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Table of Contents
Vol. 43, No. 1, 2010
Issue release date: December 2009
Psychopathology 2010;43:8–16

Psychosis, Affective Disorders and Anxiety in Autistic Spectrum Disorder: Prevalence and Nosological Considerations

Skokauskas N. · Gallagher L.
aDepartment of Child Psychiatry, St. James’s Hospital, and bDepartment of Psychiatry, School of Medicine, Trinity Centre for Health Sciences, St. James’s Hospital, Dublin, Ireland

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Background: This review aimed to find relevant published studies on the co-morbidity of autism and Asperger’s syndrome with psychotic, anxiety and/or mood disorders, assess them, synthesize the findings, present an overview and make recommendations for future research. Methods: Systematic literature searches were performed using several databases. Selected articles had to describe an original study that provided prevalence and/or incidence estimates on autism and/or Asperger’s syndrome co-morbidity with psychotic, anxiety and/or mood disorders. Results and Conclusion: There is conflicting evidence regarding the frequency of schizophrenia in this population. Depression appears to be common, although most individuals with autism do not have sufficient language skills to verbalize changes in mood. Anxiety disorders represent the most common psychiatric co-morbidity in this population.

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  1. APA: Diagnostic and Statistical Manual of Mental Disorders, ed 4, text revision. Washington, American Psychiatric Press, Inc, 2000.
  2. Lainhart JE: Psychiatric problems in individuals with autism, their parents and siblings. Int Rev Psychiatry 1999;11:278–298.
  3. Bolte S, Bosch G: The long-term outcome in two females with autism spectrum disorder. Psychopathology 2005;38:151–154.
  4. Tsai L: Taking the Mystery out of Medications in Autism/Asperger Syndromes. A Guide for Parents and Non-Medical Professionals. Arlington, Future Horizons, 2001.
  5. Steffenburg S, et al: A twin study of autism in Denmark, Finland, Iceland, Norway and Sweden. J Child Psychol Psychiatry 1989;30:405–416.
  6. Bailey A, et al: Autism as a strongly genetic disorder: evidence from a British twin study. Psychol Med 1995;25:63–77.
  7. Rutter M: Genetic studies of autism: from the 1970s into the millennium. J Abnorm Child Psychol 2000;28:3–14.
  8. Bolton PF, et al: Autism, affective and other psychiatric disorders: patterns of familial aggregation. Psychol Med 1998;28:385–395.
  9. DeLong GR, Dwyer JT: Correlation of family history with specific autistic subgroups: Asperger’s syndrome and bipolar affective disease. J Autism Dev Disord 1988;18:593–600.
  10. Leyfer OT, et al: Comorbid psychiatric disorders in children with autism: interview development and rates of disorders. J Autism Dev Disord 2006;36:849–861.
  11. Wittchen HU: Critical issues in the evaluation of comorbidity of psychiatric disorders. Br J Psychiatry Suppl 1996:9–16.

    External Resources

  12. Caron C, Rutter M: Comorbidity in child psychopathology: concepts, issues and research strategies. J Child Psychol Psychiatry 1991;32:1063–1080.
  13. Reiersen AM, Todd RD: Co-occurrence of ADHD and autism spectrum disorders: phenomenology and treatment. Expert Rev Neurother 2008;8:657–669.
  14. Gallagher L, Bellgrove M, Hawi Z, Segurado R, Fitzgerald M: ADHD, Autism Spectrum Disorders and Tourette’s Syndrome: Investigating the Evidence for Clinical and Genetic Overlap. Handbook of Attention Deficit Hyperactivity Disorder. Chichester, Wiley, 2007.
  15. Kolvin I: Studies in the childhood psychoses. I. Diagnostic criteria and classification. Br J Psychiatry 1971;118:381–384.
  16. Rutter M: Childhood schizophrenia reconsidered. J Autism Child Schizophr 1972;2:315–337.
  17. McKenna K, et al: Looking for childhood-onset schizophrenia: the first 71 cases screened. J Am Acad Child Adolesc Psychiatry 1994;33:636–644.
  18. Asperger H: Die autistischen Psychopathen im Kindesalter. Arch Psychiatr Nervenkrank 1944;117:76–136.

