Clinical and therapeutic implications of psychiatric comorbidity in high functioning autism/Asperger syndrome: An Italian study

Abstract

The present study describes the occurrence of psychiatric comorbid disorders in a cohort of 86 high functioning autism (HFA)/Asperger syndrome (AS) patients, examined at Child Neurology and Psychiatry Unit of Tor Vergata University. 38 patients out of 86 (44.2%) presented one or more psychiatric comorbidities, such as mood disorders, Attention Deficit/Hyperactivity Disorder (ADHD), Tourette syndrome (TS), anxiety disorders, including obsessive-compulsive disorder (OCD), and psychotic symptoms. We compared our sample with the evidences from the scientific literature on psychiatric comorbidity in ASD patient, in particular in HFA/AS. In this paper we focus on the high frequency of comorbid psychiatric disorders in HFA/AS patients, such as mood disorders, Attention Deficit/Hyperactivity Disorder (ADHD), Tourette syndrome (TS), anxiety disorders, including obsessive-compulsive disorder (OCD), and psychosis, including schizophrenia. We analyzed rates of all psichiatric comorbidities diagnosed in a sample of HFA/AS subjects and we compared findings from our study with the evidences from the scientific literature on psychiatric comorbidity in ASD patients, in particular HFA/AS. We point out that comorbid psychiatric symptoms can be hardly diagnosed, because they could present atipically in ASDs then in general population. Furthermore, they could be masked by ASD core symptoms.

Overlap between Autism Spectrum Disorder and Bipolar Affective Disorder

“…The study also employed a very selective clinical sample of pre-adolescents and adolescents with HFA, with the majority not receiving their ASD diagnosis until late childhood or adolescence. Still the other studies which investigated HFA reported much higher co-occurrence rates [25][26][27] .…”

“…A recent Italian study also investigated the co-occurrence of psychiatric disorders in 86 children with HFA and AS attending a university clinic. 38 patients out of 86 (44.2%) presented with 1 or more additional psychiatric conditions and 7 (18.4%) were diagnosed with BPAD [25] . Hofvander et al [41] assessed 122 consecutively referred adults with normal-intelligence ASD.…”

“…More than a half of them [12] were published over the past 5 years reflecting the growing interest in the topic. Most studies [14] investigated children, and 3 studies focused on children with high-functioning autism (HFA) [25][26][27] . All studies but one [28] employed clinical samples.…”

ADHD Symptoms in Adults with Asperger’s Disorder: Findings from a Sample in Japan

“…Although ASD and other mental disorders are often simultaneously diagnosed, the DSM-IV [1] and the ICD-10 [2] prohibit the diagnosis of ADHD in individuals with an ASD diagnosis. Previous studies indicated that the prevalence of ADHD among individuals with ASD is estimated to be 28.2% [25], particularly among those with HFA/AS its 44% -65% [26,27]. Giovinazzo et al [27] investigated psychiatric comorbidity in 86 high-functioning ASD and reported that 25 subjects (37.9%) had ADHD.…”

“…Previous studies indicated that the prevalence of ADHD among individuals with ASD is estimated to be 28.2% [25], particularly among those with HFA/AS its 44% -65% [26,27]. Giovinazzo et al [27] investigated psychiatric comorbidity in 86 high-functioning ASD and reported that 25 subjects (37.9%) had ADHD. Holtmann et al [8] examined 182 PDD subjects and reported that subjects with a severe attention problem exhibited a significantly higher degree of general psychopathology.…”