Journal Article

An exploration of concomitant psychiatric disorders in children with autism spectrum disorder

Bearss, Karen, McCracken, James T., Tierney, Elaine, Lecavalier, Luc, Johnson, Cynthia, Smith, Tristram, Scahill, Lawrence, King, Bryan, Vitiello, Benedetto, Eugene Arnold, L., McDougle, Christopher J., Handen, Benjamin, Swiezy, Naomi B., Aman, Michael G., McCracken, Courtney E.

2019

Overview

We explored patterns of concomitant psychiatric disorders in a large sample of treatment-seeking children and adolescents with autism spectrum disorder (ASD). Participants were 658 children with ASD (age 3–17 years; mean = 7.2 years) in one of six federally-funded multisite randomized clinical trials (RCT) between 1999 and 2014. All children were referred for hyperactivity or irritability. Study designs varied, but all used the Child and Adolescent Symptom Inventory or Early Childhood Inventory to assess Attention Deficit Hyperactivity Disorder (ADHD), Oppositional-Defiant Disorder (ODD), Conduct Disorder (CD), Anxiety Disorders, and Mood Disorders. In addition, several measures in common were used to assess demographic and clinical characteristics. Of the 658 children, 73% were Caucasian and 59% had an IQ >70. The rates of concomitant disorders across studies were: ADHD 81%, ODD 46%, CD 12%, any anxiety disorder 42%, and any mood disorder 8%. Two or more psychiatric disorders were identified in 66% of the sample. Of those who met criteria for ADHD, 50% also met criteria for ODD and 46% for any anxiety disorder. Associations between types of concomitant disorders and a number of demographic and clinical characteristics are presented. In this well-characterized sample of treatment-seeking children with ASD, rates of concomitant psychiatric disorders were high and the presence of two or more co-occurring disorders was common. Findings highlight the importance of improving diagnostic practice in ASD and understanding possible mechanisms of comorbidity. •We observed a high frequency of multiple concomitant DSM-defined disorders.•50% of children who met criteria for ADHD also met criteria for ODD.•46% of children who met criteria for ADHD also met criteria for an anxiety disorder.•Findings highlight the importance of improving diagnostic practices in ASD.

• Publisher: Elsevier Inc,Elsevier Limited,Elsevier
• Subject: Adolescent / Age / Anxiety / Anxiety Disorders - diagnosis / Anxiety Disorders - epidemiology / Anxiety Disorders - psychology / Attention Deficit and Disruptive Behavior Disorders - diagnosis / Attention Deficit and Disruptive Behavior Disorders - epidemiology / Attention Deficit and Disruptive Behavior Disorders - psychology / Attention Deficit Disorder with Hyperactivity - psychology / Attention deficit hyperactivity disorder / Autism / Autism spectrum disorder / Autism Spectrum Disorder - diagnosis / Autism Spectrum Disorder - epidemiology / Autism Spectrum Disorder - psychology / Autistic children / Behavior disorders / Child / Child & adolescent mental health / Child & adolescent psychiatry / Child psychology / Child, Preschool / Comorbidity / Conduct Disorder - diagnosis / Conduct Disorder - epidemiology / Conduct Disorder - psychology / Disruptive behavior / Emotional disorders / Fear & phobias / Female / Humans / Male / Mental disorders / Mood Disorders - diagnosis / Mood Disorders - epidemiology / Mood Disorders - psychology / Psychiatric disorder / Psychotropic drugs / Teenagers