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- Bejerot, Susanne, 1955-
(author)
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An autistic dimension : a proposed subtype of obsessive-compulsive disorder
- 2007
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In: Autism. - London, United Kingdom : Sage Publications. - 1362-3613 .- 1461-7005. ; 11:2, s. 101-110
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Journal article (peer-reviewed)abstract
- This article focuses on the possibility that autism spectrum disorder (ASD: Asperger syndrome, autism and atypical autism) in its milder forms may be clinically important among a substantial proportion of patients with obsessive-compulsive disorder (OCD), and discusses OCD subtypes based on this proposition. The hypothesis derives from extensive clinical experience of OCD and ASD, and literature searches on MEDLINE. Neuropsychological deficits are more common in OCD than in panic disorder and depression. Moreover, obsessive-compulsive and schizotypal personality disorders are over-represented in OCD. These may constitute mis-perceived clinical manifestations of ASD. Furthermore, repetitive behaviours and hoarding are common in Asperger syndrome. It is suggested that the comorbidity results in a more severe and treatment resistant form of OCD. OCD with comorbid ASD should be recognized as a valid OCD subtype, analogous to OCD with comorbid tics. An odd personality, with paranoid, schizotypal, avoidant or obsessive-compulsive traits, may indicate these autistic dimensions in OCD patients.
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- Bejerot, Susanne, 1955-, et al.
(author)
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Do autistic traits play a role in the bullying of obsessive-compulsive disorder and social phobia sufferers?
- 2009
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In: Psychopathology. - Basel, Switzerland : S. Karger. - 0254-4962 .- 1423-033X. ; 42:3, s. 170-176
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Journal article (peer-reviewed)abstract
- Background: Social phobia and obsessive-compulsive disorder (OCD) share several similarities: both are categorized as anxiety disorders, avoidant personality disorder and depression are common in both, they have a similar age of onset and course, and both disorders respond to treatments with serotonin reuptake inhibitors and cognitive behavioural therapy. However, OCD and social phobia differ in respect to their relation to autism spectrum disorders (ASD; i.e. Asperger's syndrome, autism, pervasive disorder not otherwise specified). Findings that suggest a link between OCD and ASD have no parallel in social phobia. Moreover, obsessive-compulsive, paranoid and schizotypal personality disorders are prevalent in OCD and in ASD, but not in social phobia. Individuals with ASD are known to be frequent targets of bullying. We hypothesised that individuals with autistic traits would have been frequent targets for bullies during their childhood, as opposed to people without such traits.Methods: Adult patients with social phobia (n = 63) or OCD (n = 65) were assessed regarding autistic traits, and interviewed about being bullied at school. A reference group (n = 551) responded to questions about being bullied.Results: There was a significant difference in the prevalence of being bullied between OCD (50%), social phobia patients (20%) and the reference group (27%). Autistic traits were more common in OCD than in social phobia. A history of being bullied was related to autistic traits among patients.Conclusions: Falling victim to bullying is not a random event. Autistic traits, i.e. low social skills, may be a predictor of being bullied in school. The high rate of bullying victims in persons who later develop OCD is suggested to be related to the overlap between OCD and ASD.
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- Gardner, Ann, et al.
(author)
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Differences at brain SPECT between depressed females with and without adult ADHD and healthy controls : etiological considerations
- 2009
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In: Behavioral and Brain Functions. - London, United Kingdom : BioMed Central (BMC). - 1744-9081. ; 5
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Journal article (peer-reviewed)abstract
- Background: Comorbidity between Attention Deficit Hyperactivity Disorder (ADHD) and mood disorders is common. Alterations of the cerebellum and frontal regions have been reported in neuro-imaging studies of ADHD and major depression.Methods: Thirty chronically depressed adult females of whom 16 had scores below, and 14 scores above, cut-offs on the 25-items Wender Utah Retrospective Scale (WURS-25) and the Wender-Reimherr Adult Attention Deficit Disorder Scale (WRAADDS) were divided into subgroups designated "Depression" and "Depression + ADHD", respectively. Twenty-one of the patients had some audiological symptom, tinnitus and/or hearing impairment. The patients were investigated with other rating scales and 99mTc-HMPAO SPECT. Controls for 99mTc-HMPAO SPECT were 16 healthy females. SPECT was analyzed by both statistical parametric mapping (SPM2) and the computerized brain atlas (CBA). Discriminant analysis was performed on the volumes of interest generated by the CBA, and on the scores from rating scales with the highest group differences.Results: The mean score of a depression rating scale (MADRS-S) was significantly lower in the "Depression" subgroup compared to in the "Depression + ADHD" subgroup. There was significantly decreased tracer uptake within the bilateral cerebellum at both SPM and CBA in the "Depression + ADHD" subgroup compared to in the controls. No decrease of cerebellar tracer uptake was observed in "Depression". Significantly increased tracer uptake was found at SPM within some bilateral frontal regions (Brodmann areas 8, 9, 10, 32) in the "Depression + ADHD" subgroup compared to in "Depression". An accuracy of 100% was obtained for the discrimination between the patient groups when thalamic uptake was used in the analysis along with scores from Socialization and Impulsivity scales.Conclusions: The findings confirm the previous observation of a cerebellar involvement in ADHD. Higher bilateral frontal 99mTc-HMPAO uptake in "Depression + ADHD" compared to in "Depression" indicate a difference between these subgroups. 99mTc-HMPAO uptake mechanisms are discussed.
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- Mörtberg, Ewa, et al.
(author)
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Temperament and character dimensions in patients with social phobia : patterns of change following treatments?
