Dimensional Characteristics of Children and Adolescents with Mood Disorders and Autism Spectrum Disorders

Abstract

Objective: We sought to identify clinical discriminators between predominantly mood disordered and predominantly autism spectrum disordered research subjects that may reflect phenotypic state and treatment response characteristics. Method: Participants were 26 boys and 4 girls aged 2 to 18 years (Mean Age = 7.70). Subjects with DSM-IV diagnoses of Major depression (N = 2), Bipolar Disorder (N = 4) and Mood Disorder not otherwise specified (NOS) (N = 11) represented the mood disorder group (MD) (N = 17, Mean Age = 8.2) and those with diagnoses of Autistic Disorder (N = 1), Asperger's Disorder (7) or Pervasive Developmental Disorder (NOS) (N = 3) comprised the autism spectrum disorder (ASD) group (N = 9, Mean Age = 6.8). Primary outcome measurements were continuous actigraphic measurements collected over one to three week periods. Secondary outcomes included personality and observational measurements. Personality characteristics reflected significant cross-group impairments related to self-control and self-discipline and differed relative to intellectual measures. Observational measurements reflected greater general impairments among the ASD group. Results: Predominantly mood disordered children demonstrated greater impairments related to sleep (P = 0.000) and sleep onset latency (P = 0.000) and were more active than ASD children during evening periods (P = 0.000). ASD children had lower verbal functioning and greater deviations from the norm on measures of cognitive development (P = 0.003) and psychosis (P = 0.047). Conclusions: Sleep disturbances, evening activity levels and phase delayed sleep appear to differentiate predominant mood and autism spectrum disordered children suggesting future areas for further exploration of neurological and phenotypic treatment response characteristics.