Thursday, 3 December 2015

OCD and autism continued

The paper by Sandra Meier and colleagues [1] (open-access available here) is served up for your reading delight today and some continued discussion about the nature of any overlap between the autism spectrum disorders (ASDs) and obsessive-compulsive disorder (OCD).

To save my poor typing hands from further disrepair, I'm gonna refer you back to a post I wrote way back in 2011 on the topic of OCD and autism and the question of symptom overlap vs. discrete conditions (see here) as a sort of starting point for some of the issues to be resolved. More recent ramblings have also covered this topic too (see here).

The Meier paper "aimed to determine the patterns of comorbidity, longitudinal risks, and shared familial risks" when it came to autism and OCD based on the use (yet again) of one of those very useful Scandinavian population health registries. Denmark was the specific country in this case and: "Among the 3,380,170 cohort members followed from 1994 to 2012, we observed that 18,184 were diagnosed with an autism spectrum disorder and 11,209 with OCD." Further analysis of the data followed, leading authors to report that: "739 individuals were diagnosed with autism spectrum disorders and OCD; 281 were first assigned a diagnosis of OCD, 253 a diagnosis of autism spectrum disorders, and 205 were simultaneously diagnosed with OCD and autism spectrum disorders." The bottom line there was that those diagnosed with OCD had an approximate "13 times higher risk of having a comorbid autism spectrum diagnosis (6.6%) compared with individuals without OCD (0.5%)."

Meier et al also looked at parents of cohort members too, and the question of whether parental diagnosis of OCD or ASD impacted on the offspring risk of subsequent diagnosis. As it happens, it did seem to play some kind of role: "A parental diagnosis of OCD increased the risk specifically for childhood autism..., Asperger’s syndrome..., or other pervasive developmental disorder." This increased risk however has to be set in the context of how other parental diagnoses (including autism) also exerted some potential effects on risk.

With several other associations reported, these are interesting data illustrating how various different diagnostic labels seem to interact with one and another and strengthening the need for increased screening and clinical awareness of such comorbidity clusters. There is more to be done in this area specifically with the idea that psychiatric and/or developmental diagnoses might not be the only important factors mediating the relationship between autism and OCD as per other research findings (see here). That something like the presence of tics might also be something to examine (see here) and where this might lead in terms of 'novel' interventions (for some at least) (see here) is something else that I'd like to see added to the research agenda in this area. Indeed, on the theme of intervention for OCD specifically with the endogenous opioid system in mind, one wonders whether autism research might be able to offer some potentially interesting future research projects (see here)...

To close, an interesting article about brand names that are not easily forgotten...


[1] Meier SM. et al. Obsessive-Compulsive Disorder and Autism Spectrum Disorders: Longitudinal and Offspring Risk. PLoS One. 2015 Nov 11;10(11):e0141703.

---------- Meier SM, Petersen L, Schendel DE, Mattheisen M, Mortensen PB, & Mors O (2015). Obsessive-Compulsive Disorder and Autism Spectrum Disorders: Longitudinal and Offspring Risk. PloS one, 10 (11) PMID: 26558765