Obsessions and compulsions in children with Asperger's syndrome or high-functioning autism: a case-control study

Objective: To compare the clinical characteristics and symptom severity of children with obsessive disorder (OCD) plus autism spectrum disorders (ASD) with those of children with OCD plus Tourette's syndrome (TS) or OCD alone.

Method: Children with OCD and ASD (OCD/ASD) (n = 12, mean age = 14.33, range: 12–18) were compared to children with OCD and TS (OCD/TS) (n = 12, mean age = 13.92, range: 9–17) and children with OCD-alone (OCD) (n = 12, mean age = 12.92, range: 9–17) on measures of obsessive-compulsive (OC) symptom frequency, severity, interference and other clinical variables.

Results: Patients from the OCD/ASD group rated their OC symptoms as equally distressing, time consuming and contributing to a similar level of interference in functioning as patients in the OCD/TS and OCD groups. The types of symptoms were similar across groups but patients with OCD/TS reported greater frequency of ordering and arranging compulsions, and a trend towards more sexual obsessions. Patients with OCD/ASD reported more peer relationship problems compared with the other two groups.

Conclusions: Children with ASD may experience a similar level of impairment from OC symptoms as children with TS plus OCD and children with OCD only. It is suggested that it is useful to establish both diagnoses given that obsessions and compulsions may respond to treatment, and their alleviation may improve functioning in children on the autism spectrum.