Psychiatric comorbidities in asperger syndrome and high functioning autism: diagnostic challenges

Abstract

Several psychiatric conditions, both internalizing and externalizing, have been documented in comorbidity with Asperger Syndrome (AS) and High Functioning Autism (HFA). In this review we examine the interplay between psychiatric comorbidities and AS/HFA. In particular, we will focus our attention on three main issues. First, we examine which psychiatric disorders are more frequently associated with AS/HFA. Second, we review which diagnostic tools are currently available for clinicians to investigate and diagnose the associated psychiatric disorders in individuals with AS/HFA. Third, we discuss the challenges that clinicians and researchers face in trying to determine whether the psychiatric symptoms are phenotypic manifestations of AS/HFA or rather they are the expression of a distinct, though comorbid, disorder. We will also consider the role played by the environment in the manifestation and interpretation of these symptoms. Finally, we will propose some strategies to try to address these issues, and we will discuss therapeutic implications.

Longitudinal comparison between male and female preschool children with autism spectrum disorder

“…However, some studies reported that girls with ASD appeared to be at greater risk than boys for internalizing psychopathology (Solomon et al 2012;Mazzone et al 2012).…”

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

“…In our sample, ADHD is the most frequent comorbid disorder (66%), specially presenting in childhood and puberty. In literature, the prevalence of ADHD among individuals with ASD is estimated to be 28.2% [3], particularly among those with HFA/AS it's 44% -65% [6]. These findings stress the clinical necessity to assess inattention and hyperactivity/impulsivity in ASD [10], and point out also the fact that often is difficult to establish early diagnosis of HFA/AS, because autistic symptoms could be masked by ADHD symptoms.…”

“…It is possible to recognize obsessions/compulsions from ASD repetitive behaviours, [6], but standardized diagnostic tools are currently not yet available.…”

“…According to all literature examined [3], tics and Tourette's syndrome had an overall prevalence of 22% -30% [4,5,6,22].…”

“…Psychiatric comorbidity occurs highly in patients with High Functioning Autism (HFA) and Asperger syndrome (AS) [4][5][6], which are milder forms of autism, according to some authors. HFA individuals have a good cognitive level, expressed by an IQ > 70.…”