A More Complex Treatment Plan
Treatment for comorbid autism and OCD can present its own set of difficulties that need to be addressed. It is essential to know which behaviors are autistic and which stem from obsessive-compulsive disorder.
Cognitive behavioral therapy is typically the most helpful treatment for OCD, and it is also used in treating OCD with autism. This behavioral intervention relies on uncovering potential triggers and learning how to manage them. It also focuses on gaining an understanding into how thoughts, emotions, and actions are all connected.
Issues with treatment for comorbid OCD and autism can include difficulties connecting emotionally and socially, which can make it harder to understand social cues and relate to others, including a therapist.
Autistic people may lack insight into their behaviors, which can make it hard for them to see the connection between their obsessions and compulsive behaviors. While someone with OCD uses the ritualistic behavior to dispel anxious thoughts, someone with autism will engage in these behaviors because they feel good without regard as to why they feel good.
Therapists have to break down the overlap between symptoms and help clients to effectively manage symptoms of both disorders. There is no cure for either disorder.
Familial Risks Of Autism Spectrum Disorders And Ocd
The parents of 86 individuals diagnosed with autism spectrum disorder had been previously diagnosed with OCD. Parental OCD increased the IRR for autism spectrum disorders in their offspring to 1.83 there was no difference in the paternal or maternal diagnosis of OCD on the offspringâs risk for autism spectrum disorders. The risk for autism spectrum disorders was somewhat increased after a parental diagnosis of OCD compared to the risk after a parental diagnosis of any psychiatric disorder , but less than the risk after a parental diagnosis of autism spectrum disorders .
Incidence rate ratios, with 95% CIs , of Autism Spectrum Disorders in Offspring of Parents with an Obsessive Compulsive Disorder, 1995â2012.
Conditions Comorbid To Autism Spectrum Disorders
Autism spectrum disorder is a developmental disorder that begins in early childhood, persists throughout adulthood, and affects three crucial areas of development: communication, social interaction and restricted patterns of behavior. There are many conditions comorbid to autism spectrum disorder such as fragile X syndrome and epilepsy.
In medicine and in psychiatry, comorbidity is the presence of one or more additional conditions co-occurring with the primary one, or the effect of such additional disorders. About 1015% of autism cases have an identifiable Mendelian condition, chromosome abnormality, or other genetic syndrome, and ASD is associated with several genetic disorders, perhaps due to an overlap in genetic causes.
Distinguishing between ASDs and other diagnoses can be challenging because the traits of ASDs often overlap with symptoms of other disorders and the characteristics of ASDs make traditional diagnostic procedures difficult.
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What Does Ocd Mean
Obsessive-compulsive disorder is a mental disorder that characterizes intrusive thoughts that lead to anxiety and compulsions, which are repetitive behaviors or mental acts that the person feels compelled to perform to relieve the anxiety. People with OCD often have difficulty with daily activities and functioning due to the time they spend on their compulsions.
Language Delay Speech Disorder And Developmental Language Disorder
Language delay is when young children have difficulties understanding and/or using spoken language. If a child has a language delay that doesnt go away, this might be a sign of a developmental language disorder. Children with developmental language disorders have language difficulties that affect their everyday lives and make it harder for them to learn to read.
A speech disorder is when children have difficulty pronouncing the sounds in words. Children with speech disorders dont necessarily have language delay or developmental language disorder.
Not all children who have language delay have problems with speech.
How common are language delays and disorders in autistic children? Autistic children have trouble communicating with others, which means their social communication development can be delayed or disordered. They might also have difficulties with other aspects of language, but their speech development is the least likely to be affected. About 25-50% of autistic children cant communicate verbally.
How are language delays and language disorders treated?Speech pathologists help children with speech and language problems. They might recommend individual or group programs that build language skills. They might also help children develop other ways to communicate, like pictures or picture boards, key word signing or speech generating devices.
Find out more
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Fear And Compulsions Are Irrational
The main difference between OCD and autism is that people with OCD typically know that their fears and compulsions are irrational, while people with autism do not always realize this. For example, someone with OCD may know that their fear of germs is irrational, but they cannot help the way they feel. People with autism may not realize that their avoidance of certain situations is unreasonable. This can make it very difficult for them to function in everyday life.
