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Cited by 65Pediatric Pain Management TechniquesAutism Spectrum Disorder ResearchAttention Deficit Hyperactivity Disorder

Prevalence of autism traits and attention-deficit hyperactivity disorder symptoms in a clinical sample of children and adolescents with chronic pain

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Wiwe Lipsker, Camilla, Bölte, Sven, Hirvikoski, Tatja, Lekander, Mats, Holmström, Linda, Wicksell, Rikard K.·2018·Journal of Pain Research
DOI 10.2147/jpr.s177534PMC PMC6235327
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Abstract

PURPOSE: Recent research has suggested that autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) may be comorbid to pediatric chronic pain, but the empirical support is yet scarce. Therefore, the current study aimed to investigate the occurrence of traits and symptoms consistent with clinically significant ASD and ADHD in a group of children and adolescents with chronic debilitating pain and examine potential differences in pain and demographic variables between children with and without clinically significant traits and symptoms of ASD and ADHD. PATIENTS AND METHODS: This cross-sectional study included 146 parent-child dyads (102 girls, 111 mothers, children 8-17 years) consecutively referred to a tertiary pain clinic. Parents completed the Social Responsiveness Scale to assess autistic traits, and Conners-3 to measure symptoms of ADHD in their children. Children completed the Lübeck Pain Questionnaire to evaluate experienced pain. RESULTS: Among children, 20 (13.7%) received scores consistent with clinically significant ASD and 29 (19.9%) received scores consistent with clinically significant ADHD, with a combined prevalence of clinically significant ASD/ADHD traits and symptoms of 26% of the total sample. Only 4.8% of children were previously diagnosed with either disorder. Among children with clinically significant ASD traits, girls were more prevalent, parents reported lower health, and the pain was more likely triggered by being in school. Among children with clinically significant ADHD symptoms, there were no gender differences and pain was more likely triggered by the family situation and new situations. No differences regarding pain intensity, duration, or frequency were found between children with and without clinically significant ASD traits or ADHD symptoms. CONCLUSION: Children with debilitating chronic pain, particularly girls, may present with an elevated risk of having a comorbid, possibly high-functioning, neurodevelopmental disorder. Results suggest that clinical assessment of pediatric chronic pain should include screening for neurodevelopmental disorders.

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  • A co-variation between pain and ASD/ADHD diagnoses was found in a Swedish study by Lisker et al.

    “A co-variation between pain and ASD/ADHD diagnoses was also found in a Swedish study performed by Lisker et al.38”

    From <p>Chronic Pain And Health-Related Quality Of Life In Women With Autism And/Or ADHD: A Prospective Longitudinal Study</p> (2019) · cites this paper as [38]

    The Results (ASD traits and ADHD symptoms combined; page unavailable) report that 26% of children at a Swedish chronic-pain clinic screened in the clinically significant range for ASD or ADHD traits. But only 4.8% had a prior diagnosis, and the Discussion says participants did not receive the assessment required for a full diagnosis. The study therefore supports co-occurring pain and traits or symptoms, not a finding of co-variation between pain and confirmed ASD/ADHD diagnoses. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Pain intensity, pain duration, pain frequency, pain sites, and perceived reasons for pain did not differ between children with and without clinically significant traits of ADHD or ASD.

    “pain intensity, pain duration, pain frequency, pain sites, and perceived reasons for pain did not differ between children with and without clinically significant traits of ADHD or ASD.38”

    From <p>Chronic Pain And Health-Related Quality Of Life In Women With Autism And/Or ADHD: A Prospective Longitudinal Study</p> (2019) · cites this paper as [38]

    The Results sections report no differences in pain intensity, duration, frequency, or sites for either group, and no difference in perceived reasons for pain onset for the ADHD group. For children with clinically significant autistic traits, however, the Results report that they were more likely to know of no reason for pain onset. Thus the claim's statement about perceived reasons does not hold for both groups. (LLM, conf=0.92)

    Experimental — accuracy not yet measured

  • Among children with ASD traits, girls were overrepresented, but among children with ADHD traits, there was no gender difference.

    “Among children with ASD traits, girls were overrepresented, but among children with ADHD traits, there was no gender difference.”

    From <p>Chronic Pain And Health-Related Quality Of Life In Women With Autism And/Or ADHD: A Prospective Longitudinal Study</p> (2019) · cites this paper as [38]

    The Abstract (Results) reports more girls among children with clinically significant ASD traits and no gender difference among those with clinically significant ADHD symptoms. The finding is limited to this clinical sample of children and adolescents with chronic pain; the claim omits both that population and the clinical-significance cutoff. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • In a sample of 146 paediatric chronic pain patients, 38 (26%) had clinical features of either ASD or ADHD, or both disorders.

    “In a sample of 146 paediatric chronic pain patients (referred to a tertiary pain clinic), 38 of the children (26% of the total sample) had clinical features of either ASD or ADHD, or both disorders.”

    From <p>Chronic Pain And Health-Related Quality Of Life In Women With Autism And/Or ADHD: A Prospective Longitudinal Study</p> (2019) · cites this paper as [38]

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Cited by

Sorted by citations

Authors
Wiwe Lipsker, C., Bölte, S., Hirvikoski, T., Lekander, M., Holmström, L., & Wicksell, R. K.
Affiliations
  • Region Stockholm (SE)
  • Stockholm University (SE)
  • Karolinska University Hospital (SE)
ORCID
Venue
Journal of Pain Research
Publisher
Informa UK Limited
Published
2018-11
Volume
Volume 11
Pages
2827-2836
ISSN
1178-7090 (ISSN-L)
DOI
10.2147/jpr.s177534
PMC
PMC6235327
OpenAlex
W2900420806
Cited by
65
References
28
Citations by year
2026: 3 · 2025: 13 · 2024: 15 · 2023: 8 · 2022: 9 · 2021: 13 · 2020: 2 · 2019: 2
FWCI
4.69
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Pain Research (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
  • eSpace (Curtin University) (submittedVersion)
Funders
  • Kommunfullmäktige, Stockholms Stad
  • Karolinska Institutet
  • Stiftelsen Sven Jerrings Fond
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
Keywords
autism spectrum disorder, attention deficit hyperactivity disorder, pediatric chronic pain, comorbidities, autistic traits, ADHD symptoms, prevalence, neurodevelopmental disorders, pain triggers, sex differences, pain clinic patients, screening

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