Treating a Child With Asperger’s Disorder and Comorbid Bipolar Disorder

Intellectual Ability, Self-perceived Social Competence, and Depressive Symptomatology in Children with High-functioning Autistic Spectrum Disorders

“…Given the difficulties detecting depression in ASD, coupled with the possibility of under-diagnosis (Frazier, Doyle, Chiu, & Coyle, 2002;Hill et al, 2004;Lainhart & Folstein, 1994), further investigations should include behavioural assessments. Increases in obsessive-compulsive behaviours, intensified ruminations and preservations, increased social withdrawal and sleep disturbances may all indicate the onset of depression (Ghaziuddin et al, 2002).…”

Asperger's Disorder and Co-Morbid Bipolar Disorder: Diagnostic and Treatment Challenges

“…With respect to treatment response, irritability, and affect dysregulation, although not core features of the pervasive developmental disorders, are frequent and compelling enough to be the object of considerable pharmacologic research and treatment (e.g., McCracken et al 2002;Hollander et al 2006) with lithium carbonate, or combined lithium and neuroleptics, have been reported to be of help in treating selected patients with infantile autism and bipolar symptomatology (Kerbeshian et al 1987;Steingard and Biederman 1987;Frazier et al 2002). Although one of the earliest controlled trials of lithium in children found no impact on autism symptoms in a crossover trial with chlorpromazine (Campbell et al 1972), it is important to distinguish improvement in mood/aggression versus a change in the core symptoms of autism.…”

Overlap between Autism Spectrum Disorder and Bipolar Affective Disorder

“…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.…”

“…Both depressive disorders and BPAD can be specified with mixed features [2] . The current or 12-month prevalence rates of mania, hypomania and bipolar disorder in population-based studies of youth range from 0 to 0.9% in children aged [14][15][16][17][18]. Lifetime prevalence rates for BPAD among youth range from 0 to 2.1%, and the lifetime prevalence rate for hypomania ranges between 0 and 0.4% [9][10][11] .…”

“…verbal aggression, increased social intrusiveness, restlessness, etc. Frazier et al [14] suggested that BPAD should be entertained as a possible co-occurring diagnosis in ASD when there is deterioration in cognition, language, behavior or activity, when there is a clear pattern of fluctuation or cyclicity in activity, behavior and interests (with 'good times' and 'bad times') and when observed behaviors indicate mood problems. A special attention should be paid at pragmatic, distracted or odd language seen in children who have language disorders as part of ASD versus the flight of ideas/thought disorder of mania [15] .…”