Addiction and Autism: A Remarkable Comorbidity?

Abstract

Objective Autism Spectrum Disorders (ASD) are well known for high prevalence’s of comorbid conditions especially anxiety, obsessions, depression and challenging behaviours. In this article we will consider the evidence for an eventual comorbidity between ASD and Addiction (Substance Use Disorders (SUD) and explore the possible underlying explanations. Methods A literature study on similarities between Addiction and ASD (at a phenotypical and neurobiological level) as well as a case note review on a year cohort of 200 consecutive admissions in an adult addiction psychiatry unit was studied here. Results In our pilot-survey 8 (men) on 118 patients were diagnosed with autism spectrum disorder. This is substantially higher than in the general population (1%) but in line with other European studies. Autism spectrum disorders and addiction can both be perceived as developmental disorders in which a genetic predisposition and vulnerability interact with environmental factors. They can be induced by early stress thus affecting the proper functioning of the cortico-striatal dopaminergic regulation systems (and also the HPA axis). There is growing evidence that ASD and SUD share developmental dysregulations of the limbic and sensorimotor cortico-striatal regulations loops. Conclusions There are clear indications that a possible comorbidity of substance abuse disorder should be considered in cases of individuals with autism spectrum disorders. This finding is important for clinicians to take into account in assessing patients with addiction problems or ASD.