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Subclinical autism spectrum symptoms in pediatric obsessive–compulsive disorder

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Abstract

The literature on subclinical autism spectrum (ASD) symptoms in pediatric obsessive–compulsive disorder (OCD) is scarce, and it remains unclear whether ASD symptoms are related to OCD severity. The aims of the present study were to assess the prevalence of ASD symptoms and age and sex differences in children and adolescents with OCD, and to explore the relation between ASD symptoms and OCD severity. This is the largest study of ASD symptoms in an OCD population to date, and the first directly aimed at elucidating sex and age differences in this matter. The study used baseline data from the Nordic Long-term OCD Treatment Study in which parents of 257 children and adolescents with OCD aged 7–17 completed the Autism Spectrum Screening Questionnaire. OCD severity was assessed with the Children’s Yale–Brown Obsessive Compulsive Scale. Pediatric OCD patients were found to exhibit elevated rates of ASD symptoms compared to a norm group of school-age children. ASD symptoms were concentrated in a subgroup with a prevalence of 10–17 %. This subgroup was characterized by a male preponderance with a sex ratio of approximately 2.6:1, while children versus adolescents with OCD exhibited similar rates. Autism-specific social and communication difficulties were not related to OCD severity, while restricted repetitive behavior was positively related to OCD severity. The results indicate that clinicians need to be aware of ASD symptoms in children and adolescents with OCD since one out of ten exhibits such symptoms at a clinical sub-threshold.

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Acknowledgments

We want to thank the patients, their parents, the clinics, and therapists that participated in the NordLOTS. The present study was funded with support by the Research Foundation for Center for Child and Adolescent Psychiatry, Central Denmark Region.

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Authors and Affiliations

  1. Research Department, Center for Child and Adolescent Psychiatry, Aarhus University Hospital, Skovagervej 2, entry 81, 8240, Risskov, Denmark

    Trine Wigh Arildskov, David R. M. A. Højgaard, Per Hove Thomsen & Katja A. Hybel

  2. Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Gullhaugveien 1-3, 0484, Oslo, Norway

    Gudmundur Skarphedinsson & Tord Ivarsson

  3. Department of Child and Adolescent Psychiatry, St. Olavs University Hospital and Regional Center for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Klostergate 46, 7491, Trondheim, Norway

    Bernhard Weidle

  4. Department of Child and Adolescent Psychiatry, Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, Göteborg, Sweden

    Karin Holmgren Melin

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  1. Trine Wigh Arildskov
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  2. David R. M. A. Højgaard
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  3. Gudmundur Skarphedinsson
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Correspondence to Trine Wigh Arildskov.

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Ethics

National committees for Medical and Health Research in Denmark, Norway, and Sweden approved the NordLOTS. Parents and children/adolescents received oral and written information about the study, and written informed consent was obtained from parent(s) or legal guardian(s), and from children of 11 years or older before inclusion in the study.

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Arildskov, T.W., Højgaard, D.R.M.A., Skarphedinsson, G. et al. Subclinical autism spectrum symptoms in pediatric obsessive–compulsive disorder. Eur Child Adolesc Psychiatry 25, 711–723 (2016). https://doi.org/10.1007/s00787-015-0782-5

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