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Open Access 01-09-2017 | Review

Medical comorbidities in children and adolescents with autism spectrum disorders and attention deficit hyperactivity disorders: a systematic review

Authors: Jet B. Muskens, Fleur P. Velders, Wouter G. Staal

Published in: European Child & Adolescent Psychiatry | Issue 9/2017

Abstract

Somatic disorders occur more often in adult psychiatric patients than in the general adult population. However, in child and adolescent psychiatry this association is unclear, mainly due to a lack of integration of existing data. To address this issue, we here present a systematic review on medical comorbidity in the two major developmental disorders autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) and formulate clinical recommendations. The literature was searched using the PubMed and PsycINFO databases (2000–1 May 2016) with the keywords “[((child and adolescent) AND (Autism OR Attention Deficit Hyperactivity Disorder* OR ADHD)) AND (“Cardiovascular Diseases” [Mesh] OR “Endocrine System Diseases” [Mesh] OR “Immune System Diseases” [Mesh] OR “Neurobehavioral Manifestations” [Mesh] OR “Gastrointestinal Disorders” [Mesh] OR Somatic OR Autoimmune disease OR Nervous system disease OR Infection OR Infectious disease)]. Two raters independently assessed the quality of the eligible studies. The initial search identified 5278 articles. Based on inclusion and exclusion criteria 104 papers were selected and subsequently subjected to a quality control. This quality was assessed according to a standardized and validated set of criteria and yielded 29 studies for inclusion. This thorough literature search provides an overview of relevant articles on medical comorbidity in ADHD and/or ASD, and shows that medical disorders in these children and adolescents appear to be widespread. Those who work with children with ASD and/or ADHD should be well aware of this and actively promote routine medical assessment. Additionally, case–control studies and population-based studies are needed to provide reliable prevalence estimates. Future studies should furthermore focus on a broader evaluation of medical disorders in children and adolescents with ADHD and/or ASD to improve treatment algorithm in this vulnerable group.

Ferguson B, Dudleston K (1986) Detection of physical disorder in newly admitted psychiatric patients. Acta Psychiatr Scand 74(5):485–489CrossRefPubMed

Hall RC, Popkin MK, Devaul RA, Faillace LA, Stickney SK (1978) Physical illness presenting as psychiatric disease. Arch Gen Psychiatry 35(11):1315–1320CrossRefPubMed

Krummel S, Kathol RG (1987) What you should know about physical evaluations in psychiatric patients. Results of a survey. Gen Hosp Psychiatry 9(4):275–279CrossRefPubMed

Sternberg DE (1986) Testing for physical illness in psychiatric patients. J Clin Psychiatry 47(1 Suppl):3–9PubMed

Druss BG, Walker ER (2011) Mental disorders and medical comorbidity. Synth Project Res Synth Rep 21:1–26

Jackson IM (1998) The thyroid axis and depression. Thyroid Off J Am Thyroid Assoc 8(10):951–956. doi:10.1089/thy.1998.8.951 CrossRef

Surks MI, Ortiz E, Daniels GH, Sawin CT, Col NF, Cobin RH, Franklyn JA, Hershman JM, Burman KD, Denke MA, Gorman C, Cooper RS, Weissman NJ (2004) Subclinical thyroid disease: scientific review and guidelines for diagnosis and management. JAMA 291(2):228–238. doi:10.1001/jama.291.2.228 CrossRefPubMed

Gentile S (2006) Long-term treatment with atypical antipsychotics and the risk of weight gain: a literature analysis. Drug Saf 29(4):303–319CrossRefPubMed

Muench J, Hamer AM (2010) Adverse effects of antipsychotic medications. Am Fam Phys 81(5):617–622

10.

Daumit GL, Goldberg RW, Anthony C, Dickerson F, Brown CH, Kreyenbuhl J, Wohlheiter K, Dixon LB (2005) Physical activity patterns in adults with severe mental illness. J Nerv Ment Dis 193(10):641–646CrossRefPubMed

11.

Compton MT, Daumit GL, Druss BG (2006) Cigarette smoking and overweight/obesity among individuals with serious mental illnesses: a preventive perspective. Harv Rev Psychiatry 14(4):212–222. doi:10.1080/10673220600889256 CrossRefPubMed

12.

Rutter M, Tizard J, Yule W, Graham P, Whitmore K (1976) Research report: Isle of Wight Studies, 1964–1974. Psychol Med 6(2):313–332CrossRefPubMed

13.

