Differentiation of autism spectrum disorder and mood or anxiety disorder.
Sarah Wittkopf, Sanna Stroth, Anika Langmann and 5 others
PMID 34404245WHAT IT FOUND
Standard autism tests often flag mood and anxiety disorders as autism.
For children, specific items like stereotyped words and poor social overtures best separate the two. For adolescents and adults, tests are less accurate, so rely on direct observation of social communication rather than scores alone.
Key findings
01Approximately 17% of patients diagnosed with mood or anxiety disorders met the cutoff for autism on the ADOS, with anxiety disorders showing the highest overlap.
02In children (Module 3), six specific items including stereotyped use of words and quality of social overtures discriminated well between autism and mood/anxiety disorders.
03In adolescents and adults (Module 4), classification accuracy was lower, with five items such as amount of reciprocal social communication and insight being the primary discriminators.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The sample consisted of patients referred for suspected ASD, so results do not apply to the general population of people with mood or anxiety disorders. Individuals with both ASD and mood/anxiety disorders were excluded, so findings do not apply to comorbid cases. The study did not analyze differences between specific mood and anxiety subtypes. Gender differences were not analyzed due to sample distribution. The eight most discriminative items identified need validation in an independent sample.
Declared interests
Author L.P. received conference support/speaking fees from Shire and royalties from Hogrefe, Kohlhammer, and Schattauer. Author V.R. received consulting/writing payments and lecture honoraria from Lilly, Novartis, Shire, and Medice Pharma, and research support from Shire and Novartis. The study was funded by the German Federal Ministry of Education and Research.
The easy way to misread this
Do not assume that a high ADOS or ADI-R score confirms ASD in patients with anxiety or mood disorders. Nearly 17% of patients with only mood or anxiety disorders met the autism cutoff, meaning test scores alone are insufficient for diagnosis in these cases.