Differentiation and co-occurrence of obsessive-compulsive disorder and autism spectrum disorder in people with intellectual developmental disorder: a case series on symptoms specificities
| Date | 17 December 2024 |
| Pages | 61-71 |
| DOI | https://doi.org/10.1108/AMHID-04-2024-0013 |
| Published date | 17 December 2024 |
| Author | Nicole Andreini,Veronica Boniotti,Daniela Scuticchio,Annamaria Bianco,Marco O. Bertelli |
Differentiation and co-occurrence of
obsessive-compulsive disorder and autism
spectrum disorder in people with
intellectual developmental disorder: a
case series on symptoms specificities
Nicole Andreini, Veronica Boniotti, Daniela Scuticchio, Annamaria Bianco and
Marco O. Bertelli
Abstract
Purpose –In persons with an intellectual developmental disorder, obsessive-compulsive disorder (OCD)
and autism spectrum disorder (ASD) are often difficult to differentiate, particularly when patients present
major communication difficulties and low accessibility to subjective symptoms and clinicians are poorly
trained in the specific psychopathological phenomenology.OCD and ASD share some important symptoms
such as repetitiveness of behaviours, low flexibilityto contextual variations or a narrow range of interests. The
purpose of this study is to identify and describe symptomatological specificities, including how they
manifest at behavioural level.
Design/methodology/approach –The present study is a retrospective case series study (n¼3)
focusing on in-depth assessment, detection and comprehension of symptomatological specificities as
well as on the directobservation of behavioural symptoms.
Findings –Some symptoms such as signs of sudden autonomous nervous system activation or
behavioural equivalents of obsessive thoughts are crucial in achieving an effective differential or
comorbidity diagnosis. These symptoms can be identified through a multidisciplinary and
comprehensive evaluation, integrating present clinicaland test findings with a thorough developmental
and medical history. Symptoms should also be interpreted in the light of antecedent, contextual and
personalfactors.
Originality/value –Differential diagnosis between OCD and ASD in persons with major cognitive and
communication issues is a rather neglected research area, although it has significant implications for
treatmentplanning and implementation.
Keywords Autism spectrum disorder, Intellectual developmental disorder,
Neurodevelopmental disorders, Obsessive-compulsive disorder
Paper type Case study
1. Introduction
Diagnosing obsessive-compulsive disorder (OCD) in people with autism spectrum disorder
(ASD) is challenging, especially if intellectual developmental disorders (IDD) are also
present. In fact, ASD and OCD are heterogeneous syndromes sharing several significant
observable symptoms, such as a narrow range of interests, rigid and repetitive behaviours
(RRB) and anxiety (Vitiello et al.,1989;Chok and Koesler, 2014;Gautam and Bhatia, 2015;
Barnhill, 2022). In people with IDD, problem behaviours such as oppositional or aggressive
Nicole Andreini, Veronica
Boniotti, Daniela
Scuticchio, Annamaria
Bianco and Marco O.
Bertelli are all based at the
CREA (Research and
Clinical Center), San
Sebastiano Foundation,
Misericordia di Firenze,
Florence, Italy.
Received 29 April 2024
Revised 11 November 2024
Accepted 21 November 2024
Funding. This research did not
receive any specific grant from
funding agencies in the public,
commercial or not-for-profit
sectors.
Informed consent. Written
informed consent was obtained
to publish the reports and the
information has been identified
to protect anonymity.
Conflict of interest. The authors
declare that they have no
known competing financial
interests or personal
relationships that could have
appeared to influence the work
reported in this case series.
DOI 10.1108/AMHID-04-2024-0013 VOL. 19 NO. 12025, pp. 61-71, ©Emerald Publishing Limited, ISSN 2044-1282 jADVANCES IN MENTAL HEALTH AND INTELLECTUAL DISABILITIES jPAGE 61
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