Abstract
Objective: To analyze the characteristics of the Prevalence of Psychiatric Comorbidities in ASD and the Main Challenges of Differential Diagnosis. Literature review: The coexistence of psychiatric comorbidities in patients with Autism Spectrum Disorder (ASD) is an area of considerable research and clinical concern, exhibiting significantly elevated prevalence rates. These rates vary depending on the population studied and the diagnostic method employed, underscoring the inherent complexity of the subject. Differential diagnosis thus becomes a crucial step for the implementation of effective and individualized treatment. Several studies have addressed the frequency of comorbidities such as Attention Deficit Hyperactivity Disorder (ADHD), Anxiety Disorders, and even Mood Disorders in patients with ASD, highlighting the need for a multidisciplinary approach to the clinical management of these individuals. Final considerations: In summary, the high incidence of psychiatric comorbidities in patients with ASD necessitates careful differential diagnosis and a more holistic treatment approach that considers the interaction between ASD and other concurrent psychiatric conditions.
References
ALLELY CS, et al. Autism spectrum disorder and personality disorders: How do clinicians carry out a differential diagnosis?. Autism, 2023; 10(6): 1847-1850.
AMERICAN PSYCHIATRIC ASSOCIATION. Diagnostic and statistical manual of mental disorders. 5nd ed. Arlington, VA: 2013.
ARNEVIK EA e HELVERSCHOU SB. Autism Spectrum Disorder and Co-occurring Substance Use Disorder - A Systematic Review. Subst Abuse. 2016; 10(1): 69-75.
BHANDARI S, Thrombotic Thrombocytopenic Purpura. N Engl J Med, 2019; 380(16): 23.
BOOGERT, F, et al. Sensory processing and alcohol use in adults with autism spectrum disorder. Alcohol, 2023; 19(114): 25-30.
BROOKMAN-FRAZEE L, et al. Characterizing psychiatric comorbidity in children with autism spectrum disorder receiving publicly funded mental health services. Autism, 2019; 23(7): 1745-1758.
CAPRIOLA-HALL NN, et al. Caution When Screening for Autism among Socially Anxious Youth. Journal of Autism and Developmental Disorders, 2020; 51(5): 1540-1549.
CHIURAZZI P, et al. Genetic analysis of intellectual disability and autism. Acta Biomed, 2020; 91(13-S): e2020003.
CRAIG F, et al. Overlap between Autism Spectrum Disorders and attention deficit hyperactivity disorder: searching for distinctive/common clinical features. Autism Research, 2015; 8(3): 328-337.
DE BRUIN EI, et al. High rates of psychiatric co-morbidity in PDD-NOS. Journal of Autism and Developmental Disorders, 2007; 37(5): 877-886.
DUNALSKA A, et al. Comorbidity of bipolar disorder and autism spectrum disorder - review paper. Psychiatr Pol, 2021; 55(6): 1421-1431.
FARAG F, et al. Avoidant/restrictive food intake disorder and autism spectrum disorder: clinical implications for assessment and management. Dev Med Child Neurol, 2022; 64(2): 176-182.
GARGARO BA, et al. Autism and ADHD: how far have we come in the comorbidity debate?. Neuroscience & Biobehavioral Reviews, 2011; 35(5): 1081-1088.
GONZÁLEZ MC, et al. Autism spectrum disorder: Clinical diagnosis and ADOS Test. Revista Chilena De Pediatria, 2019; 90(5): 485-491.
HERVÁS A. Género femenino y autismo: infra detección y mis diagnósticos. Medicina (Buenos Aires), 2022; 82(Supl. I): 37-42.
HOFVANDER B, et al. Psychiatric and psychosocial problems in adults with normal-intelligence autism spectrum disorders. BMC Psychiatry, 2009; 9: 35.
HOSSAIN MM, et al. Prevalence of comorbid psychiatric disorders among people with autism spectrum disorder: An umbrella review of systematic reviews and meta-analyses. Psychiatry Res, 2020; 287: 112922.
HUDSON CC, et al. Prevalence of Depressive Disorders in Individuals with Autism Spectrum Disorder: a Meta-Analysis. J Abnorm Child Psychol, 2019; 47(1): 165-175.
HYMAN SL, et al. Identification, Evaluation, and Management of Children With Autism Spectrum Disorder. Council On Children With Disabilities, Section On Developmental And Behavioral Pediatrics. Pediatrics, 2020; 145(1): e20193447.
