International Meeting for Autism Research (May 7 - 9, 2009): Psychiatric Comorbidities in Patients with Asperger Syndrome and High Functioning Autism: Clinical and Treatment Implications

Psychiatric Comorbidities in Patients with Asperger Syndrome and High Functioning Autism: Clinical and Treatment Implications

Friday, May 8, 2009
Northwest Hall (Chicago Hilton)
12:00 PM
M. C. Porfirio , Child Psychiatric Department, Tor Vergata University, Rome, Italy
G. Giana , Child Psychiatric Department, Tor Vergata University, Rome, Italy
B. Manzi , Child Psychiatric Department, Tor Vergata University, Rome, Italy
S. Benedetti , Child Psychiatric Department, Tor Vergata University, Rome, Italy
A. Benvenuto , Child Psychiatric Department, Tor Vergata University, Rome, Italy
F. Caretto , Child Psychiatric Department, Tor Vergata University, Rome, Italy
P. Curatolo , Child Psychiatric Department, Tor Vergata University, Rome, Italy
Background: Psychiatric disorders are common and frequently multiple in children with autism spectrum disorders (ASD), but only few systematic and structured studies have investigated the psychiatric comorbidities in ASD. Furthermore, changes in mood and behavior are wrongly attributed to the individual’s developmental disorder rather than to a comorbid psychiatric condition.

Objectives: This study evaluated retrospectively the psychiatric comorbidities  in patients with High Functioning Autism/ Asperger Syndrome (HFA/AS), referred to the Child Psychiatric Department of “Tor Vergata” University in the period 2003-2008.

Methods: Participants were 79 children, adolescents and young adults (73 males, 6 females), aged between 4-30 years and all had a QI over 65 on Weschler Scale. Subjects were assessed for both ASD and psychiatric disorder by an experienced child psychiatrist utilizing ADI-R, ADOS and DSM-IV psychiatric diagnostic assessment (K-SADS, CBCL, CDI, MASC, Conner’s Scales and SNAP-IV).

Results: The rate of psychiatric disorders in this group was 55%. Attention Deficit Hyperactivity Disorder (ADHD) was the most frequent associated  psychiatric condition,  observed in 28/79 patients (35%). Many children with HFA/AS often were initially misdiagnosed with ADHD. Bipolar spectrum disorders were observed in 5/79 patients (6%). Other comorbidities included anxiety, tics, obsessive symptoms, oppositional defiant and conduct disorder. 20 of 79 (25%) patients received a pharmacological treatment for comorbidities, that led a decrease in problematic behaviors and improve clinical functioning.

Conclusions: This study shows a very high rate of psychiatric disorders in this group and suggest that diagnosis of an ASD should be routinely followed by systematic assessment for other psychiatric disorders. Detecting psychiatric comorbidities  may help to identify targets for specific intervention that could reduce overall impairment and improve quality of life.

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