A Review of Childhood Behavioral Problems and Disorders in the Development of Obesity: Attention Deficit/Hyperactivity Disorder, Autism Spectrum Disorder, and Beyond

Attention-deficit/hyperactivity disorder is one of the most common comorbidities in individuals with autism spectrum disorder. However, the clinical implications of the co-occurrence of these two disorders are still poorly understood. Based on a preregistered protocol (PROSPERO CRD42020193880), this systematic review identified 34 articles, published between January 1, 2014, and September 1, 2020, on cognitive, adaptive/social, and behavioral manifestations in children and adolescents with a diagnosis of autism spectrum disorder and attention-deficit/hyperactivity disorder (ASD+). The majority of available studies found a tendency toward a significant poorer cognitive performance in individuals with ASD+ compared with those with autism spectrum disorder alone (ASD−). The analysis of social/adaptive processes suggested that ASD+ is associated with lower functioning in comparison with ASD−. Finally, individuals with ASD+ were more likely to develop emotional/behavioral difficulties, in particular externalizing problems. Although some studies did not find differences among the two groups, overall co-occurring ASD+ may constitute a distinctive phenotype with a greater likelihood of cognitive, adaptive dysfunction, and mental health symptoms compared with ASD−. These results may inform the setting up and implementation of care pathways for individuals with attention-deficit/hyperactivity disorder and autism spectrum disorder. Lay abstract This work aimed to review recent research on the characteristics of individuals who have both autism spectrum disorder and attention-deficit/hyperactivity disorder due to their high co-occurrence. Thirty-four studies were analyzed and main findings summarized in two content domains focusing on areas that could enhance our understanding of the cognitive and behavioral characteristics of individuals with autism spectrum disorder + attention-deficit/hyperactivity disorder (ASD+). Most of the results suggested that ASD+ is a co-occurring condition associated with more severe impairments in cognitive functioning, adaptive behavior, and increased likelihood to present more emotional/behavioral problems. These results will be helpful to provide improved care plans for individuals with both attention-deficit/hyperactivity disorder and autism spectrum disorder.

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ANTI-PCA/YO AND ANTI-GAD LEVELS IN AUTISM SPECTRUM DISORDER AND ATTENTION DEFICIT HYPERACTIVITY DISORDER

10.21506/j.ponte.2018.4.4 ◽

2018 ◽

Vol 74 (4) ◽

Author(s):

Cagatay Ugur ◽

Ozden Sukran Uneri ◽

Esra Yurumez

Keyword(s):

Autism Spectrum Disorder ◽

Attention Deficit Hyperactivity Disorder ◽

Attention Deficit ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Hyperactivity Disorder

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Attention Deficit Hyperactivity Disorder in Autism Spectrum Disorder

The Oxford Handbook of Autism and Co-Occurring Psychiatric Conditions ◽

10.1093/oxfordhb/9780190910761.013.9 ◽

2020 ◽

pp. 158-176

Author(s):

Karen Bearss ◽

Aaron J. Kaat

Keyword(s):

Autism Spectrum Disorder ◽

Attention Deficit Hyperactivity Disorder ◽

Attention Deficit ◽

Autism Spectrum ◽

Developmental Trajectory ◽

Spectrum Disorder ◽

Adhd Symptoms ◽

Functional Impairments ◽

Hyperactivity Disorder ◽

Delayed Recognition

This chapter will review the available evidence on individuals with co-occurring diagnoses of autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). This chapter contends that children diagnosed with both disorders (ASD+ADHD) are a subset of the ASD population that is at risk for delayed recognition of their ASD diagnosis, poor treatment response, and poorer functional outcomes compared to those with ASD without ADHD. Specifically, the chapter highlights the best estimates of the prevalence of the comorbidity, the developmental trajectory of people with co-occurring ASD and ADHD, how ADHD symptoms change across development, overlapping genetic and neurobiological risk factors, psychometrics of ADHD diagnostic instruments in an ASD population, neuropsychological and functional impairments associated with co-occurring ASD and ADHD, and the current state of evidence-based treatment for both ASD and ADHD symptoms. Finally, the chapter discusses fruitful avenues of research for improving understanding of this high-risk comorbidity so that mechanism-to-treatment pathways for ADHD in children with ASD can be better developed.

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Medications for attention-deficit/hyperactivity disorder in individuals with or without coexisting autism spectrum disorder: analysis of data from the Swedish prescribed drug register

Journal of Neurodevelopmental Disorders ◽

10.1186/s11689-020-09352-z ◽

2020 ◽

Vol 12 (1) ◽

Author(s):

Viktoria Johansson ◽

Sven Sandin ◽

Zheng Chang ◽

Mark J. Taylor ◽

Paul Lichtenstein ◽

...

Keyword(s):

Autism Spectrum Disorder ◽

Attention Deficit Hyperactivity Disorder ◽

Attention Deficit ◽

Clinical Studies ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Prescribing Patterns ◽

Adhd Medication ◽

Hyperactivity Disorder ◽

Drug Register

Abstract Background Clinical studies found that medication for attention-deficit/hyperactivity disorder (ADHD) is effective in coexisting autism spectrum disorder (ASD), but current research is based on small clinical studies mainly performed on children or adolescents. We here use register data to examine if individuals with ADHD and coexisting ASD present differences in the prescribing patterns of ADHD medication when compared to individuals with pure ADHD. Methods Data with information on filled prescriptions and diagnoses was retrieved from the Swedish Prescribed Drug Register and the National Patient Register. We identified 34,374 individuals with pure ADHD and 5012 individuals with ADHD and coexisting ASD, aged between 3 and 80 years. The first treatment episode with ADHD medications (≥ 2 filled prescriptions within 90 days) and daily doses of methylphenidate during a 3-year period was measured. Odds ratios (ORs) were calculated for the likelihood of being prescribed ADHD medication in individuals with and without ASD and Wilcoxon rank-sum test was used to compare group differences in dose per day. Results Individuals with ADHD and coexisting ASD were less likely to start continuous treatment with ADHD medication (ADHD 80.5%; ADHD with ASD 76.2%; OR, 0.80; 95% confidence interval, 0.75-0.86), were less likely to be prescribed methylphenidate, and were more commonly prescribed second line treatments such as dexamphetamine, amphetamine, or modafinil. No group difference was observed for atomoxetine. In adults with ADHD and coexisting ASD, methylphenidate was prescribed in lower daily doses over three years as compared to individuals with pure ADHD. Conclusions The findings indicate that there are differences in the medical treatment of individuals with or without ASD. If these differences are due to different medication responses in ASD or due to other factors such as clinicians’ perceptions of medication effects in patients with ASD, needs to be further studied.

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