Evidence‐Based Practice in the Face of Complexity and Comorbidity: A Case Study of an Adolescent With <scp>A</scp>sperger's Syndrome, Anxiety, Depression, and Chronic Pain

Loades, Maria

doi:10.1111/jcap.12108

Cited by 13 publications

(22 citation statements)

References 44 publications

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“… 40 Moreover, psychiatric disorders, in particular, anxiety and depression, are common in pediatric chronic pain, 41 , 42 and have been associated with elevated levels of functional impairments. 36 , 43 – 45 A few clinical reports, 46 – 49 a number of studies on abdominal pain, 20 , 50 a study on migraine, 51 and a recent study on neuropsychological function in chronic pain 40 have suggested that ASD and ADHD may be comorbid to pediatric chronic pain and that such comorbid neurodevelopmental conditions may go undetected. Importantly, however, the prevalence of these disorders, including clinically significant traits, in pediatric patients with chronic pain is still unclear.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of autism traits and attention-deficit hyperactivity disorder symptoms in a clinical sample of children and adolescents with chronic pain

Lipsker

Bölte

Hirvikoski

et al. 2018

JPR

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PurposeRecent research has suggested that autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) may be comorbid to pediatric chronic pain, but the empirical support is yet scarce. Therefore, the current study aimed to investigate the occurrence of traits and symptoms consistent with clinically significant ASD and ADHD in a group of children and adolescents with chronic debilitating pain and examine potential differences in pain and demographic variables between children with and without clinically significant traits and symptoms of ASD and ADHD.Patients and methodsThis cross-sectional study included 146 parent–child dyads (102 girls, 111 mothers, children 8–17 years) consecutively referred to a tertiary pain clinic. Parents completed the Social Responsiveness Scale to assess autistic traits, and Conners-3 to measure symptoms of ADHD in their children. Children completed the Lübeck Pain Questionnaire to evaluate experienced pain.ResultsAmong children, 20 (13.7%) received scores consistent with clinically significant ASD and 29 (19.9%) received scores consistent with clinically significant ADHD, with a combined prevalence of clinically significant ASD/ADHD traits and symptoms of 26% of the total sample. Only 4.8% of children were previously diagnosed with either disorder. Among children with clinically significant ASD traits, girls were more prevalent, parents reported lower health, and the pain was more likely triggered by being in school. Among children with clinically significant ADHD symptoms, there were no gender differences and pain was more likely triggered by the family situation and new situations. No differences regarding pain intensity, duration, or frequency were found between children with and without clinically significant ASD traits or ADHD symptoms.ConclusionChildren with debilitating chronic pain, particularly girls, may present with an elevated risk of having a comorbid, possibly high-functioning, neurodevelopmental disorder. Results suggest that clinical assessment of pediatric chronic pain should include screening for neurodevelopmental disorders.

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Section: Introductionmentioning

confidence: 99%

Prevalence of autism traits and attention-deficit hyperactivity disorder symptoms in a clinical sample of children and adolescents with chronic pain

Lipsker

Bölte

Hirvikoski

et al. 2018

JPR

View full text Add to dashboard Cite

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“…However, the overall prevalence of comorbid neurodevelopmental disorders, such as autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD), has not yet been established . A few cases described in the literature have indicated an overlap between chronic pain and ASD, including two on children who were under 12 years of age , and other studies have suggested that abdominal pain appears to be common and persistent among children with ASD . Furthermore, a 2017 study by Arruda et al reported that migraine, frequent migraine and ADHD were comorbid in the paediatric population.…”

Section: Introductionmentioning

confidence: 99%

A case report and literature review of autism and attention deficit hyperactivity disorder in paediatric chronic pain

et al. 2018

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“… 69 Previous cases in the literature showed an overlap between ASD and chronic pain, particularly among adolescents. 6 , 70 , 72 As previously mentioned, ASD has a strong genetic contribution, and advances of arrays and sequencing technologies have provided tools to elucidate both de novo single nucleotide variants and copy number variations and other genetic variants that contribute to approximately 10% to 40% of cases. 49 , 73–75 Sodium channels in ASD research have gained significant traction, with SCN2A , a gene that encodes a voltage-gated sodium channel subtype 2 alpha protein (Na v 1.2), becoming a front runner due to the sheer amount of de novo single nucleotide variants that occur in patients.…”

Section: The Autism Spectrum Disorder Risk Gene Scn9a and Pain Comorbiditiesmentioning

confidence: 99%

A mini-review: Bridging the gap between autism spectrum disorder and pain comorbidities

Brown

Singh

2020

Canadian Journal of Pain

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Background Pain is a complex neurobiological response with a multitude of causes; however, patients with autism spectrum disorder (ASD) often report chronic pain with no known etiology. Recent research has been aimed toward identifying the causal mechanisms of pain in mouse and human models of ASD. In recent years, efforts have been made to better document and explore secondary phenotypes observed in ASD patients in the clinic. As new sequencing studies have become more powered with larger cohorts within ASD, specific genes and their variants are often left uncharacterized or validated. In this review we highlight ASD risk genes often presented with pain comorbidities. Aims This mini-review bridges the gap between two fields of literature, neurodevelopmental disorders and pain research. We discuss the importance of the genetic landscape of ASD and its links to pain phenotypes. Results Among the numerous genes implicated in ASD, few have been implicated with varying severities of pain comorbidity. Mutations in these genes, such as SCN9A, SHANK3 , and CNTNAP2 , lead to altered neuronal function that produce different responses to pain, shown in both mouse and human models. Conclusion There is a necessity to use new technologies to advance the current understanding of ASD risk genes and their contributions to pain. Secondly, there is a need to power future ASD risk genes associated with pain with their own cohort, because a better understanding is needed of this subpopulation.

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Evidence‐Based Practice in the Face of Complexity and Comorbidity: A Case Study of an Adolescent With Asperger's Syndrome, Anxiety, Depression, and Chronic Pain

Abstract: Routine outcome measurement demonstrated the effectiveness of the intervention.

Cited by 13 publications

References 44 publications

Prevalence of autism traits and attention-deficit hyperactivity disorder symptoms in a clinical sample of children and adolescents with chronic pain

Prevalence of autism traits and attention-deficit hyperactivity disorder symptoms in a clinical sample of children and adolescents with chronic pain

A case report and literature review of autism and attention deficit hyperactivity disorder in paediatric chronic pain

A mini-review: Bridging the gap between autism spectrum disorder and pain comorbidities

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