Obsessive-compulsive behaviors as common in autism as in OCD

People with high-functioning autistic-spectrum disorders (ASD) display similar levels of obsessive and compulsive behavior as those with obsessive-compulsive disorder (OCD), suggest UK study findings.

Previous studies have revealed that obsessive and repetitive behaviors are a common and disabling feature of ASD. However, it is not known how such behaviors compare with those seen in patients with OCD.

To investigate, Ailsa Russell, from the Institute of Psychiatry in London, and colleagues studied 40 patients with high-functioning ASD and an average age of 36.6 years, and 45 gender-matched patients with a primary diagnosis of OCD who were aged an average of 27.9 years.

All the participants completed the Yale-Brown Obsessive-Compulsive Scale and Symptom Checklist, and OCD behaviors were delineated from the typical behaviors and interests displayed by patients with ASD.

In all, 50% of the patients with ASD had comorbid diagnoses, of whom 27.5% were diagnosed with affective disorder, 25% with OCD, 7.5% with schizophrenia, and 10% were found to have an anxiety disorder other than OCD.

Comparing the two groups revealed that the frequencies of obsessive and compulsive behaviors were similar in ASD and OCD patients, although somatic obsessions and repeating rituals were more common in the OCD group.

The team also reports in the British Journal of Psychiatry that, although the OCD group had higher obsessive-compulsive symptom severity ratings, up to 50% of patients with ASD recorded moderate or greater levels of interference from their symptoms.

"From a therapeutic perspective, clinicians need to consider the possibility of significant obsessive-compulsive symptoms in ASD, rather than classifying repetitive phenomenology as characteristic of ASD," the researchers write.

They add: "Individuals with ASD who have distressing levels of obsessive-compulsive symptoms may benefit from standard treatments for OCD, such as serotonin reuptake inhibitors, and cognitive and behavioral therapies, but controlled trials are needed to evaluate the efficacy of these interventions in ASD."


Br J Psychiatry 2005; 186: 525-528