2.6 PSYCHOPHARMACOLOGICAL TREATMENT OF COMORBID PSYCHIATRIC DISORDERS IN PATIENTS WITH AUTISM SPECTRUM DISORDER

SummaryAutism spectrum disorder (ASD) is a heterogeneous disorder with clearly recognisable core features, but without reliable biomarkers as yet. It has a high rate of comorbid psychiatric disorders which need to be identified and appropriately treated. Emerging concepts in genetics, pathobiology and outcome measurement have potential to significantly advance the treatment of both ASD and its comorbidities over the following decades.

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Prevalence of Comorbid Psychiatric Disorders in Children and Adolescents with Autism Spectrum Disorder

Journal of Experimental & Clinical Medicine ◽

10.1016/j.jecm.2014.10.005 ◽

2014 ◽

Vol 6 (6) ◽

pp. 179-186 ◽

Cited By ~ 7

Author(s):

Luke Y. Tsai

Keyword(s):

Autism Spectrum Disorder ◽

Children And Adolescents ◽

Psychiatric Disorders ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Comorbid Psychiatric Disorders ◽

Adolescents With Autism

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Prevalence of comorbid psychiatric disorders among people with autism spectrum disorder: An umbrella review of systematic reviews and meta-analyses

10.31124/advance.11497014 ◽

2020 ◽

Cited By ~ 1

Author(s):

Md Mahbub Hossain ◽

Nusrat Khan ◽

Abida Sultana ◽

Ping Ma ◽

E. Lisako J. McKyer ◽

...

Keyword(s):

Autism Spectrum Disorder ◽

Psychiatric Disorders ◽

Systematic Reviews ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Current Evidence ◽

Umbrella Review ◽

Comorbid Psychiatric Disorders ◽

Analytic Review ◽

Meta Analyses

With ever-increasing prevalence of various mental disorders worldwide, a comprehensive evaluation of the prevalence of co-occurring psychiatric disorders among individuals with autism spectrum disorder (ASD) is needed to strengthen the knowledge base. This umbrella review aims to summarize the current evidence on the prevalence of comorbid psychiatric disorders among people with ASD. A systematic search of 12 major databases and additional sources was conducted. Any systematically conducted narrative, qualitative, or meta-analytic review reporting the prevalence of psychiatric disorders among people with ASD with no age or geographical restriction were included. From a total of 2755 records, 26 articles representing 14 systematic reviews and 12 meta-analyses met the criteria of this review. The synthesized findings reveal a high burden of comorbid psychiatric disorders among people with ASD, including anxiety disorders, depressive disorders, bipolar and mood disorders, schizophrenia spectrum, suicidal behavior disorders, attention-deficit/hyperactivity disorder, disruptive, impulse-control and conduct disorders amongst diverse age groups, with a majority in younger participants. Most studies were conducted in developed nations, with limited evidence from low and middle-income countries. These synthesized findings provide high-quality evidence for clinical and policy-level decision-making from a global overview of the status of comorbid psychiatric disorders among people with ASD.

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Psychiatric comorbidities with autism spectrum disorder in an adult clinic sample

BJPsych Open ◽

10.1192/bjo.2021.639 ◽

2021 ◽

Vol 7 (S1) ◽

pp. S239-S239

Author(s):

Rifat Binte Radwan ◽

Chiro Islam Mallik

Keyword(s):

Autism Spectrum Disorder ◽

Major Depressive Disorder ◽

Depressive Disorder ◽

Psychiatric Disorders ◽

Psychiatric Patients ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Psychiatric Consultation ◽