Jones JE, Watson R, Sheth R, Caplan R, Koehn M, Seidenberg M, Hermann B (2007) Psychiatric comorbidity in children with new onset epilepsy. Dev Med Child Neurol 49(7):493–497. doi:10.1111/j.1469-8749.2007.00493.x CrossRefPubMed

14.

Rutter MG, Yule W (1970) A neuropsychiatric study in childhood. Clinics in developmental medicine nos. 35/36. William Heinemann Medical Books, SIMP, London

15.

Rodenburg R, Stams GJ, Meijer AM, Aldenkamp AP, Dekovic M (2005) Psychopathology in children with epilepsy: a meta-analysis. J Pediatr Psychol 30(6):453–468. doi:10.1093/jpepsy/jsi071 CrossRefPubMed

16.

Yaghmaie P, Koudelka CW, Simpson EL (2013) Mental health comorbidity in patients with atopic dermatitis. J Allergy Clin Immunol 131(2):428–433. doi:10.1016/j.jaci.2012.10.041 CrossRefPubMed

17.

McQuaid EL, Kopel SJ, Nassau JH (2001) Behavioral adjustment in children with asthma: a meta-analysis. JDBP 22(6):430–439PubMed

18.

Mitchell RH, Goldstein BI (2014) Inflammation in children and adolescents with neuropsychiatric disorders: a systematic review. J Am Acad Child Adolesc Psychiatry 53(3):274–296CrossRefPubMed

19.

Bruijn J, Locher H, Passchier J, Dijkstra N, Arts W-F (2010) Psychopathology in children and adolescents with migraine in clinical studies: a systematic review. Pediatrics 126(2):323–332CrossRefPubMed

20.

Genizi J, Gordon S, Kerem NC, Srugo I, Shahar E, Ravid S (2013) Primary headaches, attention deficit disorder and learning disabilities in children and adolescents. J Headache Pain 14:54. doi:10.1186/1129-2377-14-54 CrossRefPubMedPubMedCentral

21.

Scharko AM (2006) DSM psychiatric disorders in the context of pediatric HIV/AIDS. AIDS Care 18(5):441–445. doi:10.1080/09540120500213487 CrossRefPubMed

22.

Vissoker RE, Latzer Y, Gal E (2015) Eating and feeding problems and gastrointestinal dysfunction in Autism Spectrum Disorders. Res Autism Spectr Disord 12:10–21CrossRef

23.

Stigler KA, Sweeten TL, Posey DJ, McDougle CJ (2009) Autism and immune factors: a comprehensive review. Res Autism Spectr Disord 3(4):840–860CrossRef

24.

Antshel KM (2010) ADHD, learning, and academic performance in phenylketonuria. Mol Genet Metab 99(Suppl 1):S52–S58. doi:10.1016/j.ymgme.2009.09.013 CrossRefPubMed

25.

Aldinger KA, Lane CJ, Veenstra-VanderWeele J, Levitt P (2015) Patterns of risk for multiple co-occurring medical conditions replicate across distinct cohorts of children with Autism Spectrum Disorder. Autism Res 8(6):771–781CrossRefPubMedPubMedCentral

26.

Buie T, Campbell DB, Fuchs GJ 3rd, Furuta GT, Levy J, Vandewater J, Whitaker AH, Atkins D, Bauman ML, Beaudet AL, Carr EG, Gershon MD, Hyman SL, Jirapinyo P, Jyonouchi H, Kooros K, Kushak R, Levitt P, Levy SE, Lewis JD, Murray KF, Natowicz MR, Sabra A, Wershil BK, Weston SC, Zeltzer L, Winter H (2010) Evaluation, diagnosis, and treatment of gastrointestinal disorders in individuals with ASDs: a consensus report. Pediatrics 125(Suppl 1):S1–S18. doi:10.1542/peds.2009-1878C CrossRefPubMed

27.

Schieve LA, Gonzalez V, Boulet SL, Visser SN, Rice CE, Van Naarden BK, Boyle CA (2012) Concurrent medical conditions and health care use and needs among children with learning and behavioral developmental disabilities, National Health Interview Survey, 2006–2010. Res Dev Disabil 33(2):467–476. doi:10.1016/j.ridd.2011.10.008 CrossRefPubMed

28.

Merikangas KR, Calkins ME, Burstein M, He JP, Chiavacci R, Lateef T, Ruparel K, Gur RC, Lehner T, Hakonarson H, Gur RE (2015) Comorbidity of physical and mental disorders in the neurodevelopmental genomics cohort study. Pediatrics 135(4):e927–e938. doi:10.1542/peds.2014-1444 CrossRefPubMedPubMedCentral

29.