If you think you or your child may be showing signs of OCD or autism, it is important to talk to a doctor or mental health professional. While there are some similarities between the two disorders, they are also quite different. A professional will be able to help you figure out what is going on and how to best deal with it.
How Do Comorbid Conditions Affect People On The Spectrum
As mentioned before, the vast majority of people with ASD will be diagnosed with at least one comorbid condition during their lifetime.11,3 It is important to understand the impacts of these diagnoses, because most conditions that co-occur with autism have potential to seriously affect well-being and quality of life.9 Some comorbid symptoms can cause much more harm than an autism diagnosis, especially conditions like depression, epilepsy or anxiety, which can have lasting effects.12
Beyond all of this, it is important to remember that because many individuals on the spectrum communicate differently to the general population, comorbid conditions may not look the same as they do in a neurotypical person. Keep this in mind when you are assessing yourself or your child on the spectrum.
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It Is Normal To Wonder
When your child with autism suddenly demonstrates a new repetitive behavior, it is normal to ask yourself: Is this OCD ? Parents are justifiably concerned if a new stim appears, or if their child seems to develop a new compulsive habit, such as leaving the house, going back in, and then walking out the door again every time you want to go out.
Overlaps And Differences Between Ocd And Autism
There are overlaps between autism and OCD. Many behaviours are found in both:
- compulsive like behaviours
- ritualised patterns of behaviour
- resistance to change and restricted interests.
However, for autistic people, repetitivebehaviours are often soothing and a source of enjoyment .But if you have OCD, the obsessions/compulsions are intrusive and upsetting.
To give an example, an autistic person or someone diagnosed with OCD may repeatedly flick a light switch on and off. The autistic person may be doing this because they like the sound of the switch and the visual feedback when the light flashes on and off. The person with OCD may be doing it because they believe that unless the light switch is flicked on and off 15 times, something bad will happen to their family.
The overlaps between autistic traits and OCD symptoms may lead some professionals to dismiss OCD symptoms as autistic traits, leading to under-diagnosis of OCD in autistic people.
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Eating Disorders Comorbid With Autism
I will conclude by discussing a condition often comorbid with autism that has affected me personally, namely eating disorders. I have had severe selective eating issues which developed at the age of 2 ½ years, at which time other classic autistic traits also manifested themselves this is how I know that they are related to autism.
What distinguishes the food issues common in autistics with more familiar eating disorders like anorexia and bulimia is that, whereas the latter are typically caused by concerns related to body image, autistic issues are more likely to involve a relationship with the food itself, which presents sensory stimuli such as taste and texture. In such cases, it can be regarded as a sensory issue comparable to the auditory and visual sensitivities that are so well-known in autistics. Still, this often results in poor eating habits that can in turn lead to obesity yet another comorbid condition not uncommon among autistics.
I have lived with this condition my entire life and was known as an extreme picky eater throughout my childhood. As an adult, I often tell people that I have the eating habits of a 12-year-old, and to this day prefer the kinds of food that are typically found on a childrens menu. Many years ago, I was referred to by someone as anorexic because I was very thin at the time . In fact, the conditions that I have been living with are known as food neophobia and food aversion .
Recommendations And Strategies Of Interventions
As reviewed, several studies investigating the psychiatric comorbidity in individuals with AS/HFA have been conducted. Still, there is uncertainty as to the best way of identifying and conceptualizing psychiatric disorders in AS/HFA.
Although people with AS/HFA can suffer from important comorbidities, according to what Ghazziudin observed, psychiatric disorders go unrecognized in many individuals with AS/HFA .
