Comparing psychopathology rates across autism spectrum disorders and intellectual disabilities

Date05 November 2018
Pages163-172
DOIhttps://doi.org/10.1108/AMHID-04-2018-0023
Published date05 November 2018
AuthorMartyn Matthews,Elliot Bell,Brigit Mirfin-Veitch
Subject MatterHealth & social care,Learning & intellectual disabilities
Comparing psychopathology rates
across autism spectrum disorders and
intellectual disabilities
Martyn Matthews, Elliot Bell and Brigit Mirfin-Veitch
Abstract
Purpose The purpose of this paper is to compare the rates and patterns of comorbid anxiety, depression
and ADHD across people with: autism spectrum disorder (ASD) plus intellectual disability (ID), ASD/no ID
(AS/HFA) and ID only.
Design/methodology/approach Data were obtained using structured file review and two psychometric
screening instruments. File reviews used a modified version of the Case Review Protocol from the Diagnostic
Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities. Screening employed the Reiss
Screen for Maladaptive Behaviour and the ASD-Comorbidity-Adults scale.
Findings Levels of anxiety, depression and ADHD were high for all three groups, and greater than in
general population studies. Between groups, the AS/HFA sample had significantly higher anxiety, while the
ASD/ID group had significantly greater ADHD. Groups did not differ on measures of depression or total
psychopathology. Levels of ADHD, but not anxiety or depression, increased with severity of ID and ASD
symptoms.
Research limitations/implications More research is needed on the relationship between ASD and both
anxiety and ADHD, particularly the identification of these comorbid conditions and their treatment.
Practical implications Rigorous screening for comorbid mental health conditions is required to achieve
the best outcomes for adults with ASD.
Originality/value The study used a broader community-based sample than previous comorbidity
research. Including adults with ID but without ASD enabled a comparison of types and rates of disorder
across three distinct but related groups with neurodevelopmental disorders.
Keywords Comorbidity, ADHD, ASD, Autism, Depression, Psychiatric disorder
Paper type Research paper
A comprehensive meta-analysis (Steel et al., 2014) indicates a 12-month prevalence for all
common mental disorders of 17.6 per cent in the general population, and according to the latest
World Health Organisation (2017) report on common mental disorders, the global prevalence
rate of depression is 4.4 per cent and anxiety disorders 3.6 per cent. Whilst there is substantial
literature on psychiatric comorbidity amongst children and adolescents with autism spectrum
disorders (ASDs), research examining this issue amongst adults is relatively new (Matson and
Williams, 2014a). Studies to date indicate that rates of psychopathology are significantly higher
for adults with ASD than for the general population (Kannabiran and McCarthy, 2009; Matson
and Williams, 2013; Moss et al., 2015), a finding which is also well established in people with
intellectual disability (ID) (Cooper et al., 2007, 2015; Deb et al., 2001). However, results from
studies of psychiatric comorbidity with autism vary greatly, depending on methodology and the
source of the sample population.
There are now severa l studies which examine multiple c omorbidities in adults, and many mo re
on specific psychiatric disorders which can co-occur with ASD (see Table I). A number of
neurobiological (Bachevalier and Loveland, 2006; Bellani et al., 2013), psychological (Cooper
et al., 2007) and social (Cooper et al., 2007) explanations for the rates of increased prevalence
of additional psychiatric disorders in adults with ASD have been proposed. A further
Received 18 April 2018
Revised 6 September 2018
Accepted 17 September 2018
The authors are grateful to the
editor and reviewers of AMHID
who provided particularly helpful
feedback on sections of the paper
which greatly improved the
original manuscript.
Martyn Matthews is Autism and
Developmental Disabilities
Consultant at Kestrel
Consulting, Wellington, New
Zealand; and is at the
Department of Psychological
Medicine, Otago University,
Wellington, New Zealand.
Elliot Bell is based at the
Department of Psychological
Medicine, Otago University,
Wellington, New Zealand.
Brigit Mirfin-Veitch is Director of
the Donald Beasley Institute,
Dunedin, New Zealand; and is
at the Centre for Postgraduate
Nursing, Otago University,
Christchurch, New Zealand.
DOI 10.1108/AMHID-04-2018-0023 VOL. 12 NO. 5/6 2018, pp.163-172, © Emerald Publishing Limited, ISSN 2044-1282
j
ADVANCESIN MENTAL HEALTH AND INTELLECTUAL DISABILITIES
j
PAGE163

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