Co-occurring Psychiatric Disorders in Preschool and Elementary School-Aged Children with Autism Spectrum Disorder

Abstract We employed a clinical sample of young children with ASD, with and without intellectual disability, to determine the rate and type of psychiatric disorders and possible association with risk factors. We assessed 101 children (57 males, 44 females) aged 4.5–9.8 years. 90.5 % of the sample met the criteria. Most common diagnoses were: generalized anxiety disorder (66.5 %), specific phobias (52.7 %) and attention deficit hyperactivity disorder (59.1 %). Boys were more likely to have oppositional defiant disorder (OR 3.9). Higher IQ was associated with anxiety disorders (OR 2.9) and older age with agoraphobia (OR 5.8). Night terrors was associated with parental psychological distress (OR 14.2). Most young ASD children met the criteria for additional psychopathology.

[1]  J. Blacher,et al.  Preschool children with intellectual disability: syndrome specificity, behaviour problems, and maternal well-being. , 2005, Journal of intellectual disability research : JIDR.

[2]  R. Kessler,et al.  Short screening scales to monitor population prevalences and trends in non-specific psychological distress , 2002, Psychological Medicine.

[3]  S. Green,et al.  Anxiety Disorders and Sensory Over-Responsivity in Children with Autism Spectrum Disorders: Is There a Causal Relationship? , 2010, Journal of autism and developmental disorders.

[4]  G. Baird,et al.  The persistence and stability of psychiatric problems in adolescents with autism spectrum disorders. , 2013, Journal of child psychology and psychiatry, and allied disciplines.

[5]  A. Erkanli,et al.  Longitudinal dimensionality of adolescent psychopathology: testing the differentiation hypothesis. , 2010, Journal of child psychology and psychiatry, and allied disciplines.

[6]  H. Egger,et al.  Prevalence of psychiatric disorders in preschoolers. , 2012, Journal of child psychology and psychiatry, and allied disciplines.

[7]  B. Leventhal,et al.  The Autism Diagnostic Observation Schedule—Generic: A Standard Measure of Social and Communication Deficits Associated with the Spectrum of Autism , 2000, Journal of autism and developmental disorders.

[8]  Kanak Ghosh,et al.  A methodology for estimating the population by ethnic group for areas within England. , 2006, Population trends.

[9]  A. Brereton,et al.  Manual for the Developmental Behaviour Checklist: Primary Carer Version (DBC-P) and Teacher Version (DBC-T) (2nd ed.) , 2002 .

[10]  S. Calhoun,et al.  Variables Related to Sleep Problems in Children with Autism. , 2009 .

[11]  R. Ferdinand,et al.  High Rates of Psychiatric Co-Morbidity in PDD-NOS , 2007, Journal of autism and developmental disorders.

[12]  A. Azizian,et al.  Comparison of DSM-IV symptoms in elementary school-age children with PDD versus clinic and community samples , 2005, Autism : the international journal of research and practice.

[13]  N. M. Mukaddes,et al.  High rates of psychiatric co-morbidity in individuals with Asperger's disorder , 2010 .

[14]  J. Baio Prevalence of autism spectrum disorders--Autism and Developmental Disabilities Monitoring Network, 14 sites, United States, 2008. , 2012, Morbidity and mortality weekly report. Surveillance summaries.

[15]  Abdel-Hady El-Gilany,et al.  Sex differences in Arab children with Autism spectrum disorders , 2011 .

[16]  A. Richdale,et al.  Sleep problems in autism spectrum disorders: prevalence, nature, & possible biopsychosocial aetiologies. , 2009, Sleep medicine reviews.

[17]  L. Gallagher,et al.  Psychosis, Affective Disorders and Anxiety in Autistic Spectrum Disorder: Prevalence and Nosological Considerations , 2009, Psychopathology.

[18]  Janet E. Lainhart,et al.  Comorbid Psychiatric Disorders in Children with Autism: Interview Development and Rates of Disorders , 2006, Journal of autism and developmental disorders.

[19]  H. Egger,et al.  Common emotional and behavioral disorders in preschool children: presentation, nosology, and epidemiology. , 2006, Journal of child psychology and psychiatry, and allied disciplines.

[20]  H. Koot,et al.  DSM-IV disorders in children with borderline to moderate intellectual disability. I: prevalence and impact. , 2003, Journal of the American Academy of Child and Adolescent Psychiatry.

[21]  Alaattin Erkanli,et al.  Test-Retest Reliability of the Preschool Age Psychiatric Assessment (PAPA). , 2006, Journal of the American Academy of Child and Adolescent Psychiatry.

