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


CONCLUSIONS
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.
Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Gullhaug Torg 4B, Oslo, Norway. tord.ivarsson@r-bup.no
Tord
T
Ivarsson
Karin
K
Melin
D000293:Adolescent; D000367:Age Factors; D001321:Autistic Disorder / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D015897:Comorbidity; D035061:Control Groups; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology*; D010290:Parents / Q000523:psychology; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D012720:Severity of Illness Index; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D005879:Tourette Syndrome / Q000175:diagnosis / Q000453:epidemiology