Prevalence of Anxiety Disorders in Chinese Children with Autism Spectrum Disorder in Hong Kong

Abstract

Background: Autism spectrum disorder (ASD) is a pervasive neurodevelopmental disorder. Children with ASD are faced with various challenges considering their lifelong neurodevelopmental disabilities. Comorbid psychiatric disorders are found to be prevalent among children with ASD. Anxiety disorders are one of the most prevalent psychiatric comorbidities in this population and have been associated with debilitating psychosocial impairment. Objective: This study aimed to examine the prevalence of comorbid anxiety disorders among Chinese school-age children diagnosed with ASD in a child and adolescent psychiatry outpatient clinic in Hong Kong. Methods: This cross-sectional study was conducted at the Yaumatei Child and Adolescent Mental Health Service specialist outpatient clinic from August 2019 to April 2020. The sample consisted of one hundred thirty-two subjects aged 6 to <12 years who were diagnosed with ASD. The Developmental, Dimensional and Diagnostic Interview were administered to confirm the diagnosis of ASD. The National Institute of Mental Health Diagnostic Interview Schedule for Children-Version 5, parent version was administered for the assessment of comorbid anxiety disorders. Results: The one-year prevalence rate of any anxiety disorder was 28.8%. The most common anxiety disorder was specific phobia (22.7%), followed by social anxiety disorder (13.6%), separation anxiety disorder (3.8%), generalized anxiety disorder (3.8%) and selective mutism (1.5%). No subjects were diagnosed with panic disorder or agoraphobia. Conclusion: Anxiety disorders are prevalent among Chinese school-age children with ASD in Hong Kong. Early recognition and identification of comorbid anxiety disorders are necessary in the diagnostic process of ASD.