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Autism spectrum traits in children and adolescents with obsessive-compulsive disorder (OCD)

Journal article
Authors Tord Ivarsson
Karin Melin
Published in Journal of Anxiety Disorders
Volume 22
Issue 6
Pages 969-978
ISSN 0887-6185
Publication year 2008
Published at Institute of Clinical Sciences
Pages 969-978
Language en
Links dx.doi.org/10.1016/j.janxdis.2007.1...
Keywords school-age-children, screening questionnaire, diagnostic interview, asperger-syndrome, tic disorders, prevalence, family, epidemiology, metaanalysis, reliability
Subject categories Psychiatry, Psychology

Abstract

Abstract Objective Assess the prevalence of autistic traits (AST) in pediatric obsessive-compulsive disorder (OCD) and relate them to OCD co-morbidity and compare them with published normative data. Methods Pediatric patients with obsessive-compulsive disorder (n = 109) according to the DSM-IV were studied using parent ratings of the Autistic Symptom/Syndrome Questionnaire to assess AST symptoms as a continuous rather than categorical trait. The KSADS, a semi-structured psychiatric interview, was used for the psychiatric diagnostic evaluation. Also, the Children's Yale-Brown Obsessive-Compulsive Scale was used to assess OCD severity and other clinical features. Results AST was common among our patients. Symptom scores were highest in cases with co-morbid Autistic Spectrum Disorders, but cases with other co-morbidities as tics/Tourette and attention/behavioral disorders also scored higher. All sub-groups, including OCD without these co-morbidities scored higher than the Swedish normative group. Using ANOVA, co-morbid ASD and tics/Tourette (plus a term for gender by tic interaction indicating that girls with tics scored high, otherwise low) and pathological doubt contributed (R2 = .41) to the AST-traits, while OCD severity and co-morbid anxiety- and depressive disorders did not. Conclusion AST traits are prevalent in OCD and seem to be intricately associated with the co-morbidities as well as the OCD syndrome itself. The findings might have implication for our nosological understanding of OCD which currently is discussed. Keywords: Obsessive-compulsive disorder; Autistic traits; Autism spectrum disorders; Co-morbidity; Childhood; Adolescence

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