The influence of sex and age on prevalence rates of comorbid conditions in autism

Abstract

Individuals with ASD frequently experience one or more comorbid conditions. Here, we investigate the influence of sex and age-two important, yet understudied factors-on ten common comorbid conditions in ASD, using cross-sectional data from 4790 individuals with ASD and 1,842,575 individuals without ASD. Epilepsy, ADHD, and CNS/cranial anomalies showed exceptionally large proportions in both male (>19%) and female (>15%), children/adolescents with ASD. Notably, these prevalence rates decreased drastically with age in both males and females. In contrast, the prevalence of schizophrenia increased with age affecting a disproportionately large number of older (≥35 year) adult males (25%), compared to females (7.7%), with ASD. Bowel disorders showed a complex U-pattern accompanied by changes in sex disparity with age. These results highlight crucial differences between cross-sectional comorbidity patterns and their interactions with sex and age, which may aid in the development of effective sex- and age-specific diagnostic/treatment strategies for ASD and comorbid conditions. Autism Res 2017, 10: 778-789. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

Prevalence of Co-occurring Medical and Behavioral Conditions/Symptoms Among 4- and 8-Year-Old Children with Autism Spectrum Disorder in Selected Areas of the United States in 2010

“…In line with other studies (Gurney et al 2006; Levy et al 2010; Lundstrom et al 2015; Nicholas et al 2009; Simonoff et al 2008; Supekar et al 2017; Wiggins et al 2015), we documented a high prevalence of co-occurring conditions/symptoms in those with ASD. As indicated by others (e.g., Levy et al 2010; Lundstrom et al 2015) and confirmed in our study, only a small proportion of children with ASD did not have any co-occurring condition/symptom.…”

“…In addition, affected individuals may have co-occurring conditions/symptoms. The most frequently reported are: intellectual disability (ID); Attention Deficit Hyperactivity Disorder (ADHD); developmental regression; behavioral, sleep, sensory processing, and gastrointestinal problems; and ASD-associated genetic conditions, such as Down syndrome, Fragile X syndrome (Bauman 2010; Gurney et al 2006; Kielinen et al 2004; Krakowiak et al 2008; Levy et al 2010; Lundstrom et al 2015; Simonoff et al 2008; Supekar et al 2017; Wiggins et al 2009). …”

“…Studies have documented sociodemographic differences in the prevalence of some co-occurring conditions. For example, Supekar et al (2017) reported sex differences in ADHD and epilepsy in those with ASD. Likewise, Non-Hispanic White children were more likely to have a diagnosis of ADHD than children from other racial/ethnic groups (Coker et al 2016).…”

“…Further, while a few studies reported differences in the prevalence of co-occurring conditions/symptoms between age groups (Croen et al 2015; Lever and Geurts 2016; Mannion and Leader 2016; Supekar et al 2017), there is a need for large population-based studies. In this study, we compared the prevalence of various medical and behavioral co-occurring conditions/symptoms between 4- and 8-year-old children in a population-based sample, accounting for sociodemographic differences.…”

Association between schizophrenia and autism spectrum disorder: A systematic review and meta‐analysis

“…Four studies were carried out in Denmark [Abdallah et al, ; Maibing et al, ; Mouridsen, Rich, & Isager, ; Mouridsen, Rich, Isager, & Nedergaard, ], two studies in the United States [Joshi et al, ; Supekar, Iyer, & Menon, ], two in Sweden [Selten, Lundberg, Rai, & Magnusson, ; Stahlberg, Soderstrom, Rastam, & Gillberg, ], one in Norway [Bakken et al, ], one in Canada [Bradley et al, ], and one in the Netherlands [Fiksinski et al, ]. The sample sizes ranged from 12 [Bradley et al, ] to 9,062 [Selten et al, ] individuals with ASD and from 12 [Bradley et al, ] to 1,842,575 [Supekar et al, ] controls. Additionally, the mean ages of the samples ranged from 4.9 years old [Mouridsen, Rich, Isager, et al, ] to 32.2 ± 9.1 years old [Stahlberg et al, ].…”