Pain

Prevalence of autism traits and attention-deficit hyperactivity disorder symptoms in a clinical sample of children and adolescents with chronic pain

A possible connection between childhood pain, joint hypermobility and Neurodevelopmental disorders

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