- 2007
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In: Psychiatry Research. - Clare, Ireland : Elsevier. - 0165-1781 .- 1872-7123. ; 152:1, s. 81-90
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Journal article (peer-reviewed)abstract
- The aim of this study was to examine Temperament and Character Inventory (TCI) profiles in patients with social phobia (DSM-IV) and to outline patterns of change following intensive group cognitive therapy (IGCT), individual cognitive therapy (ICT) and treatment as usual (TAU). One hundred patients recruited by advertisements in local papers were randomized to IGCT, ICT and TAU. Patients (n=59) who completed diagnostic evaluation and TCI assessments at baseline and 1-year follow-up were examined in this study. Patients differed from healthy controls in novelty seeking (NS), harm avoidance (HA), self-directedness (SD), cooperativeness (C), and self-transcendence (ST). Treatments overall were associated with decrease in HA, while increase in SD was observed after psychotherapy only. Reduced social anxiety was correlated with decrease in HA and increase in SD. High HA at baseline was related to poor treatment outcome in all treatments. To conclude, patients with social phobia show a temperamental vulnerability for developing anxiety and character traits associated with personality disorders. Successful treatment is related to decrease in HA and increase in SD. High HA at baseline may suggest a need for extensive treatment in order to achieve remission.
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| 16. |
- Rydén, E., et al.
(author)
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A history of childhood attention-deficit hyperactivity disorder (ADHD) impacts clinical outcome in adult bipolar patients regardless of current ADHD
- 2009
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In: Acta Psychiatrica Scandinavica. - Malden, USA : Wiley-Blackwell. - 0001-690X .- 1600-0447. ; 120:3, s. 239-246
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Journal article (peer-reviewed)abstract
- Objective: The occurrence of comorbid attention-deficit hyperactivity disorder (ADHD) might have an impact of the course of the bipolar disorder.Method: Patients with bipolar disorder (n = 159) underwent a comprehensive evaluation with respect to affective symptoms. Independent psychiatrists assessed childhood and current ADHD, and an interview with a parent was undertaken.Results: The prevalence of adult ADHD was 16%. An additional 12% met the criteria for childhood ADHD without meeting criteria for adult ADHD. Both these groups had significantly earlier onset of their first affective episode, more frequent affective episodes (except manic episodes), and more interpersonal violence than the bipolar patients without a history of ADHD.Conclusion: The fact that bipolar patients with a history of childhood ADHD have a different clinical outcome than the pure bipolar group, regardless of whether the ADHD symptoms remained in adulthood or not, suggests that it represent a distinct early-onset phenotype of bipolar disorder.
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| 17. |
- Rydén, E., et al.
(author)
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Autism spectrum disorder in an adult psychiatric population : A naturalistic cross sectional controlled study
- 2008
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In: Clinical Neuropsychiatry. - 1724-4935. ; 5:1, s. 13-21
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Journal article (peer-reviewed)abstract
- Object: Autism spectrum disorders (ASD) e.g. autism, Asperger syndrome, and Pervasive developmental disorder not otherwise specified, have yet to become a focus of attention in clinical adult psychiatry. The aims of the present study were firstly to characterize psychiatric patients with ASD in regard to demographical factors, psychiatric comorbidity and personality traits and compare the ASD group with a psychiatric control group in these respects. Secondly. we wanted to compare differences of personalily traits between females and males in the ASD group.Method: Adult psychiatric patients where ASD or attention deficit hyperactivily disorder (ADHD) was suspected were referred to a tertiary unit in Stockholm 2001-2006. All patients diagnosed at the unit with ASD (n=84; 39 females and 45 males) were consecutively included and compared to all 46 identically interviewed and assessed patients who did not receive an ASD or ADHD diagnosis. Among scales used were the Global Assessment of Functioning (GAF), SCID II Screen, and Swedish universities Scales of Personality (SSP).Results: ASD patients had an equal educational level but a lower social and occupational functioniug. Their GAF scores were significantly lower compared to the control group. Prior to referral, major depressive disorder and obsessive-compulsive disorders were the most common psychiatric diagnoses. In the assessment approximately 1/3 fulfilled diagnostic criteria for comorbid ADHD. The patients with ASD also had significantly more schizotypal and avoidant personality traits according to SCID II screen. In SSP, patients with ASD rated themselves significantly higher on Stress-susceptibility, Embitterment, Detachment, Trait irritability and Lack of assertiveness than controls. Females with ASD scored significantly higher than males on borderline and passive-aggressive traits according to the SCID II Screen and on Embitterment and Trait irritability m the SSP.Conclusions: We could show that psychiatric patients with ASD have a low level of functioning and a personality profile which is gender specific. This may contribute to the identification and understanding of patients with ASD in adult psychiatry.
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| 18. |
- Sahlander, Carina, et al.
(author)
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Motor function in adults with Asperger's disorder : a comparative study
- 2008
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In: Physiotherapy Theory and Practice. - Philadelphia, USA : Taylor & Francis. - 0959-3985 .- 1532-5040. ; 24:2, s. 73-81
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Journal article (peer-reviewed)abstract
- In the original description of Asperger's disorder (AD), clumsiness was an associated feature. Several studies of children have shown deficits in motor control, whereas research regarding adults is scarce. The aim of the present study was to compare motor function in adults with AD, with a normal comparison group. Gross and fine motor skills were examined by a standardized, norm referenced test developed for children, but also used in young adults, the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP). In addition, a questionnaire regarding the participants' physical activity during leisure time was administered. We found that adults (age 21-35) with AD (N = 15) performed significantly worse than the normal comparison group (N = 29) in six of eight subtests in the BOTMP. Males with AD were less physically active than males in the comparison group. Among females, physical activity did not differ between the groups. There was a positive association between physical activity and gross motor function in the AD group. Participants with AD were encouraged by the assessments. Physical coaching may be an important future field for improving quality of life in adults with AD.
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