Symptom Overlap between Autism Spectrum Disorder, Generalized Social Anxiety Disorder and Obsessive-Compulsive Disorder in Adults: A Preliminary Case-Controlled Study

Abstract

Background Obsessive-compulsive disorder (OCD) and social anxiety disorder (SAD) frequently co-occur in persons with autism spectrum disorder (ASD). We studied which features distinguish 'pure' anxiety disordered patients from those with co-morbid ASD. Method In a case-controlled design in which groups were matched for age, sex and educational level, patients with OCD or SAD and co-morbid ASD were compared with patients with 'pure' (i.e. without ASD) OCD, with 'pure' SAD and a control group, using the Autism Questionnaire (AQ), Yale-Brown Obsessive-Compulsive Scales, Liebowitz Social Anxiety Scale, Beck Anxiety Inventory and questions on egodystonia of OC behaviors. Results No between patient group differences were found on social or general anxiety measures. The AQ subscales communication problems and lack of imagination discriminated best between patients with comorbid ASD and the other groups, ASD patients showing elevated scores, whereas the other patient groups scored equal to controls. On the AQ social skill subscale all patient groups showed elevated scores. On OC symptom severity, pure OCD patients showed highest scores, whereas comorbid ASD subjects scored intermediate between controls and the pure OCD group, the differences being explained by lower obsession severity in the ASD group. There were no differences between the pure OCD and comorbid ASD groups on egodystonia. Conclusion Patients with comorbid ASD differ from patients with pure OCD and SAD on autism-relate…