A case-controlled study of repetitive thoughts and behavior in adults with autistic disorder and obsessive-compulsive disorderAmerican Journal of Psychiatry

Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
American Journal of Psychiatry (Impact Factor: 13.56). 06/1995; 152(5):772-7. DOI: 10.1176/ajp.152.5.772
Source: PubMed

ABSTRACT The purpose of this study was to investigate the types of repetitive thoughts and behavior demonstrated by adults with autistic disorder and compare them with those of age- and sex-matched adults with obsessive-compulsive disorder.
Fifty consecutive patients admitted to the Yale Adult Pervasive Developmental Disorders (Autism) Clinic with a primary diagnosis of autistic disorder (DSM-III-R and DSM-IV) completed the symptom checklist of the Yale-Brown Obsessive Compulsive Scale. Types of current obsessions and compulsions were evaluated. The comparison group consisted of 50 age- and sex-matched adults with obsessive-compulsive disorder (without tics) (DSM-III-R and DSM-IV).
Direct discriminant function analysis showed that the patients with autistic disorder could be distinguished from those with obsessive-compulsive disorder on the basis of the types of current repetitive thoughts and behavior that they demonstrated. Compared to the obsessive-compulsive group, the autistic patients were significantly less likely to experience thoughts with aggressive, contamination, sexual, religious, symmetry, and somatic content. Repetitive ordering; hoarding; telling or asking (trend); touching, tapping, or rubbing; and self-damaging or self-mutilating behavior occurred significantly more frequently in the autistic patients, whereas cleaning, checking, and counting behavior was less common in the autistic group than in the patients with obsessive-compulsive disorder. In addition, a specific subset of seven obsessive-compulsive variables from the Yale-Brown Obsessive Compulsive Scale symptom checklist was identified that reliably predicted membership in the autistic group.
These results suggest that the repetitive thoughts and behavior characteristics of autism differ significantly from the obsessive-compulsive symptoms displayed by patients with obsessive-compulsive disorder. Future studies are warranted to assess the treatment response and neurobiological underpinnings of repetitive thoughts and behavior in patients with autism and obsessive-compulsive disorder.

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    • "Two studies have used a clinician - administered OCD measure ( the Yale Brown Obsessive Compulsive Scale [ Y - BOCS ] ) [ Goodman et al . , 1989 ] to compare the types of obsessive compulsive ( OC ) symptoms experienced by adults with ASD to those found in typically developing adults with a primary diagnosis of OCD [ Mcdougle et al . , 1995 ; Russell et al . , 2005 ] . Mcdougle et al . [ 1995 ] reported that adults with OCD were more likely to show aggressive and symmetry obsessions , and compul - sions related to counting , whereas individuals with ASD were more likely to display compulsions related to hoarding , or touching and tapping . However , intelli - gence quotien"
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    ABSTRACT: Little is known about the symptom profile of obsessive-compulsive disorder (OCD) in individuals who have autism spectrum disorders (ASD). It is also unknown whether self-report questionnaires are useful in measuring OCD in ASD. We sought to describe the symptom profiles of adults with ASD, OCD, and ASD + OCD using the Obsessive Compulsive Inventory-Revised (OCI-R), and to assess the utility of the OCI-R as a screening measure in a high-functioning adult ASD sample. Individuals with ASD (n = 171), OCD (n = 108), ASD + OCD (n = 54) and control participants (n = 92) completed the OCI-R. Individuals with ASD + OCD reported significantly higher levels of obsessive-compulsive symptoms than those with ASD alone. OCD symptoms were not significantly correlated with core ASD repetitive behaviors as measured on the ADI-R or ADOS-G. The OCI-R showed good psychometric properties and corresponded well with clinician diagnosis of OCD. Receiver operating characteristic analysis suggested cut-offs for OCI-R Total and Checking scores that discriminated well between ASD + versus -OCD, and fairly well between ASD-alone and OCD-alone. OCD manifests separately from ASD and is characterized by a different profile of repetitive thoughts and behaviors. The OCI-R appears to be useful as a screening tool in the ASD adult population. Autism Res 2015. © 2015 International Society for Autism Research, Wiley Periodicals, Inc. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.
    Autism Research 02/2015; DOI:10.1002/aur.1461 · 4.53 Impact Factor
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    • "Moreover, there is an evidence for an association between hoarding behavior and autism. Hoarding behavior occurs relatively frequently in children and adults with autism spectrum disorders (Bejerot, 2007; McDougle et al., 1995; Ruta, Mugno, D'Arrigo, Vitiello and Mazzone, 2010), and a distinct hoarding dimension has emerged from factor analyses of obsessive–compulsive symptoms in children with autism spectrum disorders (Anagnostou et al., 2011; Scahill et al., 2014). In addition, compared to healthy controls (although not psychiatric controls), adult patients with hoarding disorder are more likely to have autistic traits (Pertusa et al., 2012). "
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    ABSTRACT: Compared to studies in adults, there have been few studies of hoarding in children and adolescents with obsessive–compulsive disorder (OCD). In the current study, we evaluated OCD clinical features, Axis I disorders, and social reciprocity scores in 641 children and adolescents with OCD, of whom 163 (25%) had hoarding compulsions and 478 did not. We found that, as a group, youth with hoarding had an earlier age at onset and more severe lifetime OCD symptoms, poorer insight, more difficulty making decisions and completing tasks, and more overall impairment. The hoarding group also had a greater lifetime prevalence of panic disorder, specific phobia, Tourette disorder, and tics. As measured with the Social Reciprocity Scale, the hoarding group had more severe deficits in parent-rated domains of social communication, social motivation, and restricted interests and repetitive behavior. In a multivariable model, the overall social reciprocity score, age at onset of OCD symptoms, symmetry obsessions, and indecision were independently related to hoarding in these children and adolescents with OCD. These features should be considered as candidate risk factors for the development of hoarding behavior in pediatric OCD.
    Journal of Obsessive-Compulsive and Related Disorders 10/2014; 3(4). DOI:10.1016/j.jocrd.2014.08.001 · 0.81 Impact Factor
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    • "A number of OCD symptoms related to Incompleteness have been noted in individuals with ASD. In a study comparing 50 adults with autistic disorder to an age and gender-matched group of adults with OCD using the Y-BOCS symptom checklist, McDougle et al. (1995) found that the adults with autistic disorder endorsed more items related to repetitive ordering, hoarding, touching, tapping, or rubbing, and self-damaging behaviors . Of note is that over half (n ¼35) of the autistic participants in McDougle et al.'s sample also met DSM-IV criteria for mental retardation, including 15 participants who were classified as nonverbal. "
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