An update on anxiety in youth with autism spectrum disorders

Vasa, Roma A.; Mazurek, Micah O.

doi:10.1097/yco.0000000000000133

Cited by 99 publications

(59 citation statements)

References 80 publications

(90 reference statements)

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“… 18 , 47 Such stress may be linked to sexual abuse that has been associated with higher risk of ASD. 48 , 49 ASD patients are prone to stress 50 and a meta-analysis showed a strong correlation between the presence of anxiety disorders and ASD. 51 In fact, anxiety was significantly correlated with repetitive behaviors in children with ASD.…”

Section: Maternal Health Prematurity and Low Birth Weight Are Linkedmentioning

confidence: 99%

Atopic diseases and inflammation of the brain in the pathogenesis of autism spectrum disorders

et al. 2016

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Autism spectrum disorders (ASDs) affect as many as 1 in 45 children and are characterized by deficits in sociability and communication, as well as stereotypic movements. Many children also show severe anxiety. The lack of distinct pathogenesis and reliable biomarkers hampers the development of effective treatments. As a result, most children with ASD are prescribed psychopharmacologic agents that do not address the core symptoms of ASD. Autoantibodies against brain epitopes in mothers of children with ASD and many such children strongly correlate with allergic symptoms and indicate an aberrant immune response, as well as disruption of the blood–brain barrier (BBB). Recent epidemiological studies have shown a strong statistical correlation between risk for ASD and either maternal or infantile atopic diseases, such as asthma, eczema, food allergies and food intolerance, all of which involve activation of mast cells (MCs). These unique tissue immune cells are located perivascularly in all tissues, including the thalamus and hypothalamus, which regulate emotions. MC-derived inflammatory and vasoactive mediators increase BBB permeability. Expression of the inflammatory molecules interleukin (IL-1β), IL-6, 1 L-17 and tumor necrosis factor (TNF) is increased in the brain, cerebrospinal fluid and serum of some patients with ASD, while NF-kB is activated in brain samples and stimulated peripheral blood immune cells of other patients; however, these molecules are not specific. Instead the peptide neurotensin is uniquely elevated in the serum of children with ASD, as is corticotropin-releasing hormone, secreted from the hypothalamus under stress. Both peptides trigger MC to release IL-6 and TNF, which in turn, stimulate microglia proliferation and activation, leading to disruption of neuronal connectivity. MC-derived IL-6 and TGFβ induce maturation of Th17 cells and MCs also secrete IL-17, which is increased in ASD. Serum IL-6 and TNF may define an ASD subgroup that benefits most from treatment with the natural flavonoid luteolin. Atopic diseases may create a phenotype susceptible to ASD and formulations targeting focal inflammation of the brain could have great promise in the treatment of ASD.

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Section: Maternal Health Prematurity and Low Birth Weight Are Linkedmentioning

confidence: 99%

Atopic diseases and inflammation of the brain in the pathogenesis of autism spectrum disorders

et al. 2016

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“…While anxiety disorders are known to be common in children and adolescents with ASD (van Steensel et al 2011;White et al 2009;Vasa and Mazurek 2015) less is known about the prevalence of anxiety disorders in adult populations. Studies to date of adults provide an inconsistent account with prevalence estimates ranging between 28% and 77% and are limited by differences in methodological design, small sample size (Mazefsky et al 2008;Tani et al 2012), recruitment of selected samples from secondary services, or lack of a valid comparison group (Tani et al 2012;Kanai et al 2011;Bakken et al 2010;Hutton et al 2008;Buck et al 2014;Hofvander et al 2009;Russell et al 2016;Lever and Geurts 2016).…”

Section: Introductionmentioning

confidence: 99%

Anxiety Disorders in Adults with Autism Spectrum Disorder: A Population-Based Study

Nimmo-Smith

Heuvelman

Dalman

et al. 2019

J Autism Dev Disord

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Anxiety is common in children with ASD; however, the burden of specific anxiety disorders for adults with ASD is underresearched. Using the Stockholm Youth Cohort, we compared anxiety disorder diagnoses among autistic adults (n = 4049), with or without intellectual disability, and population controls (n = 217,645). We conducted additional sibling analyses. Anxiety disorders were diagnosed in 20.1% of adults with ASD compared with 8.7% of controls (RR = 2.62 [95% CI 2.47-2.79]), with greatest risk for autistic people without intellectual disability. Rates of almost all individual anxiety disorders were raised, notably obsessive-compulsive disorder and phobic anxiety disorders. Anxiety disorders were more common in full siblings and half-siblings of people with ASD. The implications of this are explored.

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“…Although pharmacological treatment using selective serotonin reuptake inhibitors (SSRIs) are an effective treatment for anxiety in neurotypical youth [26,27], research examining their use in children and adolescents on the autism spectrum is limited, and includes heterogeneous samples of youth and poor study methodology (e.g., non-randomized and uncontrolled open trials, retrospective chart reviews, unclear symptom level targets) [28]. Overall, there is little to no support for using pharmacological agents for treatment of anxiety in youth with ASD, with limited efficacy and high rates of negative side effects.…”

Section: Pharmacological Treatment For Anxiety In Children and Adolesmentioning

confidence: 99%

Anxiety in youth with autism spectrum disorders: implications for treatment

Johnco

Storch

2015

Expert Review of Neurotherapeutics

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SUMMARY Anxiety disorders are one of the most common psychiatric comorbidities among children and adolescents with autism spectrum disorders (ASD). There has been a recent proliferation of research examining the prevalence, phenomenology, assessment and treatment of anxiety disorders among youth with ASD. While there is currently very limited support for the use of pharmacological agents to treat anxiety among youth with ASD and comorbid anxiety, there has been overwhelming support across numerous modestly sized controlled studies for the efficacy of cognitive behavioral therapy. This review discusses advances in the treatment literature for anxiety in youth with ASD, and discusses the current evidence base for whether standard treatment needs to be adapted for this population.

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An update on anxiety in youth with autism spectrum disorders

Cited by 99 publications

References 80 publications

Atopic diseases and inflammation of the brain in the pathogenesis of autism spectrum disorders

Atopic diseases and inflammation of the brain in the pathogenesis of autism spectrum disorders

Anxiety Disorders in Adults with Autism Spectrum Disorder: A Population-Based Study

Anxiety in youth with autism spectrum disorders: implications for treatment

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