Anxiety, Depression, OCD & Bipolar Disorder with Autism

Internet Resources

Anxiety is a normal reaction to stress. It helps one deal with a tense situation in the office, study harder for an exam, keep focused on an important speech. In general, it helps one cope. But when anxiety becomes an excessive, irrational dread of everyday situations, it has become a disabling disorder.
National Institute of Mental Health
Anxiety disorders in children can lead to poor school attendance, low self-esteem, deficient interpersonal skills, alcohol abuse, and adjustment difficulty.
National Alliance for the Mentally Ill
In conclusion, this study has found significantly higher levels of anxiety and social anxiety in high-functioning children with autism compared with two comparison control groups... High-functioning children with autism have been found here to demonstrate worries about social situations, whether this be rumination or active avoidance.
Alinda Gillott
High-functioning children with autism were compared with two control groups on measures of anxiety and social worries. Comparison control groups consisted of children with specific language impairment (SLI) and normally developing children. Each group consisted of 15 children between the ages of 8 and 12 years and were matched for age and gender. Children with autism were found to be most anxious on both measures. High anxiety subscale scores for the autism group were separation anxiety and obsessive-compulsive disorder. These findings are discussed within the context of theories of autism and anxiety in the general population of children. Suggestions for future research are made.
Alinda Gillott et al
Donna Williams
Severe anxiety problems in children can be treated. Treatments may include a combination of the following: individual psychotherapy, family therapy, medications, behavioral treatments, and consultation to the school.
American Academy of Child and Adolescent Psychiatry
Could a closer look at the co-occurrence of mood disorders within Autism help us to work more effectively with each group?
Donna Williams
A new study has found that children with high-functioning autism or Asperger syndrome are at greater risk for anxiety and depression compared with the general population
James Adams
This study aimed to determine whether there were differences in behavioural and emotional disturbance (psychopathology) between children and adolescents with high-functioning autism and Asperger syndrome. Subjects consisted of 75 children and adolescents with high-functioning autism and 52 with Asperger's disorder (DSM-IV diagnoses). Psychopathology was measured using the Developmental Behaviour Checklist. Analysis of covariance (ANCOVA) controlling for the effects of age and cognitive level was used to determine whether the groups differed in their levels of psychopathology. It was found that children and adolescents with Asperger's disorder presented with higher levels of psychopathology than those with high-functioning autism, were more disruptive, antisocial and anxious, and had more problems with social relationships. The implications of these findings are discussed.
Bruce Tonge et al
Love is more than butterflies and teddy bears. Love needs a warrior's heart. Love needs a sword. As one ten-year-old with BD challenges put it: My mom needs to be strict with me or I'll take the place apart!
George Lynn
Surround your children with love and security. We know as adults that none of us are immune to the threats in the world today. But we can protect these children who have no way of grasping these concepts by creating a world of love and comfort.
Adelle Jameson Tilton
Based on current evidence, psychotherapy may be the first treatment for most depressed youngsters, but antidepressants should be considered for those with severe depression.
R.J. Park, I.M. Goodyear
For the parent of a child with autism and one of these comorbid conditions, life is more complicated. Often, inappropriate behaviors, which are usually blamed on autism, are actually the result of one of these associated conditions.
Adelle Jameson Tilton
Coping strategies are often used by individuals with ASD to reduce the anxiety felt in every day situations that can not be compensated for in the neurologically typical ways. The strategies themselves can manifest themselves in any number of different ways, and may be unique to the individual. It could be argued that each of the strategies used has a key component which is similar in all cases. It is suggested that all coping strategies need to be in the control of, or appear to be in control of, the individual or, that the individual has clear identifiable and recognisable boundaries around access to the strategy.
Depression is defined as an illness when the feelings of depression persist and interfere with a child or adolescent's ability to function. Children who have attentional, learning, conduct or anxiety disorders are at a higher risk for depression.
American Academy of Child and Adolescent Psychiatry
Among the 16 factors rated by the patients, the three most frequently judged to be very important in determining remission included the presence of features of positive mental health such as optimism and self-confidence; a return to one's usual, normal self; and a return to usual level of functioning, the authors report. "The results of the present study suggest that depressed patients consider symptom resolution as only one factor in determining the state of remission," the investigators conclude. "In addition, patients indicated that the presence of positive features of mental health such as optimism, vigor, and self-confidence was a better indicator of remission than the absence of the symptoms of depression."
Will Boggs
Hyperactivity, impulsivity, and inattention are seen in children with AD/HD and Bipolar Disorder, but these two disorders are radically different in terms of the impact that they have on a child's life.
George Lynn
Referred to as a loss of the ability to control one's impulses, leaving the patient vulnerable to acting on his/her impulses, disinhibition is characterized by an acute and reversible behavioral decompensation directly related to an intervention.
