Psychotherapy for co-occurring symptoms of depression, anxiety and obsessive-compulsive disorder in children and adults with autism spectrum disorder: a systematic review and meta-analysis

Wichers, Robert; Wouw, Lisa C van der; Brouwer, Marlies; Lok, Anja; Bockting, Claudi

doi:10.1017/s0033291722003415

Cited by 13 publications

(8 citation statements)

References 71 publications

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“…Inconsistencies in effect sizes with previous meta-analyses may be attributed to methodological differences such as inclusion criteria (e.g., some included non-adapted generic CBT (Sharma et al, 2021) and non-randomised controlled trials (Perihan et al, 2020; Ung, Selles, Small, & Storch, 2015)) or favouring different measures (Kreslins, Robertson, & Melville, 2015; Sharma et al, 2021; Sukhodolsky et al, 2013) and chosing pooled over separate meta-analyses (Perihan et al, 2020; Ung et al, 2015; Wichers, Van Der Wouw, Brouwer, Lok, & Bockting, 2023). Variation of effect sizes across different raters has been reported elsewhere (Kreslins et al, 2015; Sharma et al, 2021; Sukhodolsky et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Approaches to improve mental health care for autistic children and young people: a systematic review and meta-analysis

Pemovska,

Loizou,

Appleton

et al. 2023

Preprint

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Autistic children and young people (CYP) experience mental health difficulties but face many barriers to accessing and benefiting from mental health care. There is a need to explore strategies in mental health care for autistic CYP to guide clinical practice and future research and support their mental health needs. Our aim was to identify strategies used to improve mental health care for autistic CYP and examine evidence on their acceptability, feasibility, and effectiveness. A systematic review and meta-analysis were carried out. All study designs reporting acceptability/feasibility outcomes and empirical quantitative studies reporting effectiveness outcomes for strategies tested within mental health care were eligible. We conducted a narrative synthesis and separate meta-analyses by informant (self, parent, clinician). Fifty-seven papers were included, with most investigating cognitive behavioural therapy (CBT)-based interventions for anxiety and several exploring service-level strategies, such as autism screening tools, clinician training, adaptations regarding organisation of services. Most papers described caregiver involvement in therapy and reported adaptations to communication and intervention content; a few reported environmental adjustments. In the meta-analyses, parent- and clinician-reported outcomes, but not self-reported outcomes, showed with moderate certainty that CBT for anxiety was an effective treatment compared to any comparison condition in reducing anxiety symptoms in autistic individuals. The certainty of evidence for effectiveness, synthesised narratively, ranged from low to moderate. Evidence for feasibility and acceptability tended to be positive. Many identified strategies are simple, reasonable adjustments that can be implemented in services to enhance mental health care for autistic individuals. Notable research gaps persist, however.

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Section: Discussionmentioning

confidence: 99%

Approaches to improve mental health care for autistic children and young people: a systematic review and meta-analysis

Pemovska,

Loizou,

Appleton

et al. 2023

Preprint

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“…The co-occurrence of depression and anxiety is common among both adults and children [ 31 ]. In children, the co-occurrence has been associated with a range of health and social problems, which include increased risk of co-occurring conditions, poor use of health care, school problems and high parenting aggravation [ 32 ], which may have long-term impacts. The current study found that the prevalence of co-occurring anxiety and depression was 32.14%, with those with severe symptoms being more than those with mild symptoms.…”

Section: Discussionmentioning

confidence: 99%

Symptoms of Depression, Anxiety and Their Co-Occurrence among Orphaned Children in Sekhukhune District, Limpopo Province

Mokwena,

Magabe,

Ntuli

2023

Children

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Although both short- and long-term psychological challenges, specifically depression and anxiety, have been reported among orphans, there is a dearth of studies that quantify these disorders in rural settings. The aim of the study was to screen for symptoms of depression, anxiety and their co-occurrence among orphaned school-going children in rural Limpopo province, South Africa. Data were collected among primary school children in 10 schools in two villages in Limpopo province. The Revised Child Anxiety and Depression Scale (RCADS) was used to screen for symptoms of depression, anxiety and their co-occurrence among 308 orphaned learners in the selected schools. A questionnaire was used to collect socio-demographic data. STATA 13 was used to analyse the data. Descriptive statistics were used to determine the symptoms and severity of depression, anxiety and their co-occurrence. The sample of 308 consisted of the majority (60.71%) residing in Maandagshoek and being female (54.22%). Their ages ranged from 8 to 12 years, with a mean of 10.51 years. The prevalence of symptoms of depression, anxiety and co-occurrence of anxiety and depression were 23.05%, 34.09% and 32.14%, respectively. The prevalence of mental health symptoms was high among the sample. There is a need to expand the care of orphans to include mental health and not just limit their care to provide food to vulnerable children.

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Section: Therapiesmentioning

confidence: 99%

“…At present, the ongoing ASD therapy is limited to well-known brain drugs prescribed to both children and adult patients for many ASD co-symptoms: anxiety, depression, hyperactivity, and sleep problems [86,87]. Among these drugs, those effective against attention-deficit/hyperactivity disorders are employed as psychotropic and psychostimulants [1,[86][87][88]. Ongoing research, now intensely investigated, supports an association between ASD and immune/inflammatory mechanisms and proposes the development and future employment for specific inhibitory drugs [89].…”

Section: Therapiesmentioning

confidence: 99%

Autism Spectrum Disorder: Brain Areas Involved, Neurobiological Mechanisms, Diagnoses and Therapies

Lamanna,

Meldolesi

2024

IJMS

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Autism spectrum disorder (ASD), affecting over 2% of the pre-school children population, includes an important fraction of the conditions accounting for the heterogeneity of autism. The disease was discovered 75 years ago, and the present review, based on critical evaluations of the recognized ASD studies from the beginning of 1990, has been further developed by the comparative analyses of the research and clinical reports, which have grown progressively in recent years up to late 2023. The tools necessary for the identification of the ASD disease and its related clinical pathologies are genetic and epigenetic mutations affected by the specific interaction with transcription factors and chromatin remodeling processes occurring within specific complexes of brain neurons. Most often, the ensuing effects induce the inhibition/excitation of synaptic structures sustained primarily, at dendritic fibers, by alterations of flat and spine response sites. These effects are relevant because synapses, established by specific interactions of neurons with glial cells, operate as early and key targets of ASD. The pathology of children is often suspected by parents and communities and then confirmed by ensuing experiences. The final diagnoses of children and mature patients are then completed by the combination of neuropsychological (cognitive) tests and electro-/magneto-encephalography studies developed in specialized centers. ASD comorbidities, induced by processes such as anxieties, depressions, hyperactivities, and sleep defects, interact with and reinforce other brain diseases, especially schizophrenia. Advanced therapies, prescribed to children and adult patients for the control of ASD symptoms and disease, are based on the combination of well-known brain drugs with classical tools of neurologic and psychiatric practice. Overall, this review reports and discusses the advanced knowledge about the biological and medical properties of ASD.

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Psychotherapy for co-occurring symptoms of depression, anxiety and obsessive-compulsive disorder in children and adults with autism spectrum disorder: a systematic review and meta-analysis

Cited by 13 publications

References 71 publications

Approaches to improve mental health care for autistic children and young people: a systematic review and meta-analysis

Approaches to improve mental health care for autistic children and young people: a systematic review and meta-analysis

Symptoms of Depression, Anxiety and Their Co-Occurrence among Orphaned Children in Sekhukhune District, Limpopo Province

Autism Spectrum Disorder: Brain Areas Involved, Neurobiological Mechanisms, Diagnoses and Therapies

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