Konrad K, Eickhoff SB (2010) Is the ADHD brain wired differently? A review on structural and functional connectivity in attention deficit hyperactivity disorder. Hum Brain Map 31(6):904–916. doi:10.1002/hbm.21058 CrossRef

30.

Reilly C, Atkinson P, Das KB, Chin RF, Aylett SE, Burch V, Gillberg C, Scott RC, Neville BG (2014) Neurobehavioral comorbidities in children with active epilepsy: a population-based study. Pediatrics 133(6):e1586–e1593. doi:10.1542/peds.2013-3787 CrossRefPubMed

31.

Talkowski ME, Rosenfeld JA, Blumenthal I, Pillalamarri V, Chiang C, Heilbut A, Ernst C, Hanscom C, Rossin E, Lindgren AM, Pereira S, Ruderfer D, Kirby A, Ripke S, Harris DJ, Lee JH, Ha K, Kim HG, Solomon BD, Gropman AL, Lucente D, Sims K, Ohsumi TK, Borowsky ML, Loranger S, Quade B, Lage K, Miles J, Wu BL, Shen Y, Neale B, Shaffer LG, Daly MJ, Morton CC, Gusella JF (2012) Sequencing chromosomal abnormalities reveals neurodevelopmental loci that confer risk across diagnostic boundaries. Cell 149(3):525–537. doi:10.1016/j.cell.2012.03.028 CrossRefPubMedPubMedCentral

32.

Mick E, Biederman J, Prince J, Fischer MJ, Faraone SV (2002) Impact of low birth weight on attention-deficit hyperactivity disorder. JDBP 23(1):16–22PubMed

33.

Indredavik MS, Vik T, Evensen KA, Skranes J, Taraldsen G, Brubakk AM (2010) Perinatal risk and psychiatric outcome in adolescents born preterm with very low birth weight or term small for gestational age. JDBP 31(4):286–294. doi:10.1097/DBP.0b013e3181d7b1d3 PubMed

34.

Cross-Disorder Group of the Psychiatric Genomics Consortium (2013) Identification of risk loci with shared effects on five major psychiatric disorders: a genome-wide analysis. Lancet 381(9875):1371–1379. doi:10.1016/s0140-6736(12)62129-1 CrossRefPubMedCentral

35.

Muskens JB, Vermeulen K, van Deurzen PA, Tomesen EM, van der Gaag RJ, Buitelaar JK, Staal WG (2015) Somatic screening in child and adolescent psychiatry: a descriptive pilot study. Tijdschrift voor psychiatrie 57(10):710–718PubMed

36.

Diagnostic and Statistical Manual of Mental Disorders (1994) 4th edition, Text Revision (DSM-IV-TR). American Psychiatric Association, Washington, DC

37.

Diagnostic and Statistical Manual of Mental Disorders (2000) 4th rev. edition, Text Revision (DSM-IV-TR). American Psychiatric Association, Washington, DC

38.

Diagnostic and Statistical Manual of Mental Disorders (5th ed.) (2013) American Psychiatric Association, Washington, DC

39.

International Statistical Classification of Disease and Related Health Problems, 10th revision (ICD-10) (1992). World Health Organisation, Geneva

40.

Higgins JPTGS (2011) Cochrane handbook for systematic reviews of interventions version 5.1.0 [updated March 2011]. The Cochrane Collaboration

41.

Jyonouchi H, Geng L, Cushing-Ruby A, Quraishi H (2008) Impact of innate immunity in a subset of children with autism spectrum disorders: a case control study. J Neuroinflamm 5:52. doi:10.1186/1742-2094-5-52 CrossRef

42.

Chen MH, Su TP, Chen YS, Hsu JW, Huang KL, Chang WH, Chen TJ, Pan TL, Bai YM (2014) Is atopy in early childhood a risk factor for ADHD and ASD? A longitudinal study. J Psychosom Res 77(4):316–321. doi:10.1016/j.jpsychores.2014.06.006 CrossRefPubMed

43.

Gentile I, Zappulo E, Bonavolta R, Maresca R, Riccio MP, Buonomo AR, Portella G, Vallefuoco L, Settimi A, Pascotto A, Borgia G, Bravaccio C (2014) Prevalence of herpes simplex virus 1 and 2 antibodies in patients with autism spectrum disorders. In vivo (Athens, Greece) 28(4):667–671

44.

