Abstract
Individuals with autism spectrum disorder (ASD) often meet criteria for at least one additional psychiatric disorder. The present study evaluated the utility of the Mini International Neuropsychiatric Interview (MINI) in assessing co-occurring psychiatric disorders in children, adolescents, and young adults with ASD. Ninety-one percent of children/adolescents and thirty-one percent of young adults were diagnosed with one or more co-occurring diagnoses using the MINI. MINI diagnostic rates were comparable to those found in the literature on children/adolescents with ASD; however, in young adults, MINI diagnostic rates were lower relative to rates found in the literature on young adults with ASD. Implications for treatment, transitioning to adulthood, and the need for instruments developed specifically to diagnose co-occurring disorders in ASD are discussed.
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References
Aman, M. G. (2005). Treatment planning for patients with autism spectrum disorders. Journal of Clinical Psychiatry, 66(Suppl 10), 38–45.
Bardikoff, N., & McGonigle-Chalmers, M. (2014). Testing nonverbal IQ in children with Autism Spectrum Disorders. Research in Autism Spectrum Disorders, 8(9), 1200–1207.
Buck, T. R., Viskochil, J., Farley, M., Coon, H., McMahon, W. M., Morgan, J., et al. (2014). Psychiatric comorbidity and medication use in adults with autism spectrum disorder. Journal of Autism and Developmental Disorders, 44(12), 3063–3071. https://doi.org/10.1007/s10803-014-2170-2.
Burgess, S., & Cimera, R. E. (2014). Employment outcomes of transition-aged adults with autism spectrum disorders: A state of the States report. American Journal on Intellectual and Developmental Disabilities, 119(1), 64–83. https://doi.org/10.1352/1944-7558-119.1.64.
Constantino, J. N., Davis, S. A., Todd, R. D., Schindler, M. K., Gross, M. M., Brophy, S. L., et al. (2003). Validation of a brief quantitative measure of autistic traits: Comparison of the social responsiveness scale with the autism diagnostic interview-revised. Journal of Autism and Developmental Disorders, 33(4), 427–433.
Coury, D. L., Anagnostou, E., Manning-Courtney, P., Reynolds, A., Cole, L., McCoy, R., et al. (2012). Use of psychotropic medication in children and adolescents with autism spectrum disorders. Pediatrics, 130(Suppl 2), S69–76. https://doi.org/10.1542/peds.2012-0900D.
de Bruin, E. I., Ferdinand, R. F., Meester, S., de Nijs, P. F., & Verheij, F. (2007). High rates of psychiatric co-morbidity in PDD-NOS. Journal of Autism and Developmental Disorders, 37(5), 877–886. https://doi.org/10.1007/s10803-006-0215-x.
Di Martino, A., O’Connor, D., Chen, B., Alaerts, K., Anderson, J. S., Assaf, M., et al. (2017). Enhancing studies of the connectome in autism using the autism brain imaging data exchange II. Scientific Data, 4, 170010. https://doi.org/10.1038/sdata.2017.10.
Drabick, D. A., & Kendall, P. C. (2010). Developmental psychopathology and the diagnosis of mental health problems among youth. Clinical Psychology (New York), 17(4), 272–280. https://doi.org/10.1111/j.1468-2850.2010.01219.x.
Durkin, M. S., Maenner, M. J., Baio, J., Christensen, D., Daniels, J., Fitzgerald, R., et al. (2017). Autism spectrum disorder among US children (2002–2010): Socioeconomic, racial, and ethnic disparities. American Journal of Public Health, 107(11), 1818–1826. https://doi.org/10.2105/AJPH.2017.304032.
Elison, J. T., Sasson, N. J., Turner-Brown, L. M., Dichter, G., & Bodfish, J. W. (2012). Age trends in visual exploration of social and nonsocial information in children with autism. Research in Autism Spectrum Disorders, 6(2), 842–851. https://doi.org/10.1016/j.rasd.2011.11.005.
Esbensen, A. J., Greenberg, J. S., Seltzer, M. M., & Aman, M. G. (2009). A longitudinal investigation of psychotropic and non-psychotropic medication use among adolescents and adults with autism spectrum disorders. Journal of Autism and Developmental Disorders, 39(9), 1339–1349. https://doi.org/10.1007/s10803-009-0750-3.
Gadke, D. L., McKinney, C., & Oliveros, A. (2016). Autism spectrum disorder symptoms and comorbidity in emerging adults. Child Psychiatry and Human Development, 47(2), 194–201. https://doi.org/10.1007/s10578-015-0556-9.
Gjevik, E., Eldevik, S., Fjaeran-Granum, T., & Sponheim, E. (2011). Kiddie-SADS reveals high rates of DSM-IV disorders in children and adolescents with autism spectrum disorders. Journal of Autism and Developmental Disorders, 41(6), 761–769. https://doi.org/10.1007/s10803-010-1095-7.
Gotham, K., Pickles, A., & Lord, C. (2009). Standardizing ADOS scores for a measure of severity in autism spectrum disorders. Journal of Autism and Developmental Disorders, 39(5), 693–705. https://doi.org/10.1007/s10803-008-0674-3.
