Clinical characteristics of boys with comorbid autism spectrum disorder and attention deficit/hyperactivity disorder.

BACKGROUND: Autism spectrum disorder (ASD) and attention deficit / hyperactivity disorder (ADHD) are frequently comorbid and, as both are defined as neurodevelopmental disorders in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, simultaneous diagnosis is possible. However, despite the frequency of this comorbid state, its endophenotypic features remain unclear. This study thus aimed to describe the behavioral and emotional problems in boys with comorbid ASD and ADHD using the Strengths and Difficulties Questionnaire (SDQ). METHODS: In total, 102 boys (age, 6-12 years) diagnosed with one or both disorders were divided into three groups according to their clinical diagnosis: ASD + ADHD (N = 39), ASD (N = 37), and ADHD (N = 25). Symptoms and related behaviors were compared among the groups using parents' ratings of the autism spectrum quotient, ADHD rating scale-IV, and SDQ. RESULTS: In the ASD + ADHD group, the proportion of "clinical-range" cases was as high as 76.9% for the SDQ total difficulties score (TDS). The ASD + ADHD and ADHD groups had significantly higher TDS as well as behavioral problems and hyperactivity subscale scores than did the ASD group; however, the ASD + ADHD group did not have significantly different scores on any subscale compared with the other two groups. The ASD + ADHD and ASD groups also had significantly lower prosocial behavior scores than the ADHD group. CONCLUSIONS: When using the SDQ as a screening tool for neurodevelopmental disorders, a high TDS, conduct problems, hyperactivity, and low prosocial behavior can be considered characteristic of ASD and ADHD comorbidity in 6- to 12-year-old boys.

Quality of life in mothers of preschoolers with high-functioning pervasive developmental disorders.

BACKGROUND: Parents of children with pervasive developmental disorders (PDD) are likely to experience serious distress. The aims of this study were to (i) assess distress among mothers of preschoolers with high-functioning PDD (HFPDD); and (ii) examine its relation to the child's behavioral characteristics. METHODS: Participants were 30 mothers of preschoolers with HFPDD, and 30 mothers of a matched control group. Short Form 36 Health Survey Questionnaire (version 2), and the Strengths and Difficulties Questionnaire were used for assessment. The children's autistic traits were assessed using the total number of items for the DSM-IV-TR autistic disorder diagnosis. RESULTS: Mothers in the HFPDD group were more distressed mentally than physically. Neither physical nor mental distress in the group was related to the child's autistic traits, while their mental distress was significantly related to the child's behavior problems. CONCLUSIONS: Mothers in the HFPDD group were at increased risk of impaired mental wellbeing. Maternal mental distress in the group was significantly related to general behavior problems, but not to autistic traits in the child.

Impact of attention deficit hyperactivity disorder-like symptoms on the clinical features of adolescents with pervasive developmental disorders.

INTRODUCTION: Attention Deficit Hyperactivity Disorder (ADHD)-like symptoms are common among children and adolescents with Pervasive Developmental Disorders (PDD). The purpose of this study was to assess the impact of ADHD-like symptoms on the clinical features of adolescents with PDD. METHODS: A total of 72 subjects (between the ages of 12 and 17) diagnosed as having PDD were split into higher (ADHD+) and lower (ADHD-) groups according to the presence of ADHD-like symptoms as assessed with the Japanese version of the ADHD Rating Scale-IV (ADHD-RS-IV-J). Group differences in coexisting psychopathology, as assessed by the eight subscales of the Japanese version of the Child Behavior Checklist for Ages 4-18 (CBCL/4-18-J) and autistic core features, as assessed by the adolescent part of the PDD-Autism Society of Japan Rating Scale (PARS), were examined. RESULTS: The ADHD + subjects showed a significantly higher degree of general psychopathology, including both externalizing and internalizing symptoms, as compared to subjects in the ADHD- subgroup. Additionally, the ADHD + subgroup showed greater impairment according to PARS scores. DISCUSSION: These results indicate an important role of ADHD-like symptoms in PDD. Therefore, parents/caregivers may find it useful to know to what extent their child's ADHD-like symptoms deviate from the norm for PDD adolescents and the implications of these symptoms for long-term care. In addition, clinicians would be well advised to consider further systematic assessment of ADHD-like symptoms.