Psychiatric comorbidities in autism spectrum disorder: A comparative study between DSM-IV-TR and DSM-5 diagnosis

Abstract

Background/Objective: The heterogeneous clinical presentations of individuals with Autism Spectrum Disorders (ASD) pose a significant challenge for sample characterization. Therefore the main goal of DSM-5 must be to identify subgroups of ASD, including comorbidity disorders and severity. The main goal of this study is to explore the psychiatric comorbidities and the severity of symptoms that could be relevant for the phenotype characterization in ASD and also to compare these results according to the different classification criteria between the DSM-IV-TR and the DSM-5. Method: A comparative study of severity and psychiatric comorbidities was carried out between a sample of participants that only met criteria for Pervasive Developmental Disorder (PDD) according to the DSM-IV-TR and a sample of participants that also met ASD criteria according to DSM-5 classification. The recruitment of children was via educational (N = 123). The psychiatric symptoms, comorbid disorders and severity of symptoms were assessed through The Nisonger Child Behavior Rating Form, clinical interview and The Inventory of Autism Spectrum Disorder, respectively. The psychiatric comorbidities considered were: anxiety, eating behavioural problems, self-aggressiveness, hetero–aggressiveness, self-harm, obsessive compulsive disorder and attention deficit and hyperactivity disorder. Results: Statistically significant differences between both groups were found regarding obsessive compulsive disorder, eating behavioural problems and severity. Conclusions: The results support the hypothesis that patients who meet the DSM-5 criteria have more severe symptoms, not only regarding the core autistic symptoms but also in relation with psychiatric comorbidities.

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

“…The long-term health outcomes associated with ASD continue to impose a high burden of care, which necessitates a scientific evaluation of how different comorbid conditions affect people with ASD (Hoefman et al, 2014;Masi et al, 2017). Among diverse cooccurring health conditions, the issue of psychiatric comorbidity in ASD has become more relevant in recent years as the no longer excludes additional diagnoses among individuals with ASD (Romero et al, 2016). This inclusion is consistent with past research that ASD can co-occur with other psychiatric disorders (Brereton et al, 2006;Yerys et al, 2011).…”

A Scoping Review of Health Disparities in Autism Spectrum Disorder

“…In children, co-occurring diagnoses of epilepsy (Spence and Schneider 2009), gastrointestinal disorders (Nikolov et al 2009), disrupted sleep (Cortesi et al 2010), and feeding issues (Romero et al 2016) are common. There is also evidence for shared etiology between ASD and other developmental disorders, including Fragile X, Tuberous Sclerosis, and other single gene mutations, genetic syndromes, chromosomal abnormalities, and de novo copy mutations (Bolton 2009).…”

Common genetic risk variants identified in the SPARK cohort implicate DDHD2 as a novel autism risk gene

“…Both epidemiological studies and genetic studies suggested the phenotypic comorbidity (75)(76)(77)(78) or genetic correlation (14,79) of ASD with various brain and behavioral phenotypes. Thus, we evaluated the pleiotropic effect of ASD risk SNPs with twelve other brain and behavioral phenotypes (47,54,57,(80)(81)(82)(83)(84)(85)(86)(87) (Figure 5, Supplementary Table S8).…”