Gotham, K., Pickles, A., & Lord, C. (2012). Trajectories of autism severity in children using standardized ADOS scores. Pediatrics, 130(5), e1278–1284. https://doi.org/10.1542/peds.2011-3668.
Hiller, R. M., Young, R. L., & Weber, N. (2014). Sex differences in autism spectrum disorder based on DSM-5 criteria: Evidence from clinician and teacher reporting. Journal of Abnormal Child Psychology, 42(8), 1381–1393. https://doi.org/10.1007/s10802-014-9881-x.
Hofvander, B., Delorme, R., Chaste, P., Nyden, A., Wentz, E., Stahlberg, O., et al. (2009). Psychiatric and psychosocial problems in adults with normal-intelligence autism spectrum disorders. BMC Psychiatry, 9, 35. https://doi.org/10.1186/1471-244X-9-35.
Hollingshead, A. B. (1975). Four factor index of social status. New Heaven, CT: Yale University.
Hudson, C. C., Hall, L., & Harkness, K. L. (2018). Prevalence of depressive disorders in individuals with autism spectrum disorder: A meta-analysis. Journal of Abnormal Child Psychology. https://doi.org/10.1007/s10802-018-0402-1.
Hus, V., Gotham, K., & Lord, C. (2014). Standardizing ADOS domain scores: Separating severity of social affect and restricted and repetitive behaviors. Journal of Autism and Developmental Disorders, 44(10), 2400–2412. https://doi.org/10.1007/s10803-012-1719-1.
Joshi, G., Petty, C., Wozniak, J., Henin, A., Fried, R., Galdo, M., et al. (2010). The heavy burden of psychiatric comorbidity in youth with autism spectrum disorders: A large comparative study of a psychiatrically referred population. Journal of Autism and Developmental Disorders, 40(11), 1361–1370. https://doi.org/10.1007/s10803-010-0996-9.
Joshi, G., Wozniak, J., Petty, C., Martelon, M. K., Fried, R., Bolfek, A., et al. (2013). Psychiatric comorbidity and functioning in a clinically referred population of adults with autism spectrum disorders: A comparative study. Journal of Autism and Developmental Disorders, 43(6), 1314–1325. https://doi.org/10.1007/s10803-012-1679-5.
Kamio, Y., Inada, N., & Koyama, T. (2013). A nationwide survey on quality of life and associated factors of adults with high-functioning autism spectrum disorders. Autism, 17(1), 15–26. https://doi.org/10.1177/1362361312436848.
Kaufman, J., Birmaher, B., Brent, D., Rao, U., Flynn, C., Moreci, P., et al. (1997). Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): Initial reliability and validity data. Journal of the American Academy of Child and Adolescent Psychiatry, 36(7), 980–988. https://doi.org/10.1097/00004583-199707000-00021.
Kerns, C. M., & Kendall, P. C. (2012). The presentation and classification of anxiety in autism spectrum disorder. Clinical Psychology: Science and Practice, 19(4), 323–347.
Kessler, R. C., Amminger, G. P., Aguilar-Gaxiola, S., Alonso, J., Lee, S., & Ustun, T. B. (2007). Age of onset of mental disorders: A review of recent literature. Current Opinion in Psychiatry, 20(4), 359–364. https://doi.org/10.1097/YCO.0b013e32816ebc8c.
Kraper, C. K., Kenworthy, L., Popal, H., Martin, A., & Wallace, G. L. (2017). The gap between adaptive behavior and intelligence in autism persists into young adulthood and is linked to psychiatric co-morbidities. Journal of Autism and Developmental Disorders, 47(10), 3007–3017. https://doi.org/10.1007/s10803-017-3213-2.
Lainhart, J. E., Leyfer, O. T., & Folstein, S. E. (2003). Autism comorbidity Interview—Present and lifetime version (ACI-PL). Salt Lake City: University of Utah.
Leyfer, O. T., Folstein, S. E., Bacalman, S., Davis, N. O., Dinh, E., Morgan, J., et al. (2006). Comorbid psychiatric disorders in children with autism: Interview development and rates of disorders. Journal of Autism and Developmental Disorders, 36(7), 849–861. https://doi.org/10.1007/s10803-006-0123-0.
Mandell, D. S., Wiggins, L. D., Carpenter, L. A., Daniels, J., DiGuiseppi, C., Durkin, M. S., et al. (2009). Racial/ethnic disparities in the identification of children with autism spectrum disorders. American Journal of Public Health, 99(3), 493–498. https://doi.org/10.2105/AJPH.2007.131243.
Mattila, M. L., Hurtig, T., Haapsamo, H., Jussila, K., Kuusikko-Gauffin, S., Kielinen, M., et al. (2010). Comorbid psychiatric disorders associated with Asperger syndrome/high-functioning autism: A community- and clinic-based study. Journal of Autism and Developmental Disorders, 40(9), 1080–1093. https://doi.org/10.1007/s10803-010-0958-2.
Mazefsky, C. A., Kao, J., & Oswald, D. P. (2011). Preliminary evidence suggesting caution in the use of psychiatric self-report measures with adolescents with high-functioning autism spectrum disorders. Research in Autism Spectrum Disorders, 5(1), 164–174. https://doi.org/10.1016/j.rasd.2010.03.006.
