Obsessive and Compulsive Symptoms in children with Asperger Syndrome

Background: Repetitive thoughts and behaviours are characteristic and disabling symptoms of Obsessive-Compulsive Disorder (OCD). Obsessive and compulsive traits are also often displayed by children with Autism Spectrum Condition (ASC), but this has not been systematically investigated in past research.

Objectives: To examine the occurrence and characteristic features of obsessive-compulsive behaviours in children and adolescents with Asperger Syndrome (AS), with respect to a matched OCD and typically developing group (CG).

Methods: 60 consecutive subjects (20 OCD; 18 AS; 22 CG), aged 8-15 years, matched for age, gender and IQ were compared. AS and OCD patients were diagnosed according to the DSM-IV-TR criteria. The Autism Diagnostic Interview-Revised and the Autism Diagnostic Observation Schedule were used to assist in the AS diagnosis; the WISC-R was administered to assess IQ.  Obsessive and compulsive symptoms were evaluated by using the Children’s Yale-Brown Obsessive-Compulsive Scale (CY-BOCS).

Results: The AS group presented significantly higher frequencies of Hoarding (p=0.02) obsessions and Repeating (p=0.001), Ordering (p=0.001), and Hoarding (p=0.013) compulsions compared to CG. Slightly higher, but not statistically significant, frequencies of Hoarding (p=0.36) obsessions and Ordering (p=0.34) and Hoarding (p=0.22) compulsions were scored by the AS group compared to the OCD group. Finally, the OCD group reported significantly higher frequencies of Contamination (p=0.009) and Aggressive (p=0.009) obsessions and Checking (p=0.003) compulsions compared to both the AS group and CG.

Conclusions: Children with AS showed higher frequencies of obsessive and compulsive symptoms with respect to typically developing children, and these features seem to cluster around Hoarding behaviours. Additionally, a different pattern of symptoms is shown in OCD as compared to AS. Further research should be conducted to better understand the characteristics of repetitive thoughts and behaviours in ASC, and to clarify the underlying neurobiological basis of these symptoms.