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Randomized Controlled Trial
. 2019 Jan:88:57-64.
doi: 10.1016/j.comppsych.2018.10.012. Epub 2018 Nov 6.

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

Luc Lecavalier  1 , Courtney E McCracken  2 , Michael G Aman  3 , Christopher J McDougle  4 , James T McCracken  5 , Elaine Tierney  6 , Tristram Smith  7 , Cynthia Johnson  8 , Bryan King  9 , Benjamin Handen  10 , Naomi B Swiezy  11 , L Eugene Arnold  12 , Karen Bearss  13 , Benedetto Vitiello  14 , Lawrence Scahill  15
Affiliations
Randomized Controlled Trial

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

Luc Lecavalier et al. Compr Psychiatry. 2019 Jan.

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.

Keywords: Anxiety; Attention deficit hyperactivity disorder; Autism spectrum disorder; Comorbidity; Disruptive behavior; Psychiatric disorder.

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Conflict of interest statement

Financial Disclosures/Conflicts of Interest

Dr. Aman has received research contracts, consulted with, served on advisory boards, or done investigator training for Aevi Genomic Medicine; AMO Pharma; Bracket Global; CogState, Inc.; CogState Clinical Trials, Ltd.; Confluence Pharmaceutica; Coronado Biosciences; Hoffman-La Roche; Johnson and Johnson; Lumos Pharma; MedAvante, Inc.; MedAvante-Prophase; Ovid Therapeutics; ProPhase LLC; Supernus Pharmaceuticals, and Zynerba Pharmaceuticals. He receives royalties from Slosson Educational Publications. Dr. Arnold has received research funding from Forest, Lilly, Noven, Shire, Supernus, Roche, and YoungLiving; has consulted with Pfizer, Tris Pharma, and Waypoint; and been on advisory boards for Arbor, Ironshore, Otsuka, Pfizer, Roche, Seaside Therapeutics, Shire. Over the past two years, Dr. Scahill has served as a consultant to Roche, Shire, Supernus, Bracket and the Tourette Association of America. Dr. Handen has received research support from Roche, Eli Lilly, Curemark, and Autism Speaks; Dr. James McCracken has received research funding from Roche, Psyadon, and Think Now, Inc, consultant payments from Roche, payment for DSMB service from Alcobra, and expert testimony payment from Lannett. No conflicts for Drs. Lecavalier, CE McCracken; McDougle, Johnson, Swiezy, Tierney, King, Smith, Vitiello, Bearss.

Figures

Fig. 1.
Fig. 1.
Number of concomitant psychiatric diagnoses.
Fig. 2.
Fig. 2.
Proportional Venn Diagram illustrating patterns of comorbidity.
See this image and copyright information in PMC

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