Relationship between Anxiety, Depression, Somatic Complaints, and Age in Children with Autism and Children with ADHD
DOI:
https://doi.org/10.12970/2310-8231.2020.08.07Keywords:
Internalizing symptoms, somatic problems, autism, ADHD.Abstract
No study has analyzed internalizing and somatic symptoms and age in large samples of children with autism and ADHD. Mothers rated 1,436 children with autism and 1,056 with ADHD-Combined or ADHD-Inattentive, 2-17 years of age, on 25 Pediatric Behavior Scale internalizing and somatic symptoms. Generalized and separation anxiety scores were significantly higher in autism than in ADHD-C and ADHD-I, social anxiety was higher in autism than in ADHD-C, and feeling sad and depressed was higher in autism than in ADHD-I. Children with ADHD-C and ADHD-I did not differ from each other, except that sleep disturbance was greater in ADHD-C and social anxiety was greater in ADHD-I. Across age groups, generalized anxiety was often or very often a problem for 49% with autism, 29% with ADHD-C, and 26% with ADHD-I. Corresponding percentages for social anxiety were 32%, 15%, and 24%; separation anxiety 40%, 22%, and 21%; and depressed 22%, 15%, and 9%. No symptoms significantly decreased with age, and in all three diagnostic groups, depression, low self-esteem, and somatic complaints increased with age. Generalized anxiety also increased with age in autism. The frequency of clinically significant anxiety and depression was high in all three diagnostic groups (particularly autism) and was overall higher in the 13-17 year age group than at younger ages, indicating that anxiety and depression may increase with age in ADHD and autism, making early diagnosis and treatment critical.
References
Barkley RA, DuPaul GJ, McMurray MB. Comprehensive evaluation of attention deficit disorder with and without hyperactivity as defined by research criteria. J Consulting Clin Psychol 1990; 58: 775-789. https://doi.org/10.1037/0022-006X.58.6.775
Elia J, Ambrosini P, Berrettini W. ADHD characteristics: I. Concurrent co-morbidity patterns in children and adolescents. Child Adolesc Psychiatry Mental Health 2008; 2: 1-15. https://doi.org/10.1186/1753-2000-2-15
Gross!Tsur V, Goldzweig G, Landau YE, Berger I, Shmueli D, Shalev RS. The impact of sex and subtypes on cognitive and psychosocial aspects of ADHD. Dev Med Child Neurol 2006; 48: 901-5. https://doi.org/10.1017/S0012162206001976
Mayes SD, Calhoun SL, Murray MJ, Ahuja M, Smith LA. Anxiety, depression, and irritability in children with autism relative to other neuropsychiatric disorders and typical development. Res Autism Spectrum Disord 2011; 5: 474-85. https://doi.org/10.1016/j.rasd.2010.06.012
Meinzer MC, Pettit JW, Viswesvaran C. The co-occurrence of attention-deficit/hyperactivity disorder and unipolar depression in children and adolescents: A meta-analytic review. Clin Psychol Rev 2014; 34: 595-607. https://doi.org/10.1016/j.cpr.2014.10.002
Bellini S. Social skill deficits and anxiety in high-functioning adolescents with autism spectrum disorders. Focus Autism Other Dev Disabil 2004; 19: 78-86. https://doi.org/10.1177/10883576040190020201
Gadow KD, DeVincent CJ, Pomeroy J, Azizian A. Comparison of DSM-IV symptoms in elementary school-age children with PDD versus clinic and community samples. Autism 2005; 9: 392-415. https://doi.org/10.1177/1362361305056079
Hurtig T, Kuusikko S, Mattila M-L, Haapsamo H, Ebeling H, Jussila K, et al. Multi-informant reports of psychiatric symptoms among high-functioning adolescents with Asperger syndrome or autism. Autism 2009; 13: 583-98. https://doi.org/10.1177/1362361309335719
Kim JA, Szatmari P, Bryson SE, Streiner DL, Wilson FJ. The prevalence of anxiety and mood problems among children with autism and Asperger syndrome. Autism 2000; 4: 117-32. https://doi.org/10.1177/1362361300004002002
Mazzone L, Postorino V, De Peppo L, Fatta L, Lucarelli V, Reale L, et al. Mood symptoms in children and adolescents with autism spectrum disorders. Res Develop Disabil 2013; 34: 3699-708. https://doi.org/10.1016/j.ridd.2013.07.034
Russell E, Sofronoff K. Anxiety and social worries in children with Asperger syndrome. Australian New Zealand J Psychiatry 2005; 39: 633-8. https://doi.org/10.1080/j.1440-1614.2005.01637.x
