Symptom Profile of ADHD in Youth With High-Functioning Autism Spectrum Disorder: A Comparative Study in Psychiatrically Referred Populations
Abstract
Objective: To compare the clinical presentation of ADHD between youth with autism spectrum disorder (ASD) and ADHD and a sample of youth with ADHD only. Method: A psychiatrically referred sample of autism spectrum disorder (ASD) youth with ADHD attending a specialized ambulatory program for ASD (n = 107) and a sample of youth with ADHD attending a general child psychiatry ambulatory clinic (n = 74) were compared. Results: Seventy-six percent of youth with ASD met Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) criteria for ADHD. The clinical presentation of ADHD in youth with ASD was predominantly similar to its typical presentation including age at onset (3.5 ± 1.7 vs. 4.0 ± 1.9; p = .12), distribution of diagnostic subtypes, the qualitative and quantitative symptom profile, and symptom severity. Combined subtype was the most frequent presentation of ADHD in ASD youth. Conclusion: Despite the robust presentation of ADHD, a significant majority of ASD youth with ADHD failed to receive appropriate ADHD treatment (41% vs. 24%; p = .02). A high rate of comorbidity with ADHD was observed in psychiatrically referred youth with ASD, with a clinical presentation typical of the disorder.
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Biographies
Gagan Joshi, MD, is the medical director of the Alan and Lorraine Bressler Clinical and Research Program for Autism Spectrum Disorder and a psychiatrist in the Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD at Massachusetts General Hospital in Boston, Massachusetts. He is an assistant professor of psychiatry at Harvard Medical School, Boston and is board certified in general and child psychiatry. His clinical and research interests focus on the clinical and neural characterization and psychopharmacotheraputics of ASD and related psychopathology.
Stephen V. Faraone, PhD, is the director of the Medical Genetics Research Center and distinguished professor of psychiatry and neuroscience and physiology at SUNY Upstate Medical University, Syracuse. He is also senior scientific advisor to the Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD at Massachusetts General Hospital and a lecturer at Harvard Medical School, Boston, Massachusetts. His research contributions include psychiatric genetics, psychopharmacology, diagnostic issues, and methodology.
Janet Wozniak, MD, is the director of the Pediatric Bipolar Disorder Clinical and Research Program and director of the Child and Adolescent Psychiatry Outpatient Service at Massachusetts General Hospital, Boston, Massachusetts. She is an associate professor of psychiatry at Harvard Medical School and a clinical and research psychiatrist. Dr. Wozniak’s research focuses on the characteristics, longitudinal course, and treatment of pediatric bipolar disorder.
Laura Tarko, MPH, worked as a biostatistician in the Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD at Massachusetts General Hospital in Boston, Massachusetts.
Ronna Fried, EdD, is the director of neuropsychology in the Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD at Massachusetts General Hospital, Boston, Massachusetts. She oversees, trains, and supervises psychometricians that assess thousands of participants in the program every year for both clinical and research purposes. She is also an associate professor of psychology at Harvard Medical School, Boston, Massachusetts.
Maribel Galdo, MA, LCSW, is the director of business and operations of the Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD at Massachusetts General Hospital in Boston, Massachusetts.
Stephannie L. Furtak, BA, is a clinical research coordinator in the Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD at Massachusetts General Hospital in Boston, Massachusetts.
Joseph Biederman, MD, is the chief of the Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD and director of the Alan and Lorraine Bressler Clinical and Research Program for Autism Spectrum Disorders at Massachusetts General Hospital, Boston, Massachusetts. He is a professor of psychiatry at Harvard Medical School, Boston and is board certified in general and child psychiatry. His clinical and research interests include ADHD in children and adults and pediatric mood and anxiety disorders.
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Article first published online: August 1, 2014
Issue published: August 2017
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