PSYCHIATRIC COMORBIDITY OF AUTISM SPECTRUM DISORDERS: HOW TO ASSESS?

Dr. Mazefsky and his colleagues from the Department of Psychiatry at the University of Pittsburgh School of Medicine conducted a pilot study on the correlation between clinical diagnoses and diagnoses made through specific tools.

The sample consisted of 35 participants with autism spectrum disorder, without intellectual disability, ranging in age from 10 to 17 years, and with good verbal skills. Psychiatric diagnoses were established through the Autism Comorbidity Interview (ACI), which is a semi-structured interview developed to identify psychiatric symptoms in autism. Results were compared to prior community psychiatric diagnoses reported by parents or recorded in medical records. 

Approximately 60% of previous psychiatric diagnoses wasn’t confirmed by the Autism Comorbidity Interview; the lowest concordance was for bipolar disorder and obsessive-compulsive disorder diagnoses. 

Although 51% of the sample met the Autism Comorbidity Interview criteria for at least one psychiatric disorder, rates of previous diagnoses were much higher, with 77% having at least one prior psychiatric diagnosis and 60% having two or more. 

Many diagnoses prior to the ACI administration resulted to be unreliable in light of the emotional dysfunction symptoms of adolescents with autism spectrum disorders.

Knowing the complex autism phenomenology is a critical requirement in order to make a good psychiatric diagnosis.

 

 

REFERENCES

 

- Leyfer OT, Folstein SE, Bacalman S, et al. Comorbid psychiatric disorders in children with autism: interview development and rates of disorders. J Autism Dev Disord. 2006 Oct;36(7):849-61.

- Mazefsky CA, Oswald DP, Day TN, Eack SM, Minshew NJ, Lainhart JE. ASD, a Psychiatric Disorder, or Both? Psychiatric Diagnoses in Adolescents with High-Functioning ASD. J Clin Child Adolesc Psychol. 2012 May 29.