Prevalence of co-occurring mental health diagnoses in the autism population: a systematic review and meta-analysis

Lai, Meng‐Chuan; Kassee, Caroline; Besney, Richard; Bonato, Sarah; Hull, Laura; Mandy, William; Szatmári, Péter; Ameis, Stephanie H.

doi:10.1016/s2215-0366(19)30289-5

Cited by 922 publications

(797 citation statements)

References 70 publications

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“…Further, we evaluated the full-texts of 86 articles and excluded 60 articles that did not meet all the criteria of this review. Finally, 26 articles meeting all the criteria were included in this umbrella review (see Table 3), including 14 systematic reviews (Arnevik and Helverschou, 2016;Hannon and Taylor, 2013;Hedley and Uljarević, 2018;Kalyva et al, 2016;Menezes et al, 2018;Nickel et al, 2019;Padgett et al, 2010;Richa et al, 2014;Skokauskas and Gallagher, 2009;Stewart et al, 2006;Vannucchi et al, 2014;Wigham et al, 2017;Zahid and Upthegrove, 2017) and 12 meta-analyses (De Díaz-Román et al, 2018;Elrod and Hood, 2015;Hollocks et al, 2019;Hudson et al, 2019;Lai et al, 2019;Lugo-Marín et al, 2019;Lugo Marín et al, 2018;Morgan et al, 2020;van Steensel et al, 2011;van Steensel and Heeman, 2017;Zheng et al, 2018). Three clinical and one community sample were recruited comprising of children, adolescents, and young adults with ASD; study locations were not specified…”

Section: Resultsmentioning

confidence: 99%

“…Most reviews evaluated primary studies with ASD populations only among which the sample size ranged from three to 210,249 Lai et al, 2019). A few studies compared psychiatric comorbidity among ASD population with those of typically-developed control population with sample size ranging from 12 to 1,842,575 .…”

Section: Sample Size and Characteristics Of The Study Participantsmentioning

confidence: 99%

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Prevalence of comorbid psychiatric disorders among people with autism spectrum disorder: An umbrella review of systematic reviews and meta-analyses

Hossain¹,

Khan²,

Sultana³

et al. 2020

Preprint

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<p>With ever-increasing prevalence of various mental disorders worldwide, a comprehensive evaluation of the prevalence of co-occurring psychiatric disorders among individuals with autism spectrum disorder (ASD) is needed to strengthen the knowledge base. This umbrella review aims to summarize the current evidence on the prevalence of comorbid psychiatric disorders among people with ASD. A systematic search of 12 major databases and additional sources was conducted. Any systematically conducted narrative, qualitative, or meta-analytic review reporting the prevalence of psychiatric disorders among people with ASD with no age or geographical restriction were included. From a total of 2755 records, 26 articles representing 14 systematic reviews and 12 meta-analyses met the criteria of this review. The synthesized findings reveal a high burden of comorbid psychiatric disorders among people with ASD, including anxiety disorders, depressive disorders, bipolar and mood disorders, schizophrenia spectrum, suicidal behavior disorders, attention-deficit/hyperactivity disorder, disruptive, impulse-control and conduct disorders amongst diverse age groups, with a majority in younger participants. Most studies were conducted in developed nations, with limited evidence from low and middle-income countries. These synthesized findings provide high-quality evidence for clinical and policy-level decision-making from a global overview of the status of comorbid psychiatric disorders among people with ASD.</p>

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Section: Resultsmentioning

confidence: 99%

Section: Sample Size and Characteristics Of The Study Participantsmentioning

confidence: 99%

Prevalence of comorbid psychiatric disorders among people with autism spectrum disorder: An umbrella review of systematic reviews and meta-analyses

Hossain¹,

Khan²,

Sultana³

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…Individuals with Autism spectrum disorders (ASD) are diverse in their presentation of core symptoms (1), and are at increased risk for both psychiatric and somatic comorbidities (2)(3)(4).…”

Section: Introductionmentioning

confidence: 99%

“…For instance, about one third also present with intellectual disability (ID), and ADHD respectively (3,5). The clinical characterization of ASD as a combined diagnostic group, might thus not reflect one common, but possibly several distinct, underlying pathogenic processes that remain a challenge for research that aims to identify the etiology of ASD.…”

Section: Introductionmentioning

confidence: 99%

Maternal antibodies to gliadin and autism spectrum disorders in offspring - A population-based case-control study in Sweden