Timothy Wilens
Exposure Anxiety (being indirectly confrontational); the system of sensing versus that of interpretation; problems of connection (being mono and delayed processing)
Donna Williams
Anhedonia is a negative symptom that has not always been given attention in schizophrenic patients. While phenomenologically oriented psychiatrists noticed a certain lack of emotional vivacity in schizophrenic patients, schizophrenia theory in the tradition of Bleuler emphasized a different facet of schizophrenic psychopathology. It held that the retreat into wishful fantasies, autism, is a fundamental symptom of schizophrenia. Bleuler's concept of schizophrenic psychopathology was based on J.H. Jackson's evolutionary account of mental disorders. In this view, mental diseases represent a dissolution of evolutionary progress and lead to the manifestation of primitive traits in 'modern' patients. This article argues that the resulting analogies perceived between schizophrenics and 'primitive' people lead to an overemphasis on wishful, irrational thinking and to the neglect of anhedonia, the inability to experience pleasure. Moreover, socially unacceptable desires were rediscovered in these supposedly 'primitive' individuals. This situation changed fundamentally only after social and historical transformations occurred that shifted the center of psychiatric research from Germany to the United States and from an emphasis on the rational control of desires to the use of social reward in ensuring social conformity. As a consequence, Rado and Meehl placed anhedonia at the heart of their schizophrenia theories. Current developments in social interaction seem to stimulate another shift in schizophrenia theory, de-emphasizing social reward and providing room for a differentiated assessment of anhedonia in schizophrenia.
Andreas Heinz, Martin Heinz
About half of all Americans will have a mental illness during their lifetime, with symptoms beginning in the teen years for many, according to the results of a survey published in the June issue of the Archives of General Psychiatry. A second study suggests that treatment is not usually initiated when patients first present. "These studies confirm a growing understanding about the nature of mental illness across the lifespan," Thomas Insel, MD, director of the National Institute of Mental Health (NIMH) in Rockville, Maryland, said in a news release. "There are many important messages from this study, but perhaps none as important as the recognition that mental disorders are the chronic disorders of young people in the U.S."
Laurie Barclay, Medscape
This article is about how to respond to questions by people who become aware of something that is somehow now relevant to themselves, but they couldn't possibly understand the answer you know how to give.
Nathan Ory
Procedures used in stress management such as relaxation, picture rehearsal, desensitisation, assertiveness, social skill instruction, exercise and humour can easily fit into a frame of reference referred to as positive behavioural support.
June Groden, Patricia LeVasseur
Depressed children show low GH response to GHRH. The measure appears to be reliable, and the low GH response continues following clinical remission. Further studies are needed to explore the mechanism and relative specificity of this finding.
Ronald E. Dahl, Boris Birmaher, Douglas E. Williamson, Lorah Dorn, James Perel, Joan Kaufman, David A. Brent, David A. Axelson, Neal D. Ryan
Depression is second only to hypertension as the most common chronic condition encountered in medical practice.
Mary A. Whooley, Gregory E. Simon
People with AS can experience a variety of mental heath problems, notably anxiety and depression, but also impulsiveness and mood swings. They may be misdiagnosed as having a psychotic disorder.
National Autistic Society
Describes the shared pathophysiologic mechanisms of headache, mood disorders, and other neurologic disorders and define how treatment with anitepileptic drugs fits this paradigm.
Stephen D. Silberstein
The largest donor-supported organization in the world devoted exclusively to supporting scientific research on brain and behavior disorders;
Anxiety Disorders, Static Disorders of Brain Development (Autism), Defects in Metabolism of Lipids, Disorders of Purine and Pyrimidine Metabolism, Disruptive Behavioral Disorders, Habit Disorders, Mood Disorders, Neurodevelopmental Dysfunction
Richard Dalton, Isabelle Rapin, Charles Stanley, J.C. Harris, Marc Forman, Melvin Levine
Ritualistic behaviors and repetitive thoughts have been extensively studied in the last years. The definitions of obsessive-compulsive disorder and Tourette syndrome emphasize the existence of a continuum of symptoms, with high prevalence in the general population. Neurobiological findings have implicated genetic and immunological factors in the etiology of these two disorders.
Marcos T. Mercadante et al
P.H. Thomsen
OCD spectrum disorders include impulse-control disorders, somatoform disorders, eating disorders, compulsive sexual disorders, as well as Tourette's syndrome and other movement disorders.
Arun Ravindran
OCD spectrum disorders are those disorders that share similar phenomenology, family history and treatment response as OCD. The odds of having a tic disorder, somatoform disorder, mood disorder and another anxiety disorder are highly probable.
Fugen Neziroglu
In OCD, the obsessions or compulsions cause significant anxiety or distress, or they interfere with the child's normal routine, academic functioning, social activities, or relationships.
American Academy of Child and Adolescent Psychiatry
The primary motivation behind almost all of what most people would see as my "normal" behaviour, is fear... This is my relationship to the world, and you cannot change that. You can, however, change my relationship to you, by listening with an open mind, and by accepting my view of the world as equal to yours. If you do this, I may one day be able to let go of my fear when I'm with you.
