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ASD and Intellectual Disability

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Psychopathology in Adolescents and Adults with Autism Spectrum Disorders

Abstract

Intellectual disability (ID) or disorders of intellectual development, according to the most recent terminology (WHO, ICD-11 international classification of diseases (11th rev.), https://icd.who.int/, 2018), represents a meta-syndromic group of very different conditions, which share a deficit of one or more cognitive functions, prior to the acquisition of skills through learning, such as to interfere significantly, without the appropriate support, with individual functioning and adaptation. ID onsets in the first few years of life and persists across the entire life span, like autism spectrum disorder (ASD). ID and ASD frequently co-occur. Up to 35% of persons with ID have autistic pervasive features and up to 70% of persons with ASD have lower intellectual functioning in respect to the general population.

People with both ID and ASD present a higher rate of psychiatric disorders (PD), problem behaviors (PB), stereotypies, rituals, communication difficulties, and social impairment in comparison with those with ID or ASD alone. Furthermore, the co-occurrence of the two conditions has been associated with a higher probability of hospitalization and psychopharmacological treatment.

In persons with ID and ASD, the presentation of PD is quite different from the one of the general population and has been defined as atypical, chaotic, mixed, intermittent, masked, or variable. One crucial point is represented by PB, which are interpreted by some authors as possible “behavioral equivalents” of psychiatric symptoms, while other authors are more prone to always consider them as indicators of aspecific emotional stress. A careful evaluation of PB onset, course, and extinction, as well as the co-presence of other possible PD symptoms may help clinicians to distinguish; for this purpose, specific tools have been produced.

People with ID and ASD receive far more psychoactive drugs than the general population, particularly antipsychotics during adolescence and adulthood. Drugs are often prescribed to manage PB, without previous assessments of their psychopathological nature and therefore without specific indication.

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Authors and Affiliations

  1. CREA (Research and Clinical Centre), San Sebastiano Foundation, Florence, Italy

    Marco O. Bertelli

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  1. Marco O. Bertelli
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Correspondence to Marco O. Bertelli .

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Editors and Affiliations

  1. Adult Autism Centre, Mental Health Department, Local Health Unit ASL Città di Torino, Turin, Italy

    Roberto Keller

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Bertelli, M.O. (2019). ASD and Intellectual Disability. In: Keller, R. (eds) Psychopathology in Adolescents and Adults with Autism Spectrum Disorders. Springer, Cham. https://doi.org/10.1007/978-3-030-26276-1_8

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