Psychiatric comorbidity in children with high-functioning pervasive developmental disorder.

BACKGROUND: In previous studies for children with pervasive developmental disorder (PDD), the prevalence for psychiatric comorbidities has varied because of their methodological differences. In this research, our PDD subjects were strictly limited by age and IQ scores, and we utilized a semi-structured interview to diagnose their coexisting disorders. The purpose of this study is to identify reliable prevalence and types of psychiatric comorbidities in children with high-functioning PDD (HFPDD). METHODS: The subjects were 49 children aged 6-15 years with HFPDD. In order to diagnose the comorbidities among them, we used the Japanese version of the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version. RESULTS: Forty-eight cases (98%) met the criteria for at least one comorbidity. The median number of the present comorbidities per child was 2, and the mode was 2. Depression (37%), attention deficit hyperactivity disorder (49%), and oppositional defiant disorder (45%) were frequently observed. CONCLUSIONS: Our finding indicates the high prevalence of comorbidities and the variety of the comorbid disorders in children with HFPDD. It is important to be aware of those comorbid disorders to provide the children with effective treatments.

Sensory hypersensitivity in children with high-functioning pervasive developmental disorder.

BACKGROUND: Studies have shown that children with pervasive developmental disorder (PDD) have high rates of sensory hypersensitivity. In addition, a few recent studies suggested that sensory hypersensitivity was related to anxiety or depression. However, most studies had methodological limitations because they included children with mental retardation and did not examine broadband psychopathology. Therefore, the purpose of this study was to examine the prevalence of sensory hypersensitivity in children with high-functioning PDD (HFPDD) and the correlation among sensory hypersensitivity, various characteristics, and broadband psychopathology. METHODS: We assessed 132 children with HFPDD (aged 6-15 years, 75% male) that were divided into sensory hypersensitivity (HS) and sensory non-hypersensitivity (non-HS) groups. A logistic regression model was used to examine correlations among sensory hypersensitivity, age, gender, PDD subtypes, socioeconomic status, and broadband psychopathology, including symptoms of anxiety and depression. RESULTS: Of the 132 children with HFPDD, 65.9% (n = 87) were categorized as HS and 34.1% (n = 45) as non-HS. The most common sensory hypersensitivity was auditory. Logistic regression analyses revealed that sensory hypersensitivity in HFPDD was significantly associated with autistic disorder and symptoms of anxiety and depression. CONCLUSIONS: Majority of children with HFPDD exhibited sensory hypersensitivity. Our findings suggested that sensory hypersensitivity may be a core feature of HFPDD and is possibly correlated to symptoms of anxiety and depression. We propose that sensory hypersensitivity in children with PDD should be aggressively assessed.

Anxiety in children with high-functioning pervasive developmental disorder.

BACKGROUND: Anxiety symptoms in children with pervasive developmental disorder (PDD) often appear to be not as severe as those in children with anxiety disorders or often appear to be the core features of PDD, and therefore, they do not meet the diagnostic criteria for anxiety disorders. In this study, we assessed anxiety broadly in line with dimensions of anxiety and not with an operational categorical diagnosis. The objective of this study was to reveal that children with high-functioning PDD have more anxiety than children in the general population. METHODS: Forty-six children with high-functioning PDD (6-15 years old) were assessed for total anxiety and six subcategories of anxiety, including separation anxiety, generalized anxiety, social phobia, panic/agoraphobia, physical injury fears, and obsessive-compulsiveness. Anxiety in children with high-functioning PDD was compared to that in children of the general population and to that in children with anxiety disorders in a previous study. RESULTS: Children with high-functioning PDD had significantly more symptoms of total anxiety and all subcategories of anxiety except for social phobias than children in the general population, and had significantly fewer symptoms of total anxiety, separation anxiety, generalized anxiety, and social phobias than children with anxiety disorders. CONCLUSIONS: As anxiety in children with high-functioning PDD does not always meet diagnostic criteria for an anxiety disorder, psychiatrists must pay much attention to anxiety and not only depend on diagnostic criteria in order to not miss the chance of treating these children.