[22]  Luc Lecavalier,et al.  Parent-Rated Anxiety Symptoms in Children with Pervasive Developmental Disorders: Frequency and Association with Core Autism Symptoms and Cognitive Functioning , 2008, Journal of abnormal child psychology.

[23]  M. Rutter Research review: Child psychiatric diagnosis and classification: concepts, findings, challenges and potential. , 2011, Journal of child psychology and psychiatry, and allied disciplines.

[24]  I. Hertz-Picciotto,et al.  Sleep problems in children with autism spectrum disorders, developmental delays, and typical development: a population‐based study , 2008, Journal of sleep research.

[25]  S. Hall,et al.  Risk markers associated with challenging behaviours in people with intellectual disabilities: a meta-analytic study. , 2003, Journal of intellectual disability research : JIDR.

[26]  G. Baird,et al.  Prevalence of disorders of the autism spectrum in a population cohort of children in South Thames: the Special Needs and Autism Project (SNAP) , 2006, The Lancet.

[27]  Janet E. Lainhart,et al.  Overrepresentation of mood and anxiety disorders in adults with autism and their first‐degree relatives: what does it mean? , 2008, Autism research : official journal of the International Society for Autism Research.

[28]  Psychiatric Comorbidity in Children with Autism Spectrum Disorders: A Comparison with Children with ADHD , 2012, Journal of child and family studies.

[29]  H. Egger,et al.  Preschool psychopathology: lessons for the lifespan. , 2007, Journal of child psychology and psychiatry, and allied disciplines.

[30]  L. Sears,et al.  Sleep problems in children with autism , 2004, Journal of sleep research.

[31]  Carrie R. Houts,et al.  Validity of DSM-IV syndromes in preschoolers with autism spectrum disorders , 2011, Autism : the international journal of research and practice.

[32]  G. Baird,et al.  Randomized controlled double-blind trial of optimal dose methylphenidate in children and adolescents with severe attention deficit hyperactivity disorder and intellectual disability. , 2013, Journal of child psychology and psychiatry, and allied disciplines.

[33]  D. Wechsler Wechsler Intelligence Scale for Children , 2020, Definitions.

[34]  C. McDougle,et al.  Randomized, controlled, crossover trial of methylphenidate in pervasive developmental disorders with hyperactivity. , 2005, Archives of general psychiatry.

[35]  I. Moilanen,et al.  Comorbid Psychiatric Disorders Associated with Asperger Syndrome/High-functioning Autism: A Community- and Clinic-based Study , 2010, Journal of autism and developmental disorders.

[36]  R. Hastings Child behaviour problems and partner mental health as correlates of stress in mothers and fathers of children with autism. , 2003, Journal of intellectual disability research : JIDR.

[37]  Todd D. Little,et al.  The Infant–Toddler Social and Emotional Assessment (ITSEA): Factor Structure, Reliability, and Validity , 2003, Journal of abnormal child psychology.

[38]  N. Yirmiya,et al.  Psychiatric disorders in parents of children with autism: a meta-analysis. , 2005, Journal of child psychology and psychiatry, and allied disciplines.

[39]  D. Hevey,et al.  Factors Contributing to Stress in Parents of Individuals with Autistic Spectrum Disorders. , 2009 .

[40]  N. Minshew,et al.  ASD, a Psychiatric Disorder, or Both? Psychiatric Diagnoses in Adolescents with High-Functioning ASD , 2012, Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53.

[41]  G. Baird,et al.  Psychiatric disorders in children with autism spectrum disorders: prevalence, comorbidity, and associated factors in a population-derived sample. , 2008, Journal of the American Academy of Child and Adolescent Psychiatry.

[42]  K. Gadow,et al.  Predictors of Psychiatric Symptoms in Children with an Autism Spectrum Disorder , 2008, Journal of autism and developmental disorders.

[43]  J. Buitelaar,et al.  A randomized double-blind study of atomoxetine versus placebo for attention-deficit/hyperactivity disorder symptoms in children with autism spectrum disorder. , 2012, Journal of the American Academy of Child and Adolescent Psychiatry.

[44]  J. Matson,et al.  Comorbid psychopathology factor structure on the Baby and Infant Screen for Children with aUtIsm Traits-Part 2 (BISCUIT-Part 2) , 2011 .

[45]  A. Couteur,et al.  Autism diagnostic interview: A standardized investigator-based instrument , 1989, Journal of autism and developmental disorders.

[46]  G. Baird,et al.  Development and psychometric properties of the parent version of the Profile of Neuropsychiatric Symptoms (PONS) in children and adolescents , 2015, BMC Pediatrics.