Mazefsky, C. A., Oswald, D. P., Day, T. N., Eack, S. M., Minshew, N. J., & Lainhart, J. E. (2012). ASD, a psychiatric disorder, or both? Psychiatric diagnoses in adolescents with high-functioning ASD. Journal of Clinical Child & Adolescent Psychology, 41(4), 516–523. https://doi.org/10.1080/15374416.2012.686102.
McDougle, C. J., Stigler, K. A., & Posey, D. J. (2003). Treatment of aggression in children and adolescents with autism and conduct disorder. Journal of Clinical Psychiatry, 64(Suppl 4), 16–25.
Mosner, M. G., Kinard, J. L., McWeeny, S., Shah, J. S., Markiewitz, N. D., Damiano-Goodwin, C. R., et al. (2017). Vicarious effort-based decision-making in autism spectrum disorders. Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s10803-017-3220-3.
Muris, P., Steerneman, P., Merckelbach, H., Holdrinet, I., & Meesters, C. (1998). Comorbid anxiety symptoms in children with pervasive developmental disorders. Journal of Anxiety Disorders, 12(4), 387–393.
Mussey, J. L., Ginn, N. C., & Klinger, L. G. (2017). Are males and females with autism spectrum disorder more similar than we thought? Autism, 21(6), 733–737. https://doi.org/10.1177/1362361316682621.
Rosen, T. E., Mazefsky, C. A., Vasa, R. A., & Lerner, M. D. (2018). Co-occurring psychiatric conditions in autism spectrum disorder. International Review of Psychiatry, 30(1), 40–61. https://doi.org/10.1080/09540261.2018.1450229.
Sheehan, D. V., Lecrubier, Y., Sheehan, K. H., Amorim, P., Janavs, J., Weiller, E., et al. (1998). The Mini-International Neuropsychiatric Interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. The Journal of Clinical Psychiatry, 59(Suppl 20), 22–33. quiz 34–57.
Sheehan, D. V., Sheehan, K. H., Shytle, R. D., Janavs, J., Bannon, Y., Rogers, J. E., et al. (2010). Reliability and validity of the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID). Journal of Clinical Psychiatry, 71(3), 313–326. https://doi.org/10.4088/JCP.09m05305whi.
Simonoff, E., Pickles, A., Charman, T., Chandler, S., Loucas, T., & Baird, G. (2008). Psychiatric disorders in children with autism spectrum disorders: Prevalence, comorbidity, and associated factors in a population-derived sample. Journal of the American Academy of Child and Adolescent Psychiatry, 47(8), 921–929. https://doi.org/10.1097/CHI.0b013e318179964f.
Soke, G. N., Maenner, M. J., Christensen, D., Kurzius-Spencer, M., & Schieve, L. A. (2018). Prevalence of co-occurring medical and behavioral conditions/symptoms among 4- and 8-year-old children with autism spectrum disorder in selected areas of the United States in 2010. Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s10803-018-3521-1.
Stadnick, N., Chlebowski, C., Baker-Ericzen, M., Dyson, M., Garland, A., & Brookman-Frazee, L. (2017a). Psychiatric comorbidity in autism spectrum disorder: Correspondence between mental health clinician report and structured parent interview. Autism, 21(7), 841–851. https://doi.org/10.1177/1362361316654083.
Stadnick, N., Chlebowski, C., & Brookman-Frazee, L. (2017b). Caregiver-teacher concordance of challenging behaviors in children with autism spectrum disorder served in community mental health settings. Journal of Autism and Developmental Disorders, 47(6), 1780–1790. https://doi.org/10.1007/s10803-017-3101-9.
van Steensel, F. J., Bogels, S. M., & Perrin, S. (2011). Anxiety disorders in children and adolescents with autistic spectrum disorders: A meta-analysis. Clinical Child and Family Psychology Review, 14(3), 302–317. https://doi.org/10.1007/s10567-011-0097-0.
Vohra, R., Madhavan, S., & Sambamoorthi, U. (2016). Comorbidity prevalence, healthcare utilization, and expenditures of Medicaid enrolled adults with autism spectrum disorders. Autism. https://doi.org/10.1177/1362361316665222.
Funding
This research was funded by National Institutes of Health grants (Grant Numbers MH081285 and HD079124), and UNC-Chapel Hill (the Diller-Gilligan Summer Research Fellowship). In addition, this work was funded by National Institute of Mental Health (Grant Number R00MH102355 and R01MH108605). Recruitment was supported by the Clinical Translational Core of the UNC Intellectual and Developmental Disabilities Research Center (IDDRC; U54 HD079124; PI: Piven).
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Mosner, M.G., Kinard, J.L., Shah, J.S. et al. Rates of Co-occurring Psychiatric Disorders in Autism Spectrum Disorder Using the Mini International Neuropsychiatric Interview. J Autism Dev Disord 49, 3819–3832 (2019). https://doi.org/10.1007/s10803-019-04090-1
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DOI: https://doi.org/10.1007/s10803-019-04090-1