Gardner

Samuelsson

Severance

et al. 2020

Preprint

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ObjectiveIndividuals diagnosed with autism spectrum disorders (ASD) are reported to have higher levels of antibodies directed towards gliadin, a component of wheat gluten. However, no study has examined such antibodies in etiologically-relevant periods before diagnosis. The objective of this study is to investigate if maternal levels of immunoglobulin G antibodies directed at gliadin, during pregnancy and at the time of birth, are associated with ASD in offspring. MethodsIn this population-based study set in Sweden with 921 ASD cases and 1090 controls, we analyzed levels of anti-gliadin antibodies (AGA) in archived neonatal dried blood spots (NDBS, as maternal IgG is transferred to the fetus) and in paired maternal sera collected earlier in pregnancy for a subset of 547 cases and 428 controls. We examined associations to any ASD diagnosis and considering common comorbidities (i.e. intellectual disability [ID] and attentiondeficit/hyperactivity disorder [ADHD]). We compared 206 ASD cases to their unaffected siblings to examine the potential for confounding by shared familial factors. ResultsHigh levels (³90 th percentile) of maternal AGA were associated with decreased odds of ASD, particularly ASD with comorbid ID, when measured in NDBS (OR 0.51, 95% CI 0.30-0.87) with a similar trend in maternal sera (0.55, 0.24-1.29). High levels of maternal AGA were similarly associated with lower odds of ASD with ID in the sibling comparison. ConclusionsThis first study of exposure to AGA in the pre-and perinatal periods suggests that high levels of maternal AGA are associated with lower odds of ASD with ID. SF2. Maternal IgG AGA levels during pregnancy and offspring odds of ASDThe figure displays crude and adjusted OR's and 95 % CI for high levels of maternal AGA (i.e. levels in the 80-90 and > 90 th percentile categories, based on the distribution among controls) when measured in NDBS and in MS, for ASD in offspring as well as for ASD subtyped by comorbidities. The adjusted models for AGA in NDBS were adjusted for sex, maternal age, maternal BMI, maternal psychiatric history, maternal immigrant status, income, birth order, gestational age at birth and mode of delivery. The adjusted models for AGA in MS were adjusted for sex, maternal age, maternal BMI, maternal psychiatric history, maternal immigrant status, income, maternal total IgG and birth order.Abbreviations; ADHD = Attention-deficit hyperactive disorder, AGA = Antigliadin antibodies, ASD = Autism spectrum disorders, CI = Confidence interval, ID =Intellectual disability, MS = Maternal, NDBS = Neonatal dried blood spots, OR = Odds ratio

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“…Individuals with ASD commonly display inattention, impulsivity, and hyperactivity symptoms (4) and likewise, individuals with ADHD often have impaired social and communication skills (5–7). In addition, ASD and ADHD are frequently comorbid; approximately one third of children with ASD are also diagnosed with ADHD (8,9) and one fifth of children with ADHD meet diagnostic criteria for ASD (7).…”

Section: Introductionmentioning

confidence: 99%

Combining multivariate genomic approaches to elucidate the comorbidity between ASD and ADHD

Peyre

Schoeler

Liu

et al. 2020

Preprint

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1Background: Several lines of evidence point toward the presence of shared genetic factors 2 underlying Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder 3 (ADHD). However, Genome-Wide Association Studies (GWAS) have yet to identify risk 4 variants (i.e. Single-Nucleotide Polymorphisms, SNPs) shared by ADHD and ASD. 5Methods: Two complementary multivariate analyses -genomic structural equation 6 modelling (SEM) and colocalization analysis -were exploited to identify the shared SNPs for 7 ASD and ADHD, using summary data from two independent GWAS of ASD (N=46,350) 8 and ADHD individuals (N=55,374). 9Results: Genomic SEM identified 7 novel SNPs shared between ASD and ADHD (p genome-10 wide <5e-8), including three SNPs that were not identified in any of the original univariate 11 GWAS of ASD and ADHD (rs227378, rs2391769 and rs325506). We also mapped 4 novel 12 genes (MANBA, DPYD, INSM1, and PAX1) to SNPs shared by ASD and ADHD, as well as 13 4 genes that had already been mapped to SNPs identified in either ASD or ADHD GWAS 14 (SORCS3, XRN2, PTBP2 and NKX2-4). All the shared genes between ADHD and ASD 15 were more prominently expressed in the brain than the genes mapped to SNPs specific to 16 ASD or ADHD. Colocalization analyses revealed that 44% percent of the SNPs associated 17 with ASD (p<1e-6) colocalized with ADHD SNPs and 26% of the SNPs associated with 18 ADHD (p<1e-6) colocalized with ASD SNPs. 19Conclusions: Using multivariate genomic analyses, the present study reveals the shared 20 genetic pathways that underlie ASD and ADHD. Further investigation of these pathways may 21 help identify new targets for treatment of these disorders. 22 23 24 25

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Prevalence of co-occurring mental health diagnoses in the autism population: a systematic review and meta-analysis

Cited by 922 publications

References 70 publications

Prevalence of comorbid psychiatric disorders among people with autism spectrum disorder: An umbrella review of systematic reviews and meta-analyses

Prevalence of comorbid psychiatric disorders among people with autism spectrum disorder: An umbrella review of systematic reviews and meta-analyses

Maternal antibodies to gliadin and autism spectrum disorders in offspring - A population-based case-control study in Sweden

Combining multivariate genomic approaches to elucidate the comorbidity between ASD and ADHD

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