    External Resources

  19. Wing L: Asperger’s syndrome: a clinical account. Psychol Med 1981;11:115–129.
  20. Wolff S, Chick J: Schizoid personality in childhood: a controlled follow-up study. Psychol Med 1980;10:85–100.
  21. Rumsey JM, Rapoport JL, Sceery WR: Autistic children as adults: psychiatric, social, and behavioral outcomes. J Am Acad Child Psychiatry 1985;24:465–473.
  22. Szatmari P, Bartolucci G, Bremner R: Asperger’s syndrome and autism: comparison of early history and outcome. Dev Med Child Neurol 1989;31:709–720.
  23. Larsen FW, Mouridsen SE: The outcome in children with childhood autism and Asperger syndrome originally diagnosed as psychotic: a 30-year follow-up study of subjects hospitalized as children. Eur Child Adolesc Psychiatry 1997;6:181–190.
  24. Tantam D: Asperger syndrome in adulthood; in Frith U (ed): Autism and Asperger Syndrome. Cambridge, Cambridge University Press, 1991, pp 147–183.
  25. Volkmar FR, Cohen DJ: Comorbid association of autism and schizophrenia. Am J Psychiatry 1991;148:1705–1707.
  26. Ghaziuddin M, et al: Comorbidity of autistic disorder in children and adolescents. Eur Child Adolesc Psychiatry 1992;1:209–213.

    External Resources

  27. Howlin P: Autism. Preparing for Adulthood. London, Routledge, 1997.
  28. Konstantareas MM, Hewitt T: Autistic disorder and schizophrenia: diagnostic overlaps. J Autism Dev Disord 2001;31:19–28.
  29. Kanner L: Autistic disturbance of affective contact. Nerv Child 1943;2:217–250.
  30. Chung SY, Luk SL, Lee PW: A follow-up study of infantile autism in Hong Kong. J Autism Dev Disord 1990;20:221–232.
  31. Ghaziuddin M, Weidmer-Mikhail E, Ghaziuddin N: Comorbidity of Asperger syndrome: a preliminary report. J Intellect Disabil Res 1998;42:279–283.
  32. Green J, et al: Social and psychiatric functioning in adolescents with Asperger syndrome compared with conduct disorder. J Autism Dev Disord 2000;30:279–293.
  33. Kim JA, Peter S, Bryson SE, Streiner DL, Wilson FJ: The prevalence of anxiety and mood problems among children with autism and Asperger syndrome. Autism Int J Res Pract 2000;117–132.
  34. Barnhill GP: Social attribution and depression in adolescents with Asperger syndrome. Focus Autism Other Dev Disabil 2001;16:46–53.

    External Resources

  35. Cederlund M, Gillberg C: One hundred males with Asperger syndrome: a clinical study of background and associated factors. Dev Med Child Neurol 2004;46:652–660.
  36. Shtayermman O: Peer victimization in adolescents and young adults diagnosed with Asperger’s syndrome: a link to depressive symptomatology, anxiety symptomatology and suicidal ideation. Issues Compr Pediatr Nurs 2007;30:87–107.
  37. Wozniak J, et al: Mania in children with pervasive developmental disorder revisited. J Am Acad Child Adolesc Psychiatry 1997;36:1552–1559; discussion 1559–1560.
  38. Szatmari P, et al: A follow-up study of high-functioning autistic children. J Autism Dev Disord 1989;19:213–225.
  39. Muris P, et al: Comorbid anxiety symptoms in children with pervasive developmental disorders. J Anxiety Disord 1998;12:387–393.
  40. Farrugia S, Hudson J: Anxiety in adolescents with Asperger syndrome: negative thoughts, behavioral problems, and life interference. Focus Autism Other Dev Disabil 2006;21:25–35.

    External Resources

  41. World Health Organization: International Statistical Classification of Diseases and Health Related Problems: 10th Revision. Geneva, WHO, 1992.
  42. Baron-Cohen S, Wheelwright S: ‘Obsessions’ in children with autism or Asperger syndrome: content analysis in terms of core domains of cognition. Br J Psychiatry 1999;175:484–490.
  43. Ghaziuddin M, Tsai L, Ghaziuddin N: Comorbidity of autistic disorder in children and adolescents. Eur Child Adolesc Psychiatry 1992;1:209–213.

    External Resources

  44. Cath DC, et al: Symptom overlap between autism spectrum disorder, generalized social anxiety disorder and obsessive-compulsive disorder in adults: a preliminary case-controlled study. Psychopathology 2008;41:101–110.
  45. Berkson J: Limitations of the application of fourfold table analysis to hospital data. Biometrics Bull 1946;2:47–53.

    External Resources

  46. Piven J, Palmer P: Psychiatric disorder and the broad autism phenotype: evidence from a family study of multiple-incidence autism families. Am J Psychiatry 1999;156:557–563.
  47. Risch N, Spiker D, Lotspeich L, Nouri N, Hinds D, Hallmayer J, Kalaydjieva L, McCague P, Dimiceli S, Pitts T, Nguyen L, Yang J, Harper C, Thorpe D, Vermeer S, Young H, Hebert J, Lin A, Ferguson J, Chiotti C, Wiese-Slater S, Rogers T, Salmon B, Nicholas P, Petersen PB, Pingree C, McMahon W, Wong DL, Cavalli-Sforza LL, Kraemer HC, Myers RM: A genomic screen of autism: evidence for a multilocus etiology. Am J Hum Genet 1999;65:493–507.

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