JONES CRG, et al. Co-occurrence of developmental disorders: children who share symptoms of autism, dyslexia and attention deficit hyperactivity disorder. Pesquisa em Revista de Saúde Mental, 2014; 17(2): 115-124.
JOSHI G, et al. The heavy burden of psychiatric comorbidity in youth with autism spectrum disorders: a large comparative study of a psychiatrically referred population. Journal of Autism and Developmental Disorders, 2010; 40(11): 1361-1370.
JUTLA A, et al. Autism spectrum disorder and schizophrenia: an updated conceptual review. Autism Res, 2022; 15(3): 384-412.
KENTROU V, et al. Delayed autism spectrum disorder recognition in children and adolescents previously diagnosed with attention-deficit/hyperactivity disorder. Autism, 2019; 23(4): 1065-1072.
KERNS CM e KENDALL PC. The presentation and classification of anxiety in autism spectrum disorder. Clinical psychology: Science and practice, 2012; 19(4): 323-347.
LAI MC, et al. A Multidimensional Meta-Analysis of Pharmacotherapy for Autism Spectrum Disorder. The American Journal of Psychiatry, 2014; 171(8): 834-841.
LECAVALIER L, et al. An exploration of concomitant psychiatric disorders in children with autism spectrum disorder. Comprehensive Psychiatry, 2019; 88(1): 57-64.
LEE DO e OUSLEY OY. Attention-deficit hyperactivity disorder symptoms in a clinic sample of children and adolescents with pervasive developmental disorders. Journal of Child and Adolescent Psychopharmacology, 2006; 16(6): 737-746.
LEYFER OT, et al. Comorbid psychiatric disorders in children with autism: interview development and rates of disorders. Journal of Autism and Developmental Disorders, 2006; 36(7): 849-861.
LUGNEGARD T, et al. Personality disorders and autism spectrum disorders: What are the connections? Comprehensive Psychiatry, 2012; 53(4): 333-340.
MARTIN AF, et al. Co-occurring obsessive-compulsive disorder and autism spectrum disorder in young people: prevalence, clinical characteristics and outcomes. Eur Child Adolesc Psychiatry, 2020; 29(11): 1603-1611.
MATSON JL e GOLDIN RL. Comorbidity and autism: trends, topics and future directions. Research in Autism Spectrum Disorders, 2013; 7(10): 1228-1233.
MAZEFSKY CA, et al. The role of emotion regulation in autism spectrum disorder. Journal of the American Academy of Child e Adolescent Psychiatry, 2012; 51(7): 679-688.
MATSON JL, et al. Comorbidity of physical and motor problems in children with autism. Research in Autism Spectrum Disorders, 2016; 21(1): 1-7.
MULAS F e ROCA P. Concordancias entre los trastornos del espectro del autismo y el trastorno por déficit de atención/hiperactividad. Rev Neurol 2018; 66(Supl 1): S91-6.
PARMEGGIANI A, et al. Early features of autism spectrum disorder: a cross-sectional study. Italian Journal of Pediatrics, 2019; 45(10): 14.
PAZUNIAK M e PEKRUL SR. Obsessive-Compulsive Disorder in Autism Spectrum Disorder Across the Lifespan. Child Adolesc Psychiatr Clin N Am, 2020; 29(2): 419-432.
ROGERS SJ e VISMARA LA. Evidence-based comprehensive treatments for early autism. Journal of Clinical Child e Adolescent Psychology, 2008; 37(1): 8-38.
RONALD A, et al. Genetic heterogeneity between the three components of the autism spectrum: A twin study. Journal of the American Academy of Child & Adolescent Psychiatry, 2010; 45(6): 691-699.
SIMONOFF E, et al. Psychiatric disorders in children with autism spectrum disorders: Prevalence, comorbidity, and associated factors in a population-derived sample. Journal of the American Academy of Child and Adolescent Psychiatry, 2008; 47(8): 921-929.
SOKOLOVA E, et al. A causal and mediation analysis of the comorbidity between attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). J Autism Dev Disord, 2017; 47: 1595-1604.
VAN DER MEER JM, et al. Are autism spectrum disorder and attention-deficit/hyperactivity disorder different manifestations of one overarching disorder? Cognitive and symptom evidence from a clinical and population-based sample. Journal of the American Academy of Child and Adolescent Psychiatry, 2012; 51: 1160-1172.e1163.
WOZNIAK J, et al. Mania in children with pervasive developmental disorder revisited. Journal of the American Academy of Child and Adolescent Psychiatry, 1997; 36(11): 1552-1559.
