Psychiatric Co-Morbidities in Children with Autistic Spectrum Disorder

Background: Autistic Spectrum Disorder (ASD) is considered a neurodevelopmental disorder, characterized by causing marked decrease in social interaction and communication, conversation skills. The aim of this work was to explore the psychiatric co-morbidities among children with ASD.

Methods: This cross-sectional, descriptive study was carried out 55 children less than 18 years old fulfilled criteria for ASD. All patients were subjected to: Psychiatric interviewing and Psychometric tests that included Stanford-Binet test 5th edition, Arabic version of Kiddie Schedule for Affective Disorders and Schizophrenia “K-SADS, Arabic version of Childhood Autism Rating Scale (CARS), Arabic version of Conner’s Scale for ADHD and Arabic version of Screen for Child Anxiety Related Disorders (SCARED) (Child and parent versions).

Results: The majority of the studied ASD children were males younger than 13 years old, from rural areas, with mild and moderate intellectual disability, and with severe ASD symptoms. There is statistically significant difference between severity of ASD in studied children measured by CARS, and number of co-morbidities. The most prevalent psychiatric co-morbidities among studied ASD children were anxiety disorders (41.82%), followed by ADHD (36.36%).

There is statistically significant difference between severe form of ASD and psychiatric co-morbidities regarding ADHD, Tic disorder, ODD and elimination disorder, While Social anxiety and GAD were more common among children with milder forms. Among the studied children, the specific phobias, ODD and elimination disorders, were more in younger age groups. While social anxiety and psychotic disorders occurred more frequently with older age groups. GAD, somatization and depression were more frequent with females, while ADHD occurred more with males.

Conclusion: Presence of comorbid disorders among children with ASD is the rule rather than exception. Male children had more combined subtype and more severe form of the disorder. The most common comorbid psychiatric disorders with ASD are anxiety disorders and ADHD. The early identification and treatment of ASD and comorbid conditions may reduce the likelihood of impairment and persistence into adulthood.