Autism spectrum disorders in an adult psychiatric population. A naturalistic cross-sectional controlled study

Background: Autism spectrum disorders (ASD), have yet to become a focus of attention in clinical adult psychiatry. Objectives: The aims of the present study were firstly to characterize psychiatric patients with ASD in regard to demographical factors, psychiatric co-morbidity and personality traits and compare the ASD group with a psychiatric control group in these respects. Secondly, we wanted to compare differences of personality traits between females and males in the ASD group. Methods: Adult psychiatric patients where ASD or ADHD was suspected were referred to a tertiary unit in Stockholm 2001-2006. All patients diagnosed at the unit with ASD (39 females and 45 males) were consecutively included and compared to all 46 identically interviewed and assessed patients who did not receive an ASD or ADHD diagnosis. Among scales used were the GAF, SCID II Screen, and Swedish universities Scales of Personality (SSP). Results: ASD patients had an equal educational level but a lower social and occupational functioning. Their GAF scores were significantly lower compared to the control group. Prior to referral major depressive disorder and obsessive-compulsive disorders were the most common psychiatric diagnoses. In the assessment approximately 1/3 fulfilled diagnostic criteria for co-morbid ADHD. The patients with ASD also had significantly more schizotypal and avoidant personality traits according to SCID II screen. In SSP, patients with ASD rated themselves significantly higher on Stress-susceptibility, Embitterment, Detachment, Trait irritability and Lack of assertiveness than controls. Females with ASD scored significantly higher than males on borderline and passive-aggressive traits according to the SCID II Screen and on Embitterment and Trait irritability in the SSP. Conclusions: We could show that psychiatric patients with ASD have a low level of functioning and a personality profile which is gender specific. This may contribute to the identification and understanding of patients with ASD in adult psychiatry.