Major Depressive ◽

Comorbid Psychiatric Disorders

AimsAs part of continuity, prevalence of Autism Spectrum Disorder (ASD) is nearly the same in adults as children and is associated with other comorbid psychiatric disorders that have substantial impact on their life and complex the intervention. This study aimed to examine psychiatric comorbidity in referred adult ASD patients compared to non-ASD psychiatric patients. It has been hypothesized that comorbid psychiatric disorders were higher among patients with ASD than patients without ASD.MethodIn total, 36 adults with ASD referred in the year 2019 in a psychiatric consultation center in Dhaka city were included in the study. They were derived from the case register of the center. Similar number of age and sex-matched adult psychiatric patients without ASD were selected for comparison. All patients were referred for psychiatric consultation. Socio-demographic variables were collected from the patients’ record. Diagnosis of psychiatric disorders including ASD was made by an experienced psychiatrist. It was done clinically based on all available information, examination and relevant investigations. Diagnoses were assigned according to DSM-5. Then comparisons of psychiatric disorders were made between the two patient groups.ResultThe cases were ranged from 18-41 years with the mean of 26.72 ± 6.5 years. Among them, 22 were male and 14 were female. Male-female ratio was 1.6:1. Most of the subjects received no education and were from middle income family with urban background. Mean number of comorbid psychiatric disorders was 1.92 in patients with ASD and 1.67 in patients without ASD and the difference was significant (P = 0.04). Most two frequent comorbidities among ASD patients were Obsessive Compulsive Disorder (27.77%) and Major Depressive Disorder(25%) followed by Specific Phobia(19.44%), Social Phobia and Intermittent Explosive Disorder(16.67%) for each, Attention Deficit Hyperactivity Disorder(13.89%) and Conduct Disorder(11.11%). All these disorders were significantly higher than patients without ASD. Conversely, Major Depressive Disorder (30.55%) was most frequent among the patients without ASD and that was even significantly higher than patients with ASD. Other frequent disorders like Bipolar Disorder, Schizophrenia, Generalized Anxiety Disorder and Substance Related Disorder were also higher among non-ASD patients.ConclusionThis research shows that comorbid psychiatric disorders were frequently found in patients with ASD. Subsequent broad-based studies using extensive measures of psychopathology are required to confirm these preliminary findings. Greater understanding of the presence of other psychiatric disorders in ASD patients will turn this awareness into action.

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Prevalence of comorbid psychiatric disorders among people with autism spectrum disorder: An umbrella review of systematic reviews and meta-analyses

10.31124/advance.11497014.v1 ◽

2020 ◽

Cited By ~ 1

Author(s):

Md Mahbub Hossain ◽

Nusrat Khan ◽

Abida Sultana ◽

Ping Ma ◽

E. Lisako J. McKyer ◽

...

Keyword(s):

Autism Spectrum Disorder ◽

Psychiatric Disorders ◽

Systematic Reviews ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Current Evidence ◽

Umbrella Review ◽

Comorbid Psychiatric Disorders ◽

Analytic Review ◽

Meta Analyses

With ever-increasing prevalence of various mental disorders worldwide, a comprehensive evaluation of the prevalence of co-occurring psychiatric disorders among individuals with autism spectrum disorder (ASD) is needed to strengthen the knowledge base. This umbrella review aims to summarize the current evidence on the prevalence of comorbid psychiatric disorders among people with ASD. A systematic search of 12 major databases and additional sources was conducted. Any systematically conducted narrative, qualitative, or meta-analytic review reporting the prevalence of psychiatric disorders among people with ASD with no age or geographical restriction were included. From a total of 2755 records, 26 articles representing 14 systematic reviews and 12 meta-analyses met the criteria of this review. The synthesized findings reveal a high burden of comorbid psychiatric disorders among people with ASD, including anxiety disorders, depressive disorders, bipolar and mood disorders, schizophrenia spectrum, suicidal behavior disorders, attention-deficit/hyperactivity disorder, disruptive, impulse-control and conduct disorders amongst diverse age groups, with a majority in younger participants. Most studies were conducted in developed nations, with limited evidence from low and middle-income countries. These synthesized findings provide high-quality evidence for clinical and policy-level decision-making from a global overview of the status of comorbid psychiatric disorders among people with ASD.