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Severe Ocd Exacerbation In A Patient With Autism Spectrum Disorder: A Case Report
Article Information
Jasmine Gray1, Shahrzad Bazargan-Hejazi2*, Gul Ebrahim1, Daniel Cho1
1Department of Psychiatry, Charles Drew University of Medicine and Science, California, USA
2Department of Psychiatry, Charles Drew University of Medicine and Science, David Geffen School of Medicine at University of California at Los Angeles , California, USA
*Corresponding Author: Shahrzad Bazargan-Hejazi, Professor, Department of Psychiatry, Charles Drew University of Medicine and Science, David Geffen School of Medicine at UCLA, Research Director, Psychiatry Residency Training Program, 1731 E. 120th St., Los Angeles, CA 90059, USA
Received: 07 April 2021 Accepted: 20 April 2021 05 May 2021
Citation:
Jasmine Gray, Shahrzad Bazargan-Hejazi, Gul Ebrahim, Daniel Cho. Severe OCD Exacerbation in a Patient with Autism Spectrum Disorder: A Case Report. Archives of Clinical and Medical Case Reports 5 : 388-392.
Abstract
Keywords
Autism Obsessive-compulsive Anxiety COVD-19 Feeding Problem Adolescent Treatment
Article Details
1. Introduction
2. Case Presentation
2.1 Clinical evaluation
3. Discussion and Conclusions
Acknowledgements
National Institutes of Health National Center for Advancing Translational Science , Bethesda, MD UCLA CTSI Grant Number UL1TR001881
Conflict of Interest
None of the authors have any conflict of interest to report.
References
Article Views: 731
Difficulties In Performing A Diagnosis Of Psychiatric Comorbidity In Individuals With As/hfa
Recognizing psychiatric comorbidities in individuals with AS/HFA can be challenging for clinicians. Considering that individuals with AS/HFA may show an impairment in processing and describing their own feelings and emotions, the clinical information is often obtained by interviewing family members rather than the AS participants themselves or detected from a direct observation in their social environment.
Moreover, the symptoms of psychopathological conditions may be masked by those typical of AS/HFA and the threshold between autism spectrum core symptoms and comorbid symptoms can be blurred. For instance, a sudden decrease of repetitive and obsessive behaviors in individuals with AS may represent a manifestation of depressive symptoms, but could also be mistakenly ascribed to an improvement in one of the diagnostic dimensions of AS itself . In the clinical practice, various psychometric instruments, such as clinical interviews, self-report questionnaires and checklists, are widely used to assist in the diagnosis and they constitute a valuable support for clinicians. However, these diagnostic tools have been designed and standardized to spot different clusters of psychopathological symptoms referring to the general population and they may not be appropriate to AS/HFA.
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Psychiatric Symptoms Are Phenotypic Manifestation Of As/hfa Or Are They Rather Due To The Expression Of A Separate And Comorbid Disorder
Another common challenge for clinicians is to determine if psychiatric symptoms observed in AS/HFA are part of the same dimension i.e. the Autism Spectrum itself or rather represent different categorical factors i.e. a psychiatric disorder in comorbidity. This happens because, as mentioned above, the core symptoms of ASDs often mask the symptoms of the comorbid condition. A helpful strategy to disentangle this issue could be to look prospectively at the overall clinical outcome through longitudinal studies.
Longitudinal studies allow to closely follow the developmental trajectories of AS\HFA and to detect subtle changes in behavior at different stages of development in terms of progressive appearance of clinical symptoms and impact of life experiences.
Therefore, there is a clear need for longitudinal population studies to identify whether individuals with high anxiety levels and AS/HFA have increased susceptibility for depression during lifetime.
Hence, in our opinion, although cross-sectional studies are extremely useful for generating hypotheses, these hypotheses in turn need to be further confirmed by longitudinal investigations. The development of lifespan approaches could help to clarify the core of pathophysiological processes of the main disorder in ASDs, thus allowing an easier discrimination between those symptoms that are part of the AS/HFA clinical phenotype from those that are the expression of a comorbid disorder.
Understanding Autism In Relation To Ocd
Obsessive and ritualistic behaviours are one of the fundamental traits that make up both OCD and Autism. A growing number of people are diagnosed with both conditions. Although there are many similarities between the two, it is crucial to recognize precisely how each affects you individually. The critical difference between obsessive-compulsive disorder and Autism lies in anxiety.
