International Meeting for Autism Research (May 7 - 9, 2009): Comorbidities in Adult Attendees of a Specialist Autism Clinic
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Comorbidities in Adult Attendees of a Specialist Autism Clinic

Thursday, May 7, 2009
Northwest Hall (Chicago Hilton)
2:30 PM
D. Spain , Psychological Medicine and Psychiatry, Section of Brain Maturation, King's College London, Institute of Psychiatry, London, United Kingdom
T. J. Lavender , Section of Brain Maturation, Institute of Psychiatry, London, United Kingdom
C. Wilson , University of Aberdeen, Aberdeen
S. Reed , Behavioural Genetics Clinic, South London & Maudsley NHS Trust, London
E. Daly , Section of Brain Maturation, Department of Psychological Medicine and Psychiatry, Institute of Psychiatry, King's College London, London, United Kingdom
M. Craig , Psychological Medicine and Psychiatry, Institute of Psychiatry, King's College London, London, United Kingdom
D. Robertson , behavioural Genetics Clinic, South London & Maudsley NHS Trust, London
Q. Deeley , Section of Brain Maturation, Department of Psychiatry and Psychological Medicine, Institute of Psychiatry, King's College London, London, United Kingdom
D. G. Murphy , Section of Brain Maturation, Department of Psychological Medicine and Psychiatry, Institute of Psychiatry, King's College London, London, United Kingdom
Background: Prior research has reported individuals with Autistic Spectrum Disorders commonly suffer from co-morbid mental health problems, for example, social anxiety disorder, Attention Deficit Hyperactivity Disorder, and Oppositional Defiant Disorder (Simonoff et al, 2008). However so far research has been limited to those diagnosed as children, or individuals with learning disabilities (mental retardation). Moreover, nobody has investigated the mental health characteristics of (non autistic) adults who present to services seeking a diagnosis of autism.

Objectives: To investigate the mental health of adults who present (for the first time) seeking a diagnosis of autism. .

Methods: We examined 298 consecutive referrals (mean age 33 years) to a specialist out-patient clinic for adults with ASD the Maudsley Hospital, London. The assessment consisted of an in-depth psychiatric interview and additionally the Autism Diagnostic Interview (ADI) or the Autism Diagnostic Observation Shedule (ADOS).

Results: Of the 298 referrals, 110 (38%) were given a diagnosis of ASD. In those who were positively diagnosed as having an ASD, 61% had a single comorbid disorder, and 24% had two or more comorbid disorders. The commonest comorbidities were depressive disorder (18%), Obsessive Compulsive Disorder (OCD) (15%), ADHD (12%) Generalised anxiety disorder (GAD) (7%), Social Phobia (6%) and schizophrenia (6%).

In patients where a diagnosis of ASD was not made, 80% received an alternative diagnosis. Of these the commonest were depressive disorder (30%), personality disorder (19%) GAD (14%), OCD (13%), ADHD (12%) and schizophrenia (8%).

Conclusions: The burden of additional mental disorder in adults with ASD is very high. In our service most adults who seek a diagnosis of autism do not have the disorder; but the vast majority of these ‘negative ASD' cases do have other significant mental health problems. Of those who are diagnosed with ASD the majority have previously unrecognised co-morbid mental health problems requiring treatment.

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