dyslimbic
04-29-2008, 05:38 AM
Doctors may be missing bipolar disorder in autism spectrum patients
April 2008
29 April 2008
MedWire News: Bipolar disorder is the most prevalent comorbid psychiatric condition found in young patients with autism spectrum disorder (ASD), a Japanese study has found.
This finding goes against previous research showing that depression is the main psychiatric disorder in ASD, but the team from Kanazawa University Hospital says clinicians may be overlooking manic symptoms in depressed ASD patients.
"As individuals with ASD have limited verbal communication abilities and inappropriate facial expressions, it remains uncertain whether they are verbalizing their inner experiences, such as sadness or inflated self-esteem," say T Munesue and colleagues in the Journal of Affective Disorders.
The researchers also speculate that ASD and bipolar disorder may share common etiological factors, possibly through genetic pleiotrophism.
Munesue et al evaluated 44 patients with ASD aged 12 years or older who had an intelligence quotient of 70 or higher on the Wechsler Intelligence Scale.
Patients were either referred for evaluation of ASD or sought care for psychological complaints, such as school refusal, self-injury, violence, or occupational maladaptation, but were later diagnosed as having ASD.
Of the 44 patients with ASD, nine had autistic disorder, 27 had Asperger disorder, and eight had a pervasive developmental disorder.
Assessment for mood disorders using DSM-IV criteria revealed that four patients had major depressive disorder, two had bipolar I disorder, 6 had bipolar II disorder, and four patients had bipolar disorder not otherwise specified.
Notably, all of these patients had either Asperger or pervasive developmental disorder.
Munesue et al note that both ASD and bipolar disorder are highly heritable: 90% of monozygotic twins are concordant for ASD versus 10% of dizygotic twins, while 40% of monozygotic twins are concordant for bipolar disorder versus 5.4% of dizygotic twins.
"Whether there are overlapping linkage regions between ASD and bipolar disorder may warrant investigation as additional analyses of the genetics of both disorders," Munesue et al conclude.
Journal (http://www.jad-journal.com/)
April 2008
29 April 2008
MedWire News: Bipolar disorder is the most prevalent comorbid psychiatric condition found in young patients with autism spectrum disorder (ASD), a Japanese study has found.
This finding goes against previous research showing that depression is the main psychiatric disorder in ASD, but the team from Kanazawa University Hospital says clinicians may be overlooking manic symptoms in depressed ASD patients.
"As individuals with ASD have limited verbal communication abilities and inappropriate facial expressions, it remains uncertain whether they are verbalizing their inner experiences, such as sadness or inflated self-esteem," say T Munesue and colleagues in the Journal of Affective Disorders.
The researchers also speculate that ASD and bipolar disorder may share common etiological factors, possibly through genetic pleiotrophism.
Munesue et al evaluated 44 patients with ASD aged 12 years or older who had an intelligence quotient of 70 or higher on the Wechsler Intelligence Scale.
Patients were either referred for evaluation of ASD or sought care for psychological complaints, such as school refusal, self-injury, violence, or occupational maladaptation, but were later diagnosed as having ASD.
Of the 44 patients with ASD, nine had autistic disorder, 27 had Asperger disorder, and eight had a pervasive developmental disorder.
Assessment for mood disorders using DSM-IV criteria revealed that four patients had major depressive disorder, two had bipolar I disorder, 6 had bipolar II disorder, and four patients had bipolar disorder not otherwise specified.
Notably, all of these patients had either Asperger or pervasive developmental disorder.
Munesue et al note that both ASD and bipolar disorder are highly heritable: 90% of monozygotic twins are concordant for ASD versus 10% of dizygotic twins, while 40% of monozygotic twins are concordant for bipolar disorder versus 5.4% of dizygotic twins.
"Whether there are overlapping linkage regions between ASD and bipolar disorder may warrant investigation as additional analyses of the genetics of both disorders," Munesue et al conclude.
Journal (http://www.jad-journal.com/)