From: Psychiatric comorbidities in asperger syndrome and high functioning autism: diagnostic challenges
 | Study | Type of study | Sample characteristica N/Age (M ± SD) | Control Group(s)b N/Age (M ± SD) | Assessment of psychiatric comorbidityc | Findings |
---|---|---|---|---|---|---|
DEPRESSION | Green et al., 2000 [6] | Comparison between AS and CD. | 20 AS (13.75) Range: 11-19 | 20 CD (14.47) Range: 11-19 | ICD-10 | Asperger showed higher rates of depression than controls. Chronic unhappiness and loneliness were more commonly associated with AS. |
Kim et al., 2000 [7] | Follow-up to clinic series. | 19 AS 40 HFARange: 9-14 | 1751 CG Range: 9-14 | OCHS-R | 17% had clinically relevant depression scores. Depression correlated with anxiousness and externalizing behavior. | |
Barnhill, 2001 [8] | Descriptive study of depressive symptoms. | 33 AS Range: 12-17 | None | CDI | 54% reported depressive symptoms, with a significant positive relationship between depression symptoms and ability attribution for social failure. | |
Hedley et al., 2006 [9] | Relationship between social comparison processes and depressive symptoms. | 36 AS (12.9 ± 1.94) Range: 10-16 | None | SCS CDI | Participants who perceived themselves as being more dissimal to others reported higher depressive symptoms. | |
Meyer et al., 2006 [10] | Cross-selectional study about depression in AS. | 31 AS (10.1 ± 1.9) | 33 CG (10.2 ± 1.9) | BASC-SRP BASC-PRS | The children themselves reported greater symptoms of anxiety and depression. | |
Whitehouse et al., 2009 [11] | Relationship between loneliness and depressive symptoms in AS | 35 AS (14.2 ± 0.8) | 35 CG (14.4 ± 0.10) | CES-DC | Around two thirds (n = 23) of the adolescent with AS self-reported significantly higher levels of depressive symptoms than control group. | |
Lugnegård et al., 2011 [12] | Evaluation of psychiatric comorbidity | 54 AS (27.0 ± 3.9) | None | SCID | 70% had experienced at least one episode of major depression, and 27 of these (50% of the total group) had recurrent major depressions. | |
BIPOLAR | Munesue et al., 2008 [13] | Study of mood disorders in consecutive outpatients. | 44 HFA Range: 13-39 | None | DSM-IV | Sixteen patients (36.4%) were diagnosed with mood disorder. Among these bipolar disorder accounted for 75% of cases. |
Hofvander et al., 2009 [14] | Evaluation of psychiatric and psychosocial problems in ASD with normal IQ | 5AD 67 AS 50 PDD-NOS Range: 16-60 | None | DSM-IV | In the AS subgroup the most common life-time comorbid condition was mood disorder (n = 65, 53%). Criteria for a bipolar disorder (BP) were met by 10 subjects (8%), five of whom had bipolar I subtype and two bipolar II, while three were coded as unknown subtypes. | |
Lugnegård et al., 2011 [12] | Evaluation of psychiatric comorbidity | 54 AS (27.0 ± 3.9) | None | SCID | Five participants (9% of total group) met criteria for bipolar II disorder, whereas none met criteria for bipolar I disorder. | |
ANXIETY | Green et al., 2000 [6] | Comparison between AS and CD. | 20 AS(13.75) Range: 11-19 | 20 CD (14.47) Range: 11-19 | ICD-10 | Asperger showed more symptoms of general anxiety and OCD than CD |
Gillott et al., 2001 [15] | Measures of anxiety and social worries. | 15 HFA Range: 8-12 | 30 CG Range: 8-12 | SCAS SWQ | HFA group showed higher rates of anxiety than in typically developing or language impaired children. 7 of 15 children with HFA were at or above clinical mean score. | |
Burnette et al., 2005 [16] | Relations between the weak central coherence hypothesis, theory of mind skills, and social-emotional functioning. | 23 HFA (11. 25 ± 1.57) | 20 CG (11.00 ± 1.32) | BASC-SRP SASC-R | Autistic subjects self-reported significantly more social anxiety symptoms | |
Pfeiffer et al., 2005 [17] | Relationships between sensory modulation and symptoms of affective disorders. | 50 AS Range: 6-17 | None | MASC | Significant correlation was found between sensory defensiveness and anxiety in children with AS | |
Russell and Sofronoff, 2005 [18] | Examination of anxiety and social worries in AS. | 65 AS Range: 10-13 | 261 CG Range: 10-13 | SCAS SWQ | AS self-reported levels of anxiety symptoms significantly higher than control group | |
Meyer et al., 2006 [10] | Cross-selectional study about anxiety in AS. | 31 AS (10.1 ± 1.9) | 33 CG (10.2 ± 1.9) | BASC-SRP BASC-PRS | AS self-reported high social anxiety levels correlating with their social perception, understanding and experience. | |
