Autism spectrum traits in children and adolescents with obsessive-compulsive disorder (OCD)

Abstract

Objective: Assess the prevalence of autistic traits (AST) in pediatric OCD and relate them to OCD co-morbidity and compare them with published normative data.Methods: Pediatric patients with Obsessive-Compulsive Disorder (n=109) according to the DSM IV were studied using parent ratings of the Autistic Symptom/Syndrome Questionnaire to assess AST symptoms as a continuous rather than categorical trait. The KSADS, a semistructured psychiatric interview, was used for the psychiatric diagnostic evaluation. Also, the Children's Yale-Brown Obsessive Compulsive Scale was used to assess OCD severity and other clinical features.Results: AST was common among our patients. Symptom scores were highest in cases with co-morbid Autistic Spectrum Disorders, but cases with other co-morbidities as tics/Tourette and attention/behavioral disorders also scored higher. All sub-groups, including OCD without these co-morbidities scored higher than the Swedish normative group. Using ANOVA, comorbid ASD and tics/Tourette (plus a term for gender by tic interaction indicating that girls with tics scored high, otherwise low) and pathological doubt contributed (R 2 = .41) to the AST-traits, while OCD severity and co-morbid anxiety-and depressive disorders did not.Conclusion: AST traits are prevalent in OCD and seem to be intricately associated with the co-morbidities as well as the OCD syndrome itself. The findings might have implication for our nosological understanding of OCD which currently is discussed.4

Obsessive–compulsive traits in children and adolescents with Asperger syndrome

“…These results might be related in both groups to the age and the level of development and concord with previous findings, which suggested the existence in childhood OCD of some impairments in perceiving, processing and describing repetitive thoughts and behaviours [12,27]. Also, the finding of no difference in insight amongst the two groups is in line with the study by Cath et al, which pointed out that egodystonicity did not discriminate between OCD and ASD subjects [9] and with the data of Ivarsson et al, who found in a paediatric OCD sample no relationship between the OCDpatients' level of insight and the presence of ASD traits [16].…”

“…Higher prevalence of autistic traits has been found in OCD samples both in adults [5,6] and children [16], and some evidence suggests that treatments effective for OCD may be effective for repetitive thoughts and behaviours in ASD as well [15,19,24,25]. Also, family studies have reported an association between restrictive or repetitive behaviours in probands with autism and obsessive-compulsive features in parents both in multiplex [14] and sporadic autism families [1].…”

Autism spectrum disorders in adult outpatients with obsessive compulsive disorder in the UK

“…This suggests that these specific ASD domains may have a moderating effect on OCD severity. In contrast, Ivarrson and colleagues (Ivarsson and Melin, 2008), who investigated children and adolescents with OCD recruited from a Swedish hospital population, found that just roughly 9% showed symptoms of ASD. The study used a neuro psychiatric assessment supplemented by autism screening questionnaire covering current and preschool autistic symptoms completed by the parents.…”

Misdiagnosis of High Function Autism Spectrum Disorders in Adults: An Italian Case Series

“…Autism Spectrum Disorders ISSN: 2165-7890 AUO, an open access journal 'bizarre' behavior can induce a misdiagnosis of schizophrenia [11,[25][26][27]; a pattern of repetitive thoughts and behavior can lead to a misdiagnosis of obsessive disorder [28][29][30]; social withdrawal and difficulty in relationship with others can induce a misdiagnosis of social phobia [31] or schizoid/schizotypal personality disorder [32,33]; poor emotional control can cause a misdiagnosis of borderline personality disorder [34], and so on.…”