Abstract
BackgroundDespite substantial similarities and overlaps in the pathophysiology of obsessive-compulsive disorders (OCD) and autism spectrum disorders, little is known about the clinical and etiologic cohesion of these two disorders. We therefore aimed to determine the patterns of comorbidity, longitudinal risks, and shared familial risks between these disorders.MethodsIn a prospective study design we explored the effect of a prior diagnosis of OCD in patients and parents on the susceptibility to autism spectrum disorders and vice versa. Analyses were adjusted for sex, age, calendar year, parental age and place at residence at time of birth. As measures of relative risk incidence rate ratios (IRR) and accompanying 95% confidence intervals (CIs) were employed.ResultsThe risk of a comorbid diagnosis of OCD in individuals with autism spectrum disorder and aggregation of autism spectrum disorders in offspring of parents with OCD were increased. Individuals first diagnosed with autism spectrum disorders had a 2-fold higher risk of a later diagnosis of OCD (IRR = 2.18, 95% CI = 1.91–2.48), whereas individuals diagnosed with OCD displayed a nearly 4-fold higher risk to be diagnosed with autism spectrum disorders (IRR = 3.91, 95% CI = 3.46–4.40) later in life. The observed associations were somewhat stronger for less severe types of autism spectrum disorders without a comorbid diagnosis of mental disabilities.ConclusionsThe high comorbidity, sequential risk, and shared familial risks between OCD and autism spectrum disorders are suggestive of partially shared etiological mechanisms. The results have implications for current gene-searching efforts and for clinical practice.
Highlights
Autism spectrum disorders constitute a group of neuro-developmental disorders characterized by severe impairments in social interaction and communication, often accompanied by restricted, repetitive or stereotyped interests and behaviors
Individuals first diagnosed with autism spectrum disorders had a 2-fold higher risk of a later diagnosis of obsessive-compulsive disorder (OCD) (IRR = 2.18, 95% confidence intervals (CIs) = 1.91–2.48), whereas individuals diagnosed with OCD displayed a nearly 4-fold higher risk to be diagnosed with autism spectrum disorders (IRR = 3.91, 95% CI = 3.46–4.40) later in life
The observed associations were somewhat stronger for less severe types of autism spectrum disorders without a comorbid diagnosis of mental disabilities
Summary
Autism spectrum disorders constitute a group of neuro-developmental disorders characterized by severe impairments in social interaction and communication, often accompanied by restricted, repetitive or stereotyped interests and behaviors. There is considerable evidence that patients with autism spectrum disorders are at an increased risk of comorbid anxiety disorders [3,4,5,6]. A recent systematic review revealed that approximately 40% of patients with autism spectrum disorders are assigned at least one comorbid diagnosis of anxiety, the most frequent being specific phobia (30%) followed by obsessive-compulsive disorder (OCD; 17%) [7]. Given that the prevalence of OCD in the general population is estimated around 1.6% [8], it appears that OCD is more prevalent among patients with autism spectrum disorders than in the general population. Despite substantial similarities and overlaps in the pathophysiology of obsessive-compulsive disorders (OCD) and autism spectrum disorders, little is known about the clinical and etiologic cohesion of these two disorders. We aimed to determine the patterns of comorbidity, longitudinal risks, and shared familial risks between these disorders.
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