Autism spectrum disorder (ASD), including Asperger's syndrome, is a developmental disorder that begins in early childhood, persists throughout adulthood, and affects three important areas of development: communication, social interaction, and limited behavior patterns. There are many comorbid conditions for autism spectrum disorders such as fragile X syndrome and epilepsy.
In medicine and psychiatry, comorbidity is the presence of one or more additional conditions that occur simultaneously with the primary, or the effects of the additional disorder. Approximately 10-15% of cases of autism have Mendelian conditions (single genes), chromosomal abnormalities, or other genetic syndromes, and ASD is associated with some genetic disorders, possibly because of overlap in genetic causes.
Distinguishing between ASD and other diagnoses can be a challenge because the nature of ASD often overlaps with other disorder symptoms and characteristics of ASD makes traditional diagnostic procedures difficult.
Video Conditions comorbid to autism spectrum disorders
Comorbidity conditions
Anxiety
Anxiety disorders are common in children and adults with ASD. Symptoms may be affected by age, cognitive function level, level of social disturbance, and ASD-specific difficulties. Many anxiety disorders, such as social anxiety disorder and generalized anxiety disorder, are not often diagnosed in people with ASD because they are better explained by ASD itself, and it is often difficult to know whether symptoms such as compulsive examination are part of ASD or anxiety problems that occur at the same time. The prevalence of anxiety disorders in children with ASD has been reported to be anywhere between 11% and 84%; wide range of possibilities due to differences in the way the study was conducted.
Attention deficit hyperactivity disorder
Previously, manual diagnosis of DSM-IV did not allow a diagnosis with ASD and attention-deficit hyperactivity disorder (ADHD). However, after years of clinical research, the latest publication (DSM-5) in 2013 removes this ban of morbidity. Thus, individuals with autism spectrum disorder may also have a diagnosis of ADHD, with a negligent, hyperactive, mixed, or other unspecified modifier. Significant clinical symptoms of these two conditions generally occur together, and children with both sets of symptoms may respond poorly to standard ADHD treatments. Individuals with autism spectrum disorders may benefit from additional types of drugs.
Bipolar disorder
Bipolar disorder, or manic-depression, itself is often claimed to be comorbid with a number of conditions, including autism. Autism includes some symptoms that are usually found in mood disorders and anxiety.
Bowel disease
Some individuals with autism also have gastrointestinal (GI) symptoms, but there is a lack of strict data published to support the theory that children with autism have more or different GI symptoms than usual. It has been claimed that up to fifty percent of children with autism have persistent gastrointestinal problems, ranging from mild to moderate levels of inflammation in both the upper and lower intestinal tract. It has been described as syndrome, autistic enterocolitis, by Dr. Andrew Wakefield; this diagnostic terminology has been rejected by medical experts as pseudosain. His study, which included a total of 12 children, implies that the MMR vaccine causes autism and autistic enterocolitis. The Lancet eventually pulled back the Wakefield study. Subsequently, the General Medical Council of England later revoked the Wakefield license to practice medicine as a result of the study, citing many violations of Wakefield's ethical principles, including the failure to disclose the financing of lawyers preparing lawsuits against vaccine producers. Constipation, often with overflow, or encopresis, is often associated with developmental disorders in children, and is often difficult to resolve, especially among those with behavioral and communication problems.
Developmental coordination disorder
The initial account of Asperger syndrome and other diagnostic schemes include a description of developmental coordination disorder. Children with ASD may be delayed in acquiring motor skills that require motor dexterity, such as riding a bike or opening a jar, and may seem odd or "uncomfortable in their own skin". They may be poorly coordinated, or have strange or warped movements or postures, poor handwriting, or problems with motor-visual integration, visual perception skills, and conceptual learning. They may show problems with proprioception on the size of developmental coordination disturbances, balance, tandem gait, and finger-toe applications.
Epilepsy
ASD is also associated with epilepsy, with variations in the risk of epilepsy due to age, cognitive level, and type of language disorder. One in four autistic children develop seizures, often starting well in early childhood or adolescence. Convulsions, caused by abnormal electrical activity in the brain, can cause temporary loss of consciousness ("blackout"), body seizures, unusual movements, or staring spells. Sometimes contributing factors are lack of sleep or high fever. EEG can help confirm the presence of seizures. Usually, the onset of epilepsy occurs before the age of five years or during puberty. and more common in women and individuals who also have comorbid intellectual disabilities.
Fragile X Syndrome
Fragile X syndrome is the most common form of intellectual disability. It is so named because one part of the X chromosome has a broken part that looks pinched and brittle when under a microscope. Fragile X syndrome affects about two to five percent of people with ASD. If one child has Fragile X, there is a 50% chance that a boy born from the same parent will have Fragile X (see Mendel's genetics). Other members of the family who may think of having a child may also want to be examined for the syndrome.
