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

• Type of Material: Article
• Authors: Luc Lecavalier, Ohio State University; Courtney E. McCracken, Emory University; Michael G. Aman, Ohio State University; Christopher J. McDougle, Massachusetts General Hospital; James T. McCracken, University of California Los Angeles; Elaine Tierney, Johns Hopkins University; Tristram Smith, University of Rochester; Cynthia Johnson, Cleveland Clinic; Bryan King, University of California San Francisco; Benjamin Handen, University of Pittsburgh; Naomi B. Swiezy, Indiana University; L. Eugene Arnold, Ohio State University; Karen Bearss, Emory University; Benedetto Vitiello, University of Turin; Lawrence Scahill, Emory University
• Language: English
• Date: 2019-01-01
• Publisher: W B SAUNDERS CO-ELSEVIER INC
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2018
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.comppsych.2018.10.012
• Title of Journal or Parent Work: COMPREHENSIVE PSYCHIATRY
• Volume: 88
• Start Page: 57
• End Page: 64
• Grant/Funding Information: National Institute of Mental Health, NO1 MH070001, UO1 MH066766, RO1 MH083739, R01MH08096, N01MH70009, N01MH70010, N01MH70001, N01MH70070; N01MH80011, U10MH66768, U10MH66766, 5R01MH081221-02; R01MH079080; U10MH66764; M01 RR00750, M01 RR06022, M01 RR00034, M01 RR00052, MH01805; R01MH079082-05, R01 MH083247. Johnson &Johnson Pharmaceutical Research & Development (provided medication); Korczak Foundation (financial support); Marcus Foundation (financial support).
• Keywords: PERVASIVE DEVELOPMENTAL DISORDERS; Psychiatric disorder; Anxiety; Attention deficit hyperactivity disorder; Life Sciences & Biomedicine; Science & Technology; Autism spectrum disorder; PREVALENCE; Comorbidity; MEDICATION; Disruptive behavior; Psychiatry; TRIAL; COMORBIDITY
• Research Categories: Health Sciences, Public Health; Psychology, Clinical; Psychology, Cognitive; Psychology, Behavioral

Abstract

Objective: We explored patterns of concomitant psychiatric disorders in a large sample of treatment-seeking children and adolescents with autism spectrum disorder (ASD). Methods: 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. Results: 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. Conclusion: 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.