Comorbidity in autism spectrum disorder: A literature review

Abstract

Comorbidity is defined as the co-occurrence of two or more disorders in the same person (Matson & Nebel-Schwalm, 2007). The current study provides a review of the literature on comorbidity, in relation to comorbid psychiatric and medical disorders in babies and infants, children, adults and across the lifespan. We also examine comorbid conditions such as attention deficit/hyperactivity disorder (AD/HD), epilepsy, gastrointestinal symptoms, sleep problems, feeding problems and toileting problems in individuals with autism spectrum disorder.Keywords: Comorbidity, Autism Spectrum Disorder, Attention deficit/hyperactivity disorder (AD/HD), Epilepsy, Sleep problems, Gastrointestinal symptoms.3 Comorbidity in autism spectrum disorder Comorbidity in autism spectrum disorderComorbidity is defined as the co-occurrence of two or more disorders in the same person (Matson & Nebel-Schwalm, 2007). A comorbid condition is a second order diagnosis which offers core symptoms that differ from the first disorder. Comorbidity in the assessment of autism spectrum disorder (ASD) is a topic that has infrequently been addressed (Matson & Nebel-Schwalm, 2007). One of the main difficulties in diagnosing comorbid psychopathology is the lack of diagnostic instruments designed to screen for these disorders in individuals with ASD. Instruments are only recently being developed, piloted and tested for reliability and validity. Instruments designed for assessing comorbid psychopathology in adults with ASD include the Psychopathology in Autism Checklist (PAC) (Helverschou, Bakken & Martinsen, 2009) and the Autism Spectrum Disorders-Comorbidity for Adults (ASD-CA) (Matson, Terlonge & González, 2006). Instruments designed to screen for comorbid psychopathology in children are a more recent development than the instruments designed for adults. Comorbid disorders often are more difficult to diagnose at a younger age. The Baby and Infant Screen for Children with aUtIsm Traits (BISCUIT), Part II (Matson, Boisjoli & Wilkins, 2007) was developed to screen for comorbid psychopathology in infants aged 16-37 months and has been psychometrically validated (Matson, Fodstad, Mahan & Sevin, 2009). The Autism Spectrum Disorders Comorbidity-Child Version (ASD-CC) (Matson & González, 2007) is another instrument used to diagnose comorbid psychopathology in children. Leyfer, Folstein, Bacalman, Davis, Dinh, Morgan et al., (2006) modified the existing instrument The Kiddie Schedule for Affective Disorders and Schizophrenia for use with children and adolescents with ASD. The modified instrument, the Autism Comorbidity Interview-Present and Lifetime Version (ACI-PL) was used to research prevalence rates of specific disorders. Comorbid psychiatric and medical conditions 4 Comorbidity in autism spectrum disorder Babies and infantsWhile there is now a great emphasis on the early diagnosis of ASD and the provision of early intensive behavioral intervention programs, there is a lack of research regarding comorbid conditions in very young children. The Baby a...

Trends in Employment for Individuals with Autism Spectrum Disorder: a Review of the Research Literature

“…Evidence is growing that anxiety disorder is common in individuals with ASD, especially among those with Asperger's and high-functioning ASD (Hillier et al 2007b;Mannion and Leader 2013). Kuusikko et al (2008) found that anxiety disorder increased as individuals with ASD became older, while the typically developing adolescents reported a decrease of anxiety.…”

Autism Spectrum Disorder Symptoms and Comorbidity in Emerging Adults

“…Taken together, a great deal of evidence lends itself to promoting the CBCL and CBCL 1-5 as effective screeners in distinguishing between ASD and other diagnostic presentations (e.g., [14,18,[21][22][23]25]); however, given the myriad of comorbid problems associated with ASD, including but not limited to ADHD, anxiety, depression, feeding concerns, and sleep issues [25], it is essential that the effectiveness of measures at differentiating between individuals with ASD alone and those with ASD and comorbid symptoms also is evaluated. In light of this, researchers found the CBCL 1-5 to be effective at distinguishing between children with ASD with an emotional and behavioral disorder (EBD) and children with ASD without comorbid EBD [26].…”

Attention-deficit/hyperactivity disorder (AD/HD) in autism spectrum disorder

“…Recent research has demonstrated how Attention-deficit/hyperactivity disorder (AD/HD) in autism spectrum disorder (ASD) is becoming a highly researched area in the field of comorbidity research (Matson & Williams, in press;Mannion & Leader, 2013). Matson, Rieske, and Williams (2013) provided a thorough review on the relationship between autism spectrum disorders (ASD) and AD/HD.…”