Co-occurrence, Assessment and Treatment of Obsessive Compulsive Disorder in Children and Adults With Autism Spectrum Disorder

Bedford, Saashi A.; Hunsche, Michelle C.; Kerns, Connor M.

doi:10.1007/s11920-020-01176-x

Cited by 24 publications

(15 citation statements)

References 65 publications

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“…However, that study was based on a small sample of patients with previously diagnosed psychiatric disorders based on standard diagnostic criteria. The present data highlight the particular challenges in diagnosing OCD in individuals with ASD and ID in regular clinical services (Helverschou et al 2011a, Bedford et al 2020, Santore et al 2020. Thus, the ritualistic and repetitive behaviours that are core characteristics of ASD may be easily misinterpreted as symptoms of OCD and vice versa (Ghaziuddin 2005, Scahill et al 2006).…”

Section: Discussionmentioning

confidence: 88%

“… ** p < .01 (two-tailed). A Benjamini-Hochberg correction (Benjamini & Hochberg, 1995 ) using a false discovery rate of .05 was applied to control for multiple comparisons. All p-values were below the Benjamini-Hochberg critical values.…”

Section: Resultsmentioning

confidence: 99%

“…Thus, the ritualistic and repetitive behaviours that are core characteristics of ASD may be easily misinterpreted as symptoms of OCD and vice versa (Ghaziuddin 2005, Scahill et al 2006). However, ASD-related repetitive behaviours do not seem to occur against the person's will, in contrast with the uncontrollable and unpleasant compulsions typically associated with OCD (Scahill et al 2006) and the two conditions have been found to be distinct disorders (Bedford et al 2020). It is also important to be aware that proxy and self-report descriptions of OCD may be very different in individuals with ASD (Santore et al 2020).…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Psychometric properties of the Psychopathology in Autism Checklist (PAC)

Helverschou

Ludvigsen

Hove

et al. 2021

International Journal of Developmental Disabilities

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Psychiatric disorders in individuals with co-occurring autism spectrum disorders (ASD) and intellectual disability (ID) are common, but diagnosis presents many challenges. The Psychopathology in Autism checklist (PAC) is among the very few instruments specifically developed for this group of individuals. The psychometric properties of the PAC (i.e. criterion validity, specificity, sensitivity and predictive values) were explored by comparing scores with assessments on the Aberrant Behavior Checklist (ABC) and examining how well assessment by the PAC at referral predicts final clinical diagnoses. Results indicated a significant correlation with the ABC, further supporting the validity of the PAC. Sensitivity and Specificity for specific diagnoses were variable, although positive predictive value for "any diagnosis' was relatively high. The study confirms the potential value of the PAC as a screening checklist but highlights the need for clinical diagnosis to be based on a multimodal, multidisciplinary assessment.

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Section: Discussionmentioning

confidence: 88%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Psychometric properties of the Psychopathology in Autism Checklist (PAC)

Helverschou

Ludvigsen

Hove

et al. 2021

International Journal of Developmental Disabilities

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“…These variants all bear amino acids defining the prototypic rheumatoid arthritis-associated shared epitope [ 104 ]. They have also been demonstrated to be involved in the pathogenesis of autism spectrum disorders [ 105 ] that share some clinical features with OCD and which often occur comorbid with OCD [ 106 ]. Finally, also supporting an implication of HLA in OCD is the interplay between streptococcal infections and HLA alleles [ 107 ].…”

Section: Pathophysiological Considerationsmentioning

confidence: 99%

Immunological causes of obsessive-compulsive disorder: is it time for the concept of an “autoimmune OCD” subtype?

Endres

Pollak

Bechter³

et al. 2022

Transl Psychiatry

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Obsessive-compulsive disorder (OCD) is a highly disabling mental illness that can be divided into frequent primary and rarer organic secondary forms. Its association with secondary autoimmune triggers was introduced through the discovery of Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal infection (PANDAS) and Pediatric Acute onset Neuropsychiatric Syndrome (PANS). Autoimmune encephalitis and systemic autoimmune diseases or other autoimmune brain diseases, such as multiple sclerosis, have also been reported to sometimes present with obsessive-compulsive symptoms (OCS). Subgroups of patients with OCD show elevated proinflammatory cytokines and autoantibodies against targets that include the basal ganglia. In this conceptual review paper, the clinical manifestations, pathophysiological considerations, diagnostic investigations, and treatment approaches of immune-related secondary OCD are summarized. The novel concept of “autoimmune OCD” is proposed for a small subgroup of OCD patients, and clinical signs based on the PANDAS/PANS criteria and from recent experience with autoimmune encephalitis and autoimmune psychosis are suggested. Red flag signs for “autoimmune OCD” could include (sub)acute onset, unusual age of onset, atypical presentation of OCS with neuropsychiatric features (e.g., disproportionate cognitive deficits) or accompanying neurological symptoms (e.g., movement disorders), autonomic dysfunction, treatment resistance, associations of symptom onset with infections such as group A streptococcus, comorbid autoimmune diseases or malignancies. Clinical investigations may also reveal alterations such as increased levels of anti-basal ganglia or dopamine receptor antibodies or inflammatory changes in the basal ganglia in neuroimaging. Based on these red flag signs, the criteria for a possible, probable, and definite autoimmune OCD subtype are proposed.

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“…Previous studies have shown a high comorbidity of autism spectrum disorders (ASD) and OCD (Meier et al, 2015;Bedford et al, 2020) and an association between autism symptoms and OCD severity (Anholt et al, 2010;Arildskov et al, 2016). Specifically, a study by Meier et al (2015), which followed 3,380,170 participants for 8 years, found that individuals with OCD were 13 times more likely to have comorbid ASD (6.6%) than those without OCD (0.5%).…”

Section: Autism Traits As Predictors Of Long-term Ocd Outcomesmentioning

confidence: 99%

Associations of Autism Traits With Obsessive Compulsive Symptoms and Well-Being in Patients With Obsessive Compulsive Disorder: A Cross-Sectional Study

et al. 2021

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The aim of this study is to examine the association of autism traits with long-term obsessive compulsive disorder (OCD) symptoms and well-being levels in patient with OCD. Participants comprised 18 outpatients from a tertiary hospital and 100 adults who were registered in a large Japanese internet marketing research company and met OCD criteria by the Mini-International Neuropsychiatric Interview and were between the ages of 20 and 65 years. Clinical characteristics, autism trait assessed using the Autism Spectrum Quotient (AQ), OCD symptoms assessed using Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), and well-being assessed using the Flourishing Scale were assessed. Multiple regression analyses showed that a greater total score of AQ, a greater subscale score “imagination” was associated with a greater score of Y-BOCS. Greater total score of AQ, a greater subscale score “social skill,” and “imagination” were associated with lower well-being score. Autism traits, especially lack of imagination, were associated with more severe OCD symptoms. Further, autism traits, especially social skill problems and lack of imagination, were associated with lower levels of well-being. Assessment of autism traits before treatment and a strategy designed for OCD patients with autism traits may be warranted.

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Co-occurrence, Assessment and Treatment of Obsessive Compulsive Disorder in Children and Adults With Autism Spectrum Disorder

Cited by 24 publications

References 65 publications

Psychometric properties of the Psychopathology in Autism Checklist (PAC)

Psychometric properties of the Psychopathology in Autism Checklist (PAC)

Immunological causes of obsessive-compulsive disorder: is it time for the concept of an “autoimmune OCD” subtype?

Associations of Autism Traits With Obsessive Compulsive Symptoms and Well-Being in Patients With Obsessive Compulsive Disorder: A Cross-Sectional Study

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