[47]  Martin Knapp,et al.  Economic cost of autism in the UK , 2009, Autism : the international journal of research and practice.

[48]  R. Hastings,et al.  A population-based investigation of behavioural and emotional problems and maternal mental health: associations with autism spectrum disorder and intellectual disability. , 2011, Journal of child psychology and psychiatry, and allied disciplines.

[49]  N. M. Mukaddes,et al.  Psychiatric disorders in individuals with high-functioning autism and Asperger's disorder: Similarities and differences , 2010, The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry.

[50]  T Loucas,et al.  IQ in children with autism spectrum disorders: data from the Special Needs and Autism Project (SNAP) , 2010, Psychological Medicine.

[51]  Megan N. Norris,et al.  Reliability and Validity of the Children’s Interview for Psychiatric Syndromes-Parent Version in Autism Spectrum Disorders , 2012, Journal of Autism and Developmental Disorders.

[52]  A. Carter,et al.  Parenting Stress in Mothers and Fathers of Toddlers with Autism Spectrum Disorders: Associations with Child Characteristics , 2008, Journal of autism and developmental disorders.

[53]  H. Goldsmith,et al.  A Population-Based Twin Study of Parentally Reported Tactile and Auditory Defensiveness in Young Children , 2006, Journal of abnormal child psychology.

[54]  H. Meltzer,et al.  Mental Health of Children and Young People in Great Britain, 2004 , 2005 .

[55]  G. Baird,et al.  The Association Between Social Cognition and Executive Functioning and Symptoms of Anxiety and Depression in Adolescents With Autism Spectrum Disorders , 2014, Autism research : official journal of the International Society for Autism Research.

[56]  Maurice Place,et al.  The developmental, dimensional and diagnostic interview (3di): a novel computerized assessment for autism spectrum disorders. , 2004, Journal of the American Academy of Child and Adolescent Psychiatry.

[57]  G. Baird,et al.  The experience of friendship, victimization and bullying in children with an autism spectrum disorder: Associations with child characteristics and school placement , 2012 .

[58]  J. Breton,et al.  Do children aged 9 through 11 years understand the DISC Version 2.25 questions? , 1995, Journal of the American Academy of Child and Adolescent Psychiatry.

[59]  Ji-Hoon Kim,et al.  Sleep Problems in Autism Spectrum Disorder , 2013 .

[60]  H. Egger,et al.  The Preschool Age Psychiatric Assessment (PAPA): A Structured Parent Interview for Diagnosing Psychiatric Disorders in Preschool Children. , 2004 .

[61]  L. Lecavalier,et al.  Validity of Comorbid Psychiatric Disorders in Youngsters with Autism Spectrum Disorders , 2010 .

[62]  R. Wilson,et al.  Mental health of children and young people , 2017 .

[63]  S. Zubrick,et al.  Preschool psychopathology reported by parents in 23 societies: testing the seven-syndrome model of the child behavior checklist for ages 1.5-5. , 2010, Journal of the American Academy of Child and Adolescent Psychiatry.

[64]  Sarah A. Mustillo,et al.  Prevalence and development of psychiatric disorders in childhood and adolescence. , 2003, Archives of general psychiatry.

[65]  Guillermo Montes,et al.  Bullying among children with autism and the influence of comorbidity with ADHD: a population-based study. , 2007, Ambulatory pediatrics : the official journal of the Ambulatory Pediatric Association.

[66]  H. Egger,et al.  Diagnostic specificity and nonspecificity in the dimensions of preschool psychopathology. , 2007, Journal of child psychology and psychiatry, and allied disciplines.

[67]  C. McDougle,et al.  Research Units on Pediatric Psychopharmacology (RUPP) Autism Network. Background and rationale for an initial controlled study of risperidone. , 2000, Child and adolescent psychiatric clinics of North America.

[68]  E. Sponheim,et al.  Kiddie-SADS Reveals High Rates of DSM-IV Disorders in Children and Adolescents with Autism Spectrum Disorders , 2010, Journal of autism and developmental disorders.

[69]  S. Bradley-Johnson Mullen Scales of Early Learning , 1997 .

[70]  S. Leekam,et al.  The Diagnostic Interview for Social and Communication Disorders: background, inter-rater reliability and clinical use. , 2002, Journal of child psychology and psychiatry, and allied disciplines.

[71]  Y. Wing,et al.  Sleep problems of children with pervasive developmental disorders: correlation with parental stress. , 2006, Developmental medicine and child neurology.