Puig-Alcaraz C, Fuentes-Albero M, Calderon J, Garrote D, Cauli O (2015) Increased homocysteine levels correlate with the communication deficit in children with autism spectrum disorder. Psychiatry Res 229(3):1031–1037. doi:10.1016/j.psychres.2015.05.021 CrossRefPubMed

45.

Zerbo O, Leong A, Barcellos L, Bernal P, Fireman B, Croen LA (2015) Immune mediated conditions in autism spectrum disorders. Brain Behav Immun 46:232–236. doi:10.1016/j.bbi.2015.02.001 CrossRefPubMedPubMedCentral

46.

Valicenti-McDermott M, McVicar K, Rapin I, Wershil BK, Cohen H, Shinnar S (2006) Frequency of gastrointestinal symptoms in children with autistic spectrum disorders and association with family history of autoimmune disease. JDBP 27(2 Suppl):S128–S136PubMed

47.

Mouridsen S, Rich B, Isager T (2010) A longitudinal study of gastrointestinal diseases in individuals diagnosed with infantile autism as children. Child Care Health Dev 36(3):437–443CrossRefPubMed

48.

Chandler S, Carcani-Rathwell I, Charman T, Pickles A, Loucas T, Meldrum D, Simonoff E, Sullivan P, Baird G (2013) Parent-reported gastro-intestinal symptoms in children with autism spectrum disorders. J Autism Dev Disord 43(12):2737–2747CrossRefPubMed

49.

Mouridsen SE, Isager T, Rich B (2013) Diseases of the gastrointestinal tract in individuals diagnosed as children with atypical autism: a Danish register study based on hospital diagnoses. Autism 17(1):55–63CrossRefPubMed

50.

von Gontard A, Pirrung M, Niemczyk J, Equit M (2015) Incontinence in children with autism spectrum disorder. J Pediatr Urol 11(5):264.e261–267. doi:10.1016/j.jpurol.2015.04.015

51.

Mouridsen SE, Rich B, Isager T (2013) Epilepsy in individuals with a history of Asperger’s syndrome: a Danish nationwide register-based cohort study. J Autism Dev Disord 43(6):1308–1313CrossRefPubMed

52.

van Tongerloo MA, Bor HH, Lagro-Janssen AL (2012) Detecting autism spectrum disorders in the general practitioner’s practice. J Autism Dev Disord 42(8):1531–1538CrossRefPubMed

53.

Butwicka A, Lichtenstein P, Landen M, Nordenvall AS, Nordenstrom A, Nordenskjold A, Frisen L (2015) Hypospadias and increased risk for neurodevelopmental disorders. J Child Psychol Psychiatry 56(2):155–161. doi:10.1111/jcpp.12290 CrossRefPubMed

54.

Leslie DL, Kozma L, Martin A, Landeros A, Katsovich L, King RA, Leckman JF (2008) Neuropsychiatric disorders associated with streptococcal infection: a case–control study among privately insured children. J Am Acad Child Adolesc Psychiatry 47(10):1166–1172. doi:10.1097/CHI.0b013e3181825a3d CrossRefPubMedPubMedCentral

55.

Sanchez-Carpintero R, Albesa SA, Crespo N, Villoslada P, Narbona J (2009) A preliminary study of the frequency of anti-basal ganglia antibodies and streptococcal infection in attention deficit/hyperactivity disorder. J Neurol 256(7):1103–1108. doi:10.1007/s00415-009-5076-8 CrossRefPubMed

56.

Schmitt J, Romanos M, Schmitt NM, Meurer M, Kirch W (2009) Atopic eczema and attention-deficit/hyperactivity disorder in a population-based sample of children and adolescents. JAMA 301(7):724–726. doi:10.1001/jama.2009.136 CrossRefPubMed

57.

Suwan P, Akaramethathip D, Noipayak P (2011) Association between allergic sensitization and attention deficit hyperactivity disorder (ADHD). Asian Pac J Allergy Immunol/Launch Allergy Immunol Soc Thailand 29(1):57–65

58.

Tsai MC, Lin HK, Lin CH, Fu LS (2011) Prevalence of attention deficit/hyperactivity disorder in pediatric allergic rhinitis: a nationwide population-based study. Allergy Asthma Proc Off J Region State Allergy Soc 32(6):41–46. doi:10.2500/aap.2011.32.3489 CrossRef

59.