Van Steensel FJA, Bögels SM, Perrin S. Anxiety disorders in children and adolescents with autistic spectrum disorders: A meta-analysis. Clin Child Family Psychol Rev 2011; 14: 302- 17. https://doi.org/10.1007/s10567-011-0097-0
Green J, Gilchrist A, Burton D, Cox A. Social and psychiatric functioning in adolescents with Asperger syndrome compared with conduct disorder. J Autism Dev Disord 2000; 30: 279-93. https://doi.org/10.1023/A:1005523232106
Leyfer OT, Folstein SE, Bacalman S, Davis NO, Dinh E, Morgan J, et al. Comorbid psychiatric disorders in children with autism: Interview development and rates of disorders. J Autism Dev Disord 2006; 36: 849-61. https://doi.org/10.1007/s10803-006-0123-0
Rosen TE, Mazefsky CA, Vasa RA, Lerner MD. Co-occurring psychiatric conditions in autism spectrum disorder. Internat Rev Psychiatry 2018; 30: 40-61. https://doi.org/10.1080/09540261.2018.1450229
Simonoff E, Pickles A, Charman T, Chandler S, Loucas T, Baird G. Psychiatric disorders in children with autism spectrum disorders: Prevalence, comorbidity, and associated factors in a population-derived sample. J Am Acad Child Adolesc Psychiatry 2008; 47: 921-9. https://doi.org/10.1097/CHI.0b013e318179964f
Mitchison GM, Njardvik U. Prevalence and gender differences of ODD, anxiety, and depression in a sample of children with ADHD. J Attention Disord 2019; 23: 1339-45. https://doi.org/10.1177/1087054715608442
Buitelaar JK, Barton J, Danckaerts M, Friedrichs E, Gillberg C, Hazell PL, et al. A comparison of North American versus non-North American ADHD study populations. Eur Child Adolesc Psychiatry 2006; 15: 177-81. https://doi.org/10.1007/s00787-005-0523-2
Van Steensel FJA, Bögels SM, deBruin EI. Psychiatric comorbidity in children with autism spectrum disorders: A comparison with children with ADHD. J Child Family Studies 2013; 22: 368-76. https://doi.org/10.1007/s10826-012-9587-z
Costello EJ, Copeland W, Angold A. Trends in psychopathology across the adolescent years: What changes when children become adolescents, and when adolescents become adults? J Child Psychol Psychiatry 2011; 52: 1015-25. https://doi.org/10.1111/j.1469-7610.2011.02446.x
Reynolds CR, Richmond BO. Revised Children's Manifest Anxiety Scale-2 manual: Los Angeles: Western Psychological Services. 2012.
Ghaziuddin M, Weidmer!Mikhail E, Ghaziuddin N. Comorbidity of Asperger syndrome: A preliminary report. J Intellectual Disabil Res 1998; 42: 279-83. https://doi.org/10.1111/j.1365-2788.1998.tb01647.x
Brereton AV, Tonge BJ, Einfeld SL. Psychopathology in children and adolescents with autism compared to young people with intellectual disability. J Autism Dev Disord 2006; 36: 863-70. https://doi.org/10.1007/s10803-006-0125-y
Mayes SD, Calhoun SL, Murray MJ, Zahid J. Variables associated with anxiety and depression in children with autism. J Dev Physical Disabil 2011; 23: 325-37. https://doi.org/10.1007/s10882-011-9231-7
Vickerstaff S, Heriot S, Wong M, Lopes A, Dossetor D. Intellectual ability, self-perceived social competence, and depressive symptomatology in children with high-functioning autistic spectrum disorders. J Autism Dev Disord 2007; 37: 1647-64. https://doi.org/10.1007/s10803-006-0292-x
Weisbrot DM, Gadow KD, DeVincent CJ, Pomeroy J. The presentation of anxiety in children with pervasive developmental disorders. J Child Adolesc Psychopharmacol 2005; 15: 477-96. https://doi.org/10.1089/cap.2005.15.477
Mattila ML, Hurtig T, Haapsamo H, Jussila K, KuusikkoGauffin S, Kielinen M, et al. Comorbid psychiatric disorders associated with Asperger syndrome/high-functioning autism: A community- and clinic-based study. J Autism Dev Disord 2010; 40: 1080-93. https://doi.org/10.1007/s10803-010-0958-2
Achenbach TM, Edlebrock C. Manual for the Child Behavior Checklist Burlington, VT: University of Vermont. 1991.
Clark T, Feehan C, Tinline C, Vostanis P. Autistic symptoms in children with attention deficit-hyperactivity disorder. Eur Child Adolesc Psychiatry 1999; 8: 50-5. https://doi.org/10.1007/s007870050083
Miodovnik A, Harstad E, Sideridis G, Huntington N. Timing of the diagnosis of attention-deficit/hyperactivity disorder and autism spectrum disorder. Pediatrics 2015; 136: e830-e7. https://doi.org/10.1542/peds.2015-1502
Lindgren SD, Koeppl GK. Assessing child behavior problems in a medical setting: Development of the Pediatric Behavior Scale. Advances in behavioral assessment of children and families Greenwich, CT: JAI. 1987; pp. 57-90.