Gender disforia
Gender disforia is a diagnosis given to people (eg transgender) who experience discomfort associated with their gender identity. Autistic people are more likely to experience gender dysphoria.
Intellectual flaw
The fraction of autistic individuals who also meet the criteria for intellectual disability has been reported anywhere from 25% to 70%, wide variations that illustrate the difficulty of assessing autistic intelligence. For example, a study in England in 2001 of 26 autistic children found about 30% with normal-range intelligence (IQ above 70), 50% with mild to moderate intellectual disability, and about 20% with severe intellectual to severe intellectual defects (IQ under 35). For ASD in addition to autism, associations are much weaker: the same study reported normal intelligence in about 94% of 53 children with PDD-NOS. The estimate is that 40-69% of individuals with ASD have some degree of intellectual disability, with women more likely to be in a severe range of intellectual disabilities. Learning disabilities are also very comorbid in individuals with ASD. Approximately 25-75% of individuals with ASD also have some level of learning disability, although the type of learning disability varies depending on individual specific strengths and weaknesses.
The 2006 review questioned the general assumption that most autistic children have intellectual disabilities. It is possible that the relationship between intellectual disability and autism is not because they usually have common causes, but because the presence of both makes it more likely that both will be diagnosed.
The CDC states that based on information from 11 reporting countries 46% of people with autism have an IQ above 85.
Neuroinflammatory and immune disorders
The role of the immune system and nerve inflammation in the development of autism is controversial. To date, there is little evidence to support the immune hypothesis, but research on the role of immune responses and neuroin inflammation may have important clinical and therapeutic implications. The precise role of an increased immune response in the central nervous system (CNS) of patients with autism is uncertain, but may be a major factor in triggering and maintaining many comorbid conditions associated with autism. Recent studies have shown increased neuroimmunity activity in brain tissue and cerebrospinal fluid in patients with autism, supporting the view that increased immune response may be an important factor in the onset of autistic symptoms. Overview 2013 also found evidence of microglial activation and increased production of cytokines in postmortem brain samples from people with autism.
Nonverbal learning disorder
Obsessive-compulsive disorder
Obsessive-compulsive disorder is characterized by recurrent obsessive thoughts or compulsive action. About 30% of individuals with autism spectrum disorders also have OCD.
Tourette's Syndrome
The prevalence of Tourette syndrome among individuals with autism is estimated at 6.5%, higher than the prevalence of 2% to 3% for the general population. Several hypotheses for this relationship have advanced, including common genetic factors and dopamine abnormalities, glutamate or serotonin.
Sensory issues
Unusual responses to sensory stimulation are more common and prominent in individuals with autism, although there is no good evidence that sensory symptoms differentiate autism from other developmental disorders. Disturbance of sensory process of comorbidity with ASD, with comorbidity rate 42-88%.
Several studies have reported related motor problems that include poor muscle tone, poor motor planning, and walking; ASD is not associated with severe motor disturbance.
Many people with ASD often feel uncomfortable to sit or stand in a way that neurotypical people will find ordinary, and instead they will appear to be in an awkward position, such as standing with both legs together, supination, sitting cross-legged or with one leg in over others or just have an awkward gait. However, although it seems to be more common in people with ASD, all evidence is anecdotal and has not been studied at this time. It has been observed by some psychologists that there are similarities in the way in which this 'peculiar' position can manifest.
Tuberous sclerosis
Tuberous sclerosis is a rare genetic disorder that causes benign tumors to grow in the brain as well as in other vital organs. It has a strong relationship consistently with the autism spectrum. One to four percent of people with autism also have tuberous sclerosis. Research has reported that between 25% and 61% of individuals with tuberous sclerosis meet diagnostic criteria for autism with a higher proportion suggesting a widespread developmental disfunction feature.
Sleep disorder
Sleep disturbances are commonly reported by individual parents with ASD, including late onset of sleep, early risers, and poor sleep care; Sleep disorders present in 53-78% of individuals with ASD. Unlike general pediatric insomnia, rooted in behavior, sleep disturbance in individuals with comorbid ASD with other neurobiological, medical, and psychiatric problems.
If left untreated, severe sleep disturbances can exacerbate ASD behaviors such as self-injury; however, no FDA-approved pharmacological treatments for current pediatric insomnia. Some evidence suggests that melatonin supplements improve sleep patterns in children with autism but stronger, overall high quality studies are lacking.
Other mental disorders
Phobias, depression and other psychopathological disorders are often described along with ASD but this has not been systematically assessed.
Presentation of depression in ASD may depend on the level of cognitive function, with lower-functioning children displaying more behavioral problems and more functioning children displaying more traditional symptoms of depression. Depression is considered to develop and occurs more in high-functioning individuals during adolescence, as they develop greater insight into their differences than others.
Maps Conditions comorbid to autism spectrum disorders
See also
- Autism and working memory
References
Source of the article : Wikipedia
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