Someone with OCD experiences intrusive thoughts, feelings, and urges, whereby they feel an overwhelming urge to perform some behaviour to reduce unwanted feelings. In contrast, someone with Autism is likely to enjoy their routines, and in many cases, it will help them organize and make sense of the world. Both obsessive- compulsive disorder and Autism are classified as neurological disorders, in which the person experiences obsessive and repetitive thoughts however, there are some key differences.
What causes the development of Autism?
Genetics
Several different genes appear to be involved in autism spectrum disorder. Autism is commonly associated with a genetic disorder, such as Fragile X Syndrome, or Rett syndrome. For other children, changes in their genetic make-up may increase the risk of Autism. Other genes may affect brain development and the way that brain cells communicate. This knowledge could be valuable concerning the onset of Autism, as well as the severity of symptoms. Also, changes in genes appear to be inherited, while others occur spontaneously.
Environmental factors
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Comorbidity Of Autism Spectrum And Obsessive
William S Stone, Grace Chen
Abstract
In this paper, we review aspects of the comorbidity between autism spectrum disorder and obsessive compulsive disorder in a representative manner. We consider issues of co-morbidity more generally, and then review the rates of OCD and ASD separately, before considering them together. We then consider aspects of the function significance of the interaction of the two conditions, and call for additional research into this important overlap of symptoms.
Keywords
Full Text:
References
Stone WS, Seidman LJ. Neuropsychological and structural imaging endophenotypes in schizophrenia, in Developmental Psychopathology, D. Cicchetti, Editor. in press, John Wiley & Sons, Inc. Hoboken, New Jersey.
Woodman AC, Smith LE, Greenberg JS, Mailick MR. Change in autism symptoms and maladaptive behaviors in adolescence and adulthood: the role of positive family processes. J Autism Dev Disord. 2015 45:111-126.
Ashburner J, Ziviani J, Rodger S. Sensory processing and classroom emotional, behavioral, and educational outcomes in children with autism spectrum disorder. Am J Occup Ther. 2008 62:564-573.
Abrahams BS, Geschwind DH. Advances in autism genetics: on the threshold of a new neurobiology. Nat Rev Genet. 2008 9:341-355.
Lesseur C, Paquette AG, Marsit CJ. Epigenetic regulation of infant
neurobehavioral outcomes. Med Epigenet. 2014 2:71-79.
Pediatr. 2010 31:267-275.
Simonoff E, Pickles A, Charman T, Chandler S, Loucas T, Baird G.
Children With Autism Adhd At Increased Risk For Anxiety Mood Disorders
According to findings published in Pediatrics, children with both autism spectrum disorder and attention-deficit/hyperactivity disorder have an increased risk for anxiety and mood disorders.
Researchers performed a cross-sectional study of 3319 children aged 6 to 17 years with ASD, of whom 1503 reported a diagnosis of or treatment for ADHD. Primary outcome measures were professional diagnoses or treatment of anxiety disorder or mood disorder by parent report secondary measures were population demographics, report of intellectual disability, and ASD severity score by standardized questionnaire. The cohort was largely boys , white , and non-Hispanic , with a mean age of 10.3 years.
Of the children, 1025 were reported to have an anxiety disorder, 532 were reported to have a mood disorder, and 649 were reported to have intellectual disability. Comorbid ADHD increased with age and was associated with increased ASD severity . Per a generalized linear model, children with ASD and ADHD had an increased risk for both anxiety disorders and mood disorders compared with children with ASD alone. Increasing age was the most significant contributor for anxiety and mood disorders for all children in the cohort, with a higher risk for both in the adolescent group compared with the grade school-aged group.
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Impact Of Ocd On The Child And Family
These behaviors can lead to significant interference in a childs and familys life. At times, parents become prisoners to their childs OCD symptoms, doing everything they can to help their child avoid being anxious and avoid a tantrum or meltdown. Parents and caregivers are often struggling to manage other challenging behaviors, so the addition of comorbid OCD creates ever-increasing challenges. Parents, caregivers and teachers do what comes naturally, which is to provide reassurance and structure the childs day to avoid the OCD triggers. Unfortunately, reassurance and avoidance only serve to maintain the OCD and leads to increasing symptoms over time.