Lifetime co-occurring psychiatric disorders in newly diagnosed adults with attention deficit hyperactivity disorder (ADHD) or/and autism spectrum disorder (ASD)

Abstract

Background: Co-occurring psychiatric disorders in adults with Attention Deficit Hyperactivity Disorder (ADHD) and/ or Autism Spectrum Disorder (ASD) contribute to the burden of the healthcare and possibly to the delay of diagnosis. Aim of the study was to clinically assess the prevalence and compare lifetime co-occurring psychopathology in a sample of newly diagnosed ADHD and/or ASD adults and discuss the diagnostic challenges they pose. Methods: The lifetime prevalence rates of ten of the most frequently co-occurring psychiatric diagnoses was registered in 336 adults of normal intelligence who underwent a thorough clinical evaluation for the diagnosis of ADHD and/or ASD for the first time in their lives. Four study groups were formed: the ADHD (n = 151), the ASD (n = 58), the ADHD+ASD (n = 28) and the nonADHD/nonASD (NN) (n = 88) group. Results: At least one co-occurring psychopathology was found in 72.8% of the ADHD group, in 50% of the ASD group, in 72.4% of the ADHD+ASD group and in 76.1% of the NN group (p = 0.004). In all groups the most frequent psychiatric disorder was depressive disorder. The only significant difference regarding the patterns of psychiatric cooccurrence between the ADHD and the nonADHD groups (ASD and NN groups) was found for SUD (p = 0.001). Also, the proportion of subjects with Bipolar Disorder was significantly greater in the NN group as compared to those with ASD (p = 0.025). Conclusions: Our results support the high prevalence of co-occurring psychiatric disorders in adults with ADHD and/or ASD with the ASD group presenting the lowest rate. The most marked difference between the ADHD and the nonADHD groups was found for SUD. Moreover, our findings highlight the need for a thorough clinical assessment of all referred patients both in the presence and absence of ADHD and/or ASD.

Trait-Based Dimensions Discriminating Adults with Attention Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD) and, Co-occurring ADHD/ASD

“…The present study was part of a larger research project on de novo diagnosed adults with ADHD and ASD [ 38 ]. The research group included 238 adults that were assessed at the Adult Neurodevelopmental Department in the 1st Department of Psychiatry at the National and Kapodistrian University of Athens and received a de novo ADHD and/or ASD diagnosis during a three-year period.…”

“…The Adult Neurodevelopmental Department is the only nationwide center that accepts referrals from the general population across Greece for the diagnosis of ASD and ADHD in adults. It used to be specialized for the diagnosis and treatment of adult ADHD [ 38 , 39 ], but during the last ten years, the increased needs for diagnosis and treatment of adults with ASD resulted in the broadening of referral criteria in order to include suspected ASD cases. The multidisciplinary team that carries out all assessments consists of psychiatrists who have extensive experience in the diagnosis and treatment of neurodevelopmental disorders in adults and are trained in Autism Diagnostic Observation Scale (ADOS) [ 40 , 41 ], Autism Diagnostic Interview –Revised (ADI-R) [ 42 , 43 ], and Diagnostic Interview for ADHD in Adults (DIVA) [ 3 , 5 , 44 ]; clinical psychologists; a speech and language therapist; an occupational therapist; a social worker.…”

“…The assessment procedure was built on a standard diagnostic routine that is described in detail in Pehlivanidis et al [ 38 ]. Initially, all referred patients had to complete a questionnaire that comprised demographic, educational, occupational, and clinical questions and a battery of screening instruments, including modified versions of the BAARS-IV [ 45 ], the AQ [ 46 ], and the EQ [ 47 ].…”

“…Establishing symptom profiles for making a diagnosis of ADHD in individuals with ASD remains an important area of research. Of particular interest is the less studied group of the less impaired adult patients who are overlooked until adulthood and pose complex diagnostic issues [ 38 ].…”

Association of Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder Traits with Depression and Empathy Among Medical Students

“…Moreover, it has been observed that some atypically developing individuals are close to the diagnostic threshold for ADHD and/or ASD, experience few behavioral problems, display good cognitive function, and perform well, while others demonstrate various psychiatric disorders. 6 In Japanese hospital pharmacists, ADHD and ASD traits have been reported to be associated with psychological distress, burnout, and compassion fatigue. 7 A major mission of medical education is to educate physicians to express compassion and empathy toward their patients.…”