An exploration of concomitant psychiatric disorders in children with autism spectrum disorder

Luc Lecavalier, Courtney E. McCracken, Michael G. Aman, Christopher J. McDougle, James T. McCracken, Elaine Tierney, Tristram Smith, Cynthia Johnson, Bryan King, Benjamin Handen, Naomi B. Swiezy, L. Eugene Arnold, Karen Bearss, Benedetto Vitiello, Lawrence Scahill

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


Objective: We explored patterns of concomitant psychiatric disorders in a large sample of treatment-seeking children and adolescents with autism spectrum disorder (ASD). Methods: Participants were 658 children with ASD (age 3–17 years; mean = 7.2 years) in one of six federally-funded multisite randomized clinical trials (RCT) between 1999 and 2014. All children were referred for hyperactivity or irritability. Study designs varied, but all used the Child and Adolescent Symptom Inventory or Early Childhood Inventory to assess Attention Deficit Hyperactivity Disorder (ADHD), Oppositional-Defiant Disorder (ODD), Conduct Disorder (CD), Anxiety Disorders, and Mood Disorders. In addition, several measures in common were used to assess demographic and clinical characteristics. Results: Of the 658 children, 73% were Caucasian and 59% had an IQ >70. The rates of concomitant disorders across studies were: ADHD 81%, ODD 46%, CD 12%, any anxiety disorder 42%, and any mood disorder 8%. Two or more psychiatric disorders were identified in 66% of the sample. Of those who met criteria for ADHD, 50% also met criteria for ODD and 46% for any anxiety disorder. Associations between types of concomitant disorders and a number of demographic and clinical characteristics are presented. Conclusion: In this well-characterized sample of treatment-seeking children with ASD, rates of concomitant psychiatric disorders were high and the presence of two or more co-occurring disorders was common. Findings highlight the importance of improving diagnostic practice in ASD and understanding possible mechanisms of comorbidity.

Original languageEnglish (US)
Pages (from-to)57-64
Number of pages8
JournalComprehensive Psychiatry
StatePublished - Jan 2019


  • Anxiety
  • Attention deficit hyperactivity disorder
  • Autism spectrum disorder
  • Comorbidity
  • Disruptive behavior
  • Psychiatric disorder

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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