Shyu CS, Lin HK, Lin CH, Fu LS (2012) Prevalence of attention-deficit/hyperactivity disorder in patients with pediatric allergic disorders: a nationwide, population-based study. Journal of microbiology, immunology, and infection. Wei mian yu gan ran za zhi 45(3):237–242. doi:10.1016/j.jmii.2011.11.008 CrossRefPubMed

60.

Chen HJ, Lee YJ, Yeh GC, Lin HC (2013) Association of attention-deficit/hyperactivity disorder with diabetes: a population-based study. Pediatr Res 73(4 Pt 1):492–496. doi:10.1038/pr.2013.5 CrossRefPubMed

61.

Chen MH, Su TP, Chen YS, Hsu JW, Huang KL, Chang WH, Bai YM (2013) Attention deficit hyperactivity disorder, tic disorder, and allergy: is there a link? A nationwide population-based study. J Child Psychol Psychiatry 54(5):545–551. doi:10.1111/jcpp.12018 CrossRefPubMed

62.

Tsai JD, Chang SN, Mou CH, Sung FC, Lue KH (2013) Association between atopic diseases and attention-deficit/hyperactivity disorder in childhood: a population-based case–control study. Ann Epidemiol 23(4):185–188. doi:10.1016/j.annepidem.2012.12.015 CrossRefPubMed

63.

Bekdas M, Tufan AE, Hakyemez IN, Tas T, Altunhan H, Demircioglu F, Kismet E (2014) Subclinical immune reactions to viral infections may correlate with child and adolescent diagnosis of attention-deficit/hyperactivity disorder: a preliminary study from Turkey. Afr Health Sci 14(2):439–445. doi:10.4314/ahs.v14i2.21 CrossRefPubMedPubMedCentral

64.

DeMaso DR, Labella M, Taylor GA, Forbes PW, Stopp C, Bellinger DC, Rivkin MJ, Wypij D, Newburger JW (2014) Psychiatric disorders and function in adolescents with d-transposition of the great arteries. J Pediatr 165(4):760–766. doi:10.1016/j.jpeds.2014.06.029 CrossRefPubMedPubMedCentral

65.

Dillon JE, Blunden S, Ruzicka DL, Guire KE, Champine D, Weatherly RA, Hodges EK, Giordani BJ, Chervin RD (2007) DSM-IV diagnoses and obstructive sleep apnea in children before and 1 year after adenotonsillectomy. J Am Acad Child Adolesc Psychiatry 46(11):1425–1436CrossRefPubMedPubMedCentral

66.

Silva D, Colvin L, Hagemann E, Stanley F, Bower C (2014) Children diagnosed with attention deficit disorder and their hospitalisations: population data linkage study. Eur Child Adolesc Psychiatry 23(11):1043–1050CrossRefPubMed

67.

Gillberg C, Billstedt E (2000) Autism and Asperger syndrome: coexistence with other clinical disorders. Acta Psychiatr Scand 102(5):321–330CrossRefPubMed

68.

Petersen MC, Kube DA, Whitaker TM, Graff JC, Palmer FB (2009) Prevalence of developmental and behavioral disorders in a pediatric hospital. Pediatrics 123(3):e490–e495. doi:10.1542/peds.2008-2750 CrossRefPubMed

69.

Blackmer AB, Feinstein JA (2016) Management of sleep disorders in children with neurodevelopmental disorders: a review. Pharmacotherapy 36(1):84–98. doi:10.1002/phar.1686 CrossRefPubMed

70.

Cadman D, Boyle M, Szatmari P, Offord DR (1987) Chronic illness, disability, and mental and social well-being: findings of the Ontario Child Health Study. Pediatrics 79(5):805–813PubMed

71.

Cohen D, Pichard N, Tordjman S, Baumann C, Burglen L, Excoffier E, Lazar G, Mazet P, Pinquier C, Verloes A, Heron D (2005) Specific genetic disorders and autism: clinical contribution towards their identification. J Autism Dev Disord 35(1):103–116CrossRefPubMed

Title: Medical comorbidities in children and adolescents with autism spectrum disorders and attention deficit hyperactivity disorders: a systematic review
Authors: Jet B. Muskens
Fleur P. Velders
Wouter G. Staal
Publication date: 01-09-2017
Publisher: Springer Berlin Heidelberg
Published in: European Child & Adolescent Psychiatry / Issue 9/2017
Print ISSN: 1018-8827
Electronic ISSN: 1435-165X
DOI: https://doi.org/10.1007/s00787-017-1020-0

At a glance: The STEP trials

Springer Medicine

Medical comorbidities in children and adolescents with autism spectrum disorders and attention deficit hyperactivity disorders: a systematic review

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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