Sukhodolsky et al., 2008 [19] | Study of the frequency of anxiety symptoms in PDD. | 171 ASD (8.2 ± 2.6) | None | CASI | 73 (43%) had a pathological scores for at least one anxiety disorder. Higher levels of anxiety were associated with higher IQ, functional language use, and stereotyped behaviors. | |
Kuusikko et al., 2008 [20] | Association between AS/HFA and social anxiety symptoms. | 54 HFA/AS (11.2 ± 2.2) | 305 CG (12.2 ± 2.2) | SPAI-C SASC-R CBCL | Adolescents with HFA/AS suffered from more symptoms of social anxiety than the community sample on all measures. | |
Lugnegård et al., 2011 [12] | Evaluation of psychiatric comorbidity | 54 AS (27.0 ± 3.9) | None | SCID | 56% met criteria for at least one anxiety disorder, and 11 of these fulfilled diagnostic criteria for two or more anxiety disorder diagnoses. 22% had social anxiety disorder, 22% had generalized anxiety disorder, 13% had panic disorder, 15% had agoraphobia and 7% had OCD. | |
OCD | Russell et al., 2005 [21] | Study of Obsessive Repetitive behaviours in AS and OCD groups. | 40 AS/HFA (27.9 ± 8.5) | 45 OCD (36.6 ± 11.5) | Y-BOCS | The two groups had similar frequencies of obsessive-compulsive symptoms. Somatic obsession and repeating rituals were more common in the OCD group. |
South et al., 2005 [22] | Study of the four repetitive behavior categories, comparing AS/HFA and CG. | 19 AS (14.10±3.47), 21 HFA (14.28±3.02) | 21 CG (13.34 ± 3.28) | RBI, YSII | The CG showed lower scores than AS/HFA for all four repetitive behavior categories: Object Use; Motor Movements; Rigid Routines and Circumscribed Interests. | |
Zandt et al., 2007 [23] | Study of the types of ripetitive behaviours in ASD. | 19 ASD (10.97 ± 2.42) | 17 OCD (12.30 ± 2.17), 18 TD (11.942.94) | RBQ, CY-BOCS | Children with ASD reported more compulsions and obsessions than typically developing children. Consideration of the type of compulsions and obsessions in each disorder suggests that the compulsions in ASD tended to be less sophisticated. | |
Ruta et al., 2009 [24] | Examination of the occurrence and characteristic features of obsessive–compulsive behaviours. | 18 AS (10.61 ± 1.91) | 20 OCD (11.65 ± 1.69), 22 TD (10.68 ± 2.01) | CY-BOCS | The AS group displayed slightly higher frequencies of Saving/Hoarding and Ordering clusters compared to OCD group. | |
Mack et al., 2010 [25] | Clinical characteristics and symptoms severity in patients with OCD + AS/HFA; OCD + TS or OCD alone. | 12AS/HFA + OCD Range:12-18 | 12 OCD + TS Range: 9–17, 12 OCD Range: 9-17 | Y-BOCS | Children with ASD may experience a similar level of impairment, equally distressing, time consuming and contributing to a similar level of interference in functioning from obsessive/compulsive symptoms as compared to children with TS plus OCD and children with OCD only. | |
Lai et al., 2011 [26] | Behavioral Comparison of Male and Female Adults with High Functioning Autism Disorders. | 68 AS/HFA Range: 18-45 | None | BAI, BDI, OCI-R | A significant proportion of adults with AS/HFA showed clinically significant anxiety, depression, or obsessive-compulsive symptoms. Overall male and female adults with ASC were not different on these symptoms. | |
ADHD | Holtman et al., 2005 [27] | Study of the frequency of ADHD-like symptoms in AS/HFA | 104 AS/HFA Range: 3.4-20.2 | None | CBCL | Sixty-five percent of the subjects scored above the clinical cut-off on the attention problems scale |
 | Tani et al., 2006 [28] | Exploration of childhood ADHD problems retrospectively | 20 AS (27.2 ± 7.3) | 10 TD (26.5 ± 8.1) | WURS | AS group displayed higher scores as indicated from self- and parents-report. |
 | Simonoff et al., 2008 [29] | Assessment of psychiatric disorders in ASD | 112 ASD (11.5) Range: 10–13.9 | None | DSM-IV | 70.8% of ASD children had at least one current psychiatric disorder. The most common comorbidities were social anxiety (29.2%), ADHD (28.1%), and oppositional defiant disorder (28.1%). |
 | Mattila et al., 2010 [30] | Community- and clinic-based study exploring comorbid psychiatry in AS/HFA | 50 AS/HFA (12.7 ± 1.5) | None | K-SADS-PL CGAS | One or more comorbid psychiatric disorders were diagnosed in 74% of the cases. The most common disorders were behavioural (44%), anxiety (42%) and tic disorders (26%). |
 | Mukaddes et al., 2010 [31] | Comparison the rate and type of psychiatric comorbidity in children and adolescents HFA/AS | 30 AS, 30 HFA | None | K-SADS-PL | The rate of comorbid psychiatric disorders was very high in both groups. The most common disorder in both groups was attention deficit hyperactivity disorder. The AS group displayed greater comorbidity with depressive disorders and ADHD. |