Autism spectrum disorders in adult outpatients with obsessive compulsive disorder in the UK
Open accessAbstract
OBJECTIVES: Patients with obsessive compulsive disorder (OCD) frequently show traits of autism spectrum disorders (ASD). This is one of the first studies to explore the clinical impact of the overlap between OCD and ASD as a categorical diagnosis. METHODS: A cross-sectional survey in 73 adult outpatients with DSM-IV OCD. Autistic traits were measured using the Autism-Spectrum Quotient (AQ). A clinical estimate ASD diagnosis was made by interview using DSM-IV-TR criteria. OCD patients with and without autistic traits or ASD were compared on demographic and clinical parameters and level of OCD treatment-resistance based on treatment history. RESULTS: Thirty-four (47%) patients scored above the clinical threshold on the AQ (≥26) and 21 (27.8%) met diagnostic criteria for ASD. These diagnoses had not been made before. Patients with autistic traits showed a borderline significant increase in OCD symptom-severity (Yale-Brown Obsessive Compulsive Scale (Y-BOCS); p = .054) and significantly increased impairment of insight (Brown Assessment of Beliefs Scale; p = .01). There was a positive correlation between AQ and Y-BOCS scores (p = .04), but not with OCD treatment resistance. CONCLUSION: There is a high prevalence of previously undiagnosed ASD in patients with OCD. ASD traits are associated with greater OCD symptom-severity and poor insight.
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The similarity between repetitive behavioural tendencies and symptoms of anxiety and OCD may also contribute to misdiagnosis and ineffective treatment.
“The similarity between repetitive behavioural tendencies and symptoms of anxiety and OCD (Cath et al., 2008; Wikramanayake et al., 2018) may also contribute to misdiagnosis and ineffective treatment.”
From Diagnosis of autism in adulthood: A scoping review (2020) · cites this paper as Wikramanayake et al., 2018
47% scored above threshold on the AQ and 29% met criteria for autism.
“47% scored above threshold on the AQ and 29% met criteria for autism.”
From Diagnosis of autism in adulthood: A scoping review (2020) · cites this paper as Wikramanayake et al. (2018)
High autistic traits associated with worse OCD insight.
“High autistic traits associated with worse OCD insight.”
From Diagnosis of autism in adulthood: A scoping review (2020) · cites this paper as Wikramanayake et al. (2018)
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- Authors
- Wikramanayake, W. N. M., Mandy, W., Shahper, S., Kaur, S., Kolli, S., Osman, S., Reid, J., Jefferies-Sewell, K., & Fineberg, N. A.
- Affiliations
- University of Hertfordshire (GB)
- University College London (GB)
- Hertfordshire Partnership University NHS Foundation Trust (GB)
- East London NHS Foundation Trust (GB)
- Cumbria Northumberland Tyne and Wear NHS Foundation Trust (GB)
- Corresponding author
- Wikramanayake, Waduge Nishani Maheshi
- Venue
- International Journal of Psychiatry in Clinical Practice
- Publisher
- Informa UK Limited
- Published
- 2017-08-11
- Volume
- 22
- Issue
- 1
- Pages
- 54-62
- ISSN
- 1365-1501 (ISSN-L)
- 1471-1788
- OpenAlex
- W2735052027
- Cited by
- 40
- References
- 38
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 5 · 2023: 3 · 2022: 6 · 2021: 7 · 2020: 3 · 2019: 4 · 2018: 2 · 2017: 3
- FWCI
- 4.07
- Type
- journal article
- Language
- en
- Open access
- green
- discovery.ucl.ac.uk
- Locations
- International Journal of Psychiatry in Clinical Practice (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- autism spectrum disorder, obsessive-compulsive disorder, autistic traits, comorbidities, Autism Spectrum Quotient, OCD severity, insight impairment, treatment resistance, undiagnosed autism, adult outpatients
- MeSH terms
- Autism Spectrum Disorder, Adult, Cross-Sectional Studies, Female, United Kingdom, Humans, Male, Middle Aged, Obsessive-Compulsive Disorder, Outpatients, Severity of Illness Index, Comorbidity
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