Mayes SD. Checklist for Autism Spectrum Disorder. Wood Dale, IL: Stoelting. 2012. https://doi.org/10.1037/t03996-000
Mayes SD, Calhoun SL, Waschbusch DA, Baweja R. Autism and reactive attachment/disinhibited social engagement disorders: Co-occurrence and differentiation. Clin Child Psychol Psychiatry 2017; 22: 620-31. https://doi.org/10.1177/1359104516678039
Mayes SD, Calhoun SL, Mayes RD, Molitoris S. Autism and ADHD: Overlapping and discriminating symptoms. Res Autism Spectrum Disord 2012; 6: 277-85. https://doi.org/10.1016/j.rasd.2011.05.009
Tierney C, Mayes S, Lohs SR, Black A, Gisin E, Veglia M. How valid is the Checklist for Autism Spectrum Disorder when a child has apraxia of speech? J Dev Behav Pediatrics 2015; 36: 569-74. https://doi.org/10.1097/DBP.0000000000000189
Mayes SD, Calhoun SL, Murray MJ, Morrow JD, Yurich KKL, Mahr F, et al. Comparison of scores on the Checklist for Autism Spectrum Disorder, Childhood Autism Rating Scale (CARS), and Gilliam Asperger’s Disorder Scale (GADS) for children with low functioning autism, high functioning autism or Asperger’s disorder, ADHD, and typical development. J Autism Dev Disord 2009; 39: 1682-93. https://doi.org/10.1007/s10803-009-0812-6
Murray MJ, Mayes SD, Smith LA. Brief report: Excellent agreement between two brief autism scales (Checklist for Autism Spectrum Disorder and Social Responsiveness Scale) completed independently by parents and the Autism Diagnostic Interview-Revised. J Autism Dev Disord 2011; 41: 1586-90. https://doi.org/10.1007/s10803-011-1178-0
Bixler EO, Vgontzas AN, Lin HM, Liao D, Calhoun S, VelaBueno A, et al. Sleep disordered breathing in children in a general population sample: Prevalence and risk factors. Sleep 2009; 32: 731-6. https://doi.org/10.1093/sleep/32.6.731
Mayes SD, Gordon M, Calhoun SL, Bixler EO. Long-term temporal stability of measured inattention and impulsivity in typical and referred children. J Attention Disord 2014; 18: 23- 30. https://doi.org/10.1177/1087054712448961
Conrad AL, Richman L, Lindgren S, Nopoulos P. Biological and environmental predictors of behavioral sequelae in children born preterm. Pediatrics 2010; 125: e83-9. https://doi.org/10.1542/peds.2009-0634
Mayes SD, Calhoun SL, Aggarwal R, Baker C, Mathapati S, Anderson R, et al. Explosive, oppositional, and aggressive behavior in children with autism compared to other clinical disorders and typical children. Res Autism Spectrum Disord 2012; 6: 1-10. https://doi.org/10.1016/j.rasd.2011.08.001
Waxmonsky JG, Mayes SD, Calhoun SL, FernandezMendoza J, Waschbusch DA, Bixler EO. The association between disruptive mood dysregulation disorder symptoms and sleep problems in children with and without ADHD. Sleep Med 2017; 37: 180-6. https://doi.org/10.1016/j.sleep.2017.02.006
Biederman J, Faraone SV, Milberger S, Jetton JG, Chen L, Mick E, et al. Is childhood oppositional defiant disorder a precursor to adolescent conduct disorder? Findings from a four-year follow-up study of children with ADHD. J Am Acad Child Adolesc Psychiatry 1996; 35: 1193-204. https://doi.org/10.1097/00004583-199609000-00017
Faraone SV, Biederman J, Weber W, Russell RL. Psychiatric, neuropsychological, and psychosocial features of DSM-IV subtypes of attention-deficit/hyperactivity disorder: Results from a clinically referred sample. J Am Acad Child Adolesc Psychiatry 1998; 37: 185-93. https://doi.org/10.1097/00004583-199802000-00011
Efron D, Sciberras E. The diagnostic outcomes of children with suspected attention deficit hyperactivity disorder following multidisciplinary assessment. J Paediatrics Child Health 2010; 46: 392-7. https://doi.org/10.1111/j.1440-1754.2010.01750.x
King S, Waschbusch DA. Aggression in children with attention-deficit/hyperactivity disorder. Expert Rev Neurother 2010; 10: 1581-94. https://doi.org/10.1586/ern.10.146