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Use of Selective Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs) in the treatment of Autism Spectrum Disorder (ASD), Comorbid psychiatric disorders and ASD-associated symptoms: A Clinical Review

CNS Spectrums ◽

10.1017/s109285292000214x ◽

2020 ◽

pp. 1-23

Author(s):

Muralidhara Shankarapura Nanjapp ◽

Emanuel Voyiaziakis ◽

Basant Pradhan ◽

Srinagesh Mannekote Thippaiah

Keyword(s):

Autism Spectrum Disorder ◽

Psychiatric Disorders ◽

Clinical Review ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Selective Serotonin ◽

Comorbid Psychiatric Disorders ◽

Associated Symptoms ◽

Norepinephrine Reuptake

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Prevalence of comorbid psychiatric disorders among people with autism spectrum disorder: An umbrella review of systematic reviews and meta-analyses

10.31124/advance.11497014.v2 ◽

2020 ◽

Author(s):

Md Mahbub Hossain ◽

Nusrat Khan ◽

Abida Sultana ◽

Ping Ma ◽

E. Lisako J. McKyer ◽

...

Keyword(s):

Autism Spectrum Disorder ◽

Psychiatric Disorders ◽

Systematic Reviews ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Current Evidence ◽

Umbrella Review ◽

Comorbid Psychiatric Disorders ◽

Analytic Review ◽

Meta Analyses

With ever-increasing prevalence of various mental disorders worldwide, a comprehensive evaluation of the prevalence of co-occurring psychiatric disorders among individuals with autism spectrum disorder (ASD) is needed to strengthen the knowledge base. This umbrella review aims to summarize the current evidence on the prevalence of comorbid psychiatric disorders among people with ASD. A systematic search of 12 major databases and additional sources was conducted. Any systematically conducted narrative, qualitative, or meta-analytic review reporting the prevalence of psychiatric disorders among people with ASD with no age or geographical restriction were included. From a total of 2755 records, 26 articles representing 14 systematic reviews and 12 meta-analyses met the criteria of this review. The synthesized findings reveal a high burden of comorbid psychiatric disorders among people with ASD, including anxiety disorders, depressive disorders, bipolar and mood disorders, schizophrenia spectrum, suicidal behavior disorders, attention-deficit/hyperactivity disorder, disruptive, impulse-control and conduct disorders amongst diverse age groups, with a majority in younger participants. Most studies were conducted in developed nations, with limited evidence from low and middle-income countries. These synthesized findings provide high-quality evidence for clinical and policy-level decision-making from a global overview of the status of comorbid psychiatric disorders among people with ASD.

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Prediction of response to drug therapy in psychiatric disorders

Open Biology ◽

10.1098/rsob.180031 ◽

2018 ◽

Vol 8 (5) ◽

pp. 180031 ◽

Cited By ~ 23

Author(s):

Shani Stern ◽

Sara Linker ◽

Krishna C. Vadodaria ◽

Maria C. Marchetto ◽

Fred H. Gage

Keyword(s):

Autism Spectrum Disorder ◽

Bipolar Disorder ◽

Major Depression ◽

Personalized Medicine ◽

Psychiatric Disorders ◽

Association Studies ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Genome Wide Association Studies ◽

Patient Reported

Personalized medicine has become increasingly relevant to many medical fields, promising more efficient drug therapies and earlier intervention. The development of personalized medicine is coupled with the identification of biomarkers and classification algorithms that help predict the responses of different patients to different drugs. In the last 10 years, the Food and Drug Administration (FDA) has approved several genetically pre-screened drugs labelled as pharmacogenomics in the fields of oncology, pulmonary medicine, gastroenterology, haematology, neurology, rheumatology and even psychiatry. Clinicians have long cautioned that what may appear to be similar patient-reported symptoms may actually arise from different biological causes. With growing populations being diagnosed with different psychiatric conditions, it is critical for scientists and clinicians to develop precision medication tailored to individual conditions. Genome-wide association studies have highlighted the complicated nature of psychiatric disorders such as schizophrenia, bipolar disorder, major depression and autism spectrum disorder. Following these studies, association studies are needed to look for genomic markers of responsiveness to available drugs of individual patients within the population of a specific disorder. In addition to GWAS, the advent of new technologies such as brain imaging, cell reprogramming, sequencing and gene editing has given us the opportunity to look for more biomarkers that characterize a therapeutic response to a drug and to use all these biomarkers for determining treatment options. In this review, we discuss studies that were performed to find biomarkers of responsiveness to different available drugs for four brain disorders: bipolar disorder, schizophrenia, major depression and autism spectrum disorder. We provide recommendations for using an integrated method that will use available techniques for a better prediction of the most suitable drug.

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