Mayes SD, Waxmonsky J, Calhoun SL, Kokotovich C, Mathiowetz C, Baweja R. Disruptive mood dysregulation disorder (DMDD) symptoms in children with autism, ADHD, and neurotypical development and impact of co-occurring ODD, depression, and anxiety. Res Autism Spectrum Disord 2015; 18: 64-72. https://doi.org/10.1016/j.rasd.2015.07.003
Connor DF, Steeber J, McBurnett K. A review of attentiondeficit/hyperactivity disorder complicated by symptoms of oppositional defiant disorder or conduct disorder. J Dev Behav Pediatrics 2010; 31: 427-40. https://doi.org/10.1097/DBP.0b013e3181e121bd
Gillberg C, Gillberg IC, Rasmussen P, Kadesjo B, Soderstrom H, Rastam M, et al. Co-existing disorders in ADHD - Implications for diagnosis and intervention. Eur Child Adolesc Psychiatry 2004; 13 Suppl 1: I80-92. https://doi.org/10.1007/s00787-004-1008-4
Milich R, Balentine AC, Lynam DR. ADHD combined type and ADHD predominantly inattentive type are distinct and unrelated disorders. Clin Psychol: Science Practice 2001; 8: 463-88. https://doi.org/10.1093/clipsy.8.4.463
Turgay A. Aggression and disruptive behavior disorders in children and adolescents. Expert Rev Neurotherapeutics 2004; 4: 623-32. https://doi.org/10.1586/14737175.4.4.623
Mayes SD, Calhoun SL, Aggarwal R, Baker C, Mathapati S, Molitoris S, et al. Unusual fears in children with autism. Res Autism Spectrum Disord 2013; 7: 151-8. https://doi.org/10.1016/j.rasd.2012.08.002
Kanner L. Autistic disturbances of affective contact. Nervous Child 1943; 2: 217-50.
Mayes SD, Waxmonsky JG, Baweja R, Mattison RE, Memon H, Hameed U, et al. Symptom and demographic predictors of psychotropic medication use in ADHD and autism. Internat J Clin Psychiatry Mental Health 2019; 7: 10-20. https://doi.org/10.12970/2310-8231.2019.07.03
Coleman DM, Adams JB, Anderson AL, Frye RE. Rating of the effectiveness of 26 psychiatric and seizure medications for autism spectrum disorder: Results of a national survey. J Child Adolesc Psychopharmacol 2019; 29: 107-23. https://doi.org/10.1089/cap.2018.0121
Connolly SD, Bernstein GA. Practice parameter for the assessment and treatment of children and adolescents with anxiety disorders. J Am Acad Child Adolesc Psychiatry 2007; 46: 267-83. https://doi.org/10.1097/01.chi.0000246070.23695.06
Garland EJ, Kutcher S, Virani A, Elbe D. Update on the use of SSRIs and SNRIs with children and adolescents in clinical practice. J Canadian Acad Child Adolesc Psychiatry 2016; 25: 4-10.
Pliszka SR. Psychiatric comorbidities in children with attention deficit hyperactivity disorder: Implications for management. Paediatr Drugs 2003; 5: 741-50. https://doi.org/10.2165/00148581-200305110-00003
Wang Z, Whiteside SPH, Sim L, Farah W, Morrow AS, Alsawas M, et al. Comparative effectiveness and safety of cognitive behavioral therapy and pharmacotherapy for childhood anxiety disorders: A systematic review and metaanalysis. JAMA Pediatrics 2017; 171: 1049-56. https://doi.org/10.1001/jamapediatrics.2017.3036
Banneyer KN, Bonin L, Price K, Goodman WK, Storch EA. Cognitive behavioral therapy for childhood anxiety disorders: A review of recent advances. Current Psychiatry Reports 2018; 20: 65. https://doi.org/10.1007/s11920-018-0924-9
Higa-McMillan CK, Francis SE, Rith-Najarian L, Chorpita BF. Evidence base update: 50 years of research on treatment for child and adolescent anxiety. J Clin Child Adolesc Psychol 2016; 45: 91-113. https://doi.org/10.1080/15374416.2015.1046177
Oud M, Winter L, Vermeulen-Smit E, Bodden D, Nauta M, Stone L, et al. Effectiveness of CBT for children and adolescents with depression: A systematic review and metaregression analysis. Eur Psychiatry 2019; 57: 33-45. https://doi.org/10.1016/j.eurpsy.2018.12.008
Ricciardi JN, Luiselli JK, Camare M. Shaping approach response intervention for specific phobia in a child with autism. J Applied Behav Analysis 2006; 39: 445-448. https://doi.org/10.1901/jaba.2006.158-05
MTA Cooperative Group. A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. The Multimodal Treatment Study of Children with ADHD. Arch Gen Psychiatry 1999; 56: 1073-86. https://doi.org/10.1001/archpsyc.56.12.1073