Obsessive compulsive disorder affects about 1 in 100 children, and is characterized by obsessive thoughts and/or compulsive rituals. The symptoms can be merely annoying, or can cause significant difficulties at home, in school, and with friends. Physicians at the National Institute of Mental Health are interested in learning more about childhood-onset OCD and are conducting a study to see how symptoms change over time.
NIMH Division of Intramural Research Program
Neuroticism and OCPD may share a common familial aetiology with OCD.
Jack Samuels et al.
The SSRI's are not devoid of unwanted effects. Most disturbing are sexual inhibition and weight gain, specially in the long term treatment. At this moment these drugs should be the first choices in the treatment of Social Phobia.
Marcio Versiani
Findings from adult studies suggest that natural disasters produce fewer emotional problems than technological disasters, and that accidents caused by human error have less serious sequelae than those where deliberate actions cause harm. Acts of deliberate violence, particularly physical and sexual abuse, may have the worst outcome. This suggests that those with learning disability may be at risk of worse outcome if they are diagnosed to have PTSD, as abuse is the commonest aetiological factor in the onset of the disorder.
Jane McCarthy
The objective of this study was to report on the prevalence and correlates of anxiety and mood problems among 9- to 14-year-old children with Asperger syndrome (AS) and high-functioning autism. Children who received a diagnosis of autism (n 5 40) or AS (n 5 19) on a diagnostic interview when they were 4 to 6 years of age were administered a battery of cognitive and behavioural measures. Families were contacted roughly 6 years later (at mean age of 12 years) and assessed for evidence of psychiatric problems including mood and anxiety disorders. Compared with a sample of 1751 community children, AS and autistic children demonstrated a greater rate of anxiety and depression problems. These problems had a significant impact on their overall adaptation. There were, however, no differences in the number of anxiety and mood problems between the AS and autistic children within this high-functioning cohort. The number of psychiatric problems was not correlated with early autistic symptoms but was predicted to a small extent by early verbal/non-verbal IQ discrepancy scores. These data indicate that high-functioning PDD children are at greater risk for mood and anxiety problems than the general population but the correlates and risk factors for these comorbid problems remain unclear.
Joseph A. Kim et al
There have been few studies of psychopathology in adult with autism. This study examined psychiatric co-morbidity in 147 adults with intellectual disability (ID) and autism and 605 adults with ID but without autism. After controlling for the effects of gender, age, psychotropic medication and level of ID, people with autism and ID were no more likely to receive a psychiatric diagnosis than people with ID only. People with autism were less likely to receive a diagnosis of personality disorder. These findings cast doubts on the hypothesis that adults with ID and autism are more vulnerable to certain psychiatric disorders than non-autistic adults with ID.
Elias Tsakanikos et al
Depression in youth is common and treatable and responds best to multimodal treatment combining patient and family education, cognitive behavioral therapy, and antidepressant medication. The potential benefits of antidepressants outweigh the risks for adolescents. Family and psychotherapeutic interventions are most effective for prepubertal children.
Julie A. Dopheide, Medscape
Anthony James
Late-onset depression has been conceptualized as a neurologic disease. This view has been supported by studies suggesting that late-onset depression is associated with cognitive impairment and neurologic comorbidity that may or may not be clinically evident when depression is first diagnosed.Findings implicating a dysfunction of frontostriatal-limbic pathways in geriatric depression have led to the depression-executive dysfunction (DED) syndrome hypothesis. Subsequent studies suggested that DED has slow, poor, or abnormal response to classical antidepressants. DED is characterized by psychomotor retardation, reduced interest in activities, impaired insight and pronounced behavioral disability.
George S. Alexopoulos
Having AS is not a curse... it is not a disease, and it is not a disability. The depression it causes is certainly a disability, as is the post-traumatic stress, but I really do not see being different than the NTs as a disability.
Frank Klein
Children with NLD tend to suffer in the emotional realm because these children are not proficient at interpreting interpersonal interactions -- they lack insight into the feelings and perceptions of others that the rest of us glean intuitively.
Sue Thompson
Communication and a watchful eye by the parents are necessary at this time. Having a trusted adult around when school gets out, even being at the school to pick them up or watch from afar if they are taking the bus is worth looking into. Attending conferences and discussing anything out of character with teachers, aides, therapists and counselors is a must. Note any change in sleeping and eating to these professionals that work with the young person at school and maintain communication via email.
Bonnie Sayers, Bella Online
For patients with severe and persistent mental illnesses, medication treatment guidelines, or algorithms, may bring uniformity of treatment, predictability of costs, and quality of care at overall lower health care and social costs.
Trisha Suppes, Sherwood Brown, Ellen Dennehy, Ellen Habermacher
Although Abraham was impaired by his developmental disorder, it is quite clear that the symptoms of Abraham's bipolar disorder led to severe disruption of functioning.
Jean A. Frazier et al
While maintaining a vigilance for seizures, physical illnesses, and medication side effects, clinicians are now able to use low doses of psychoactive agents with potentially greater safety and fewer side effects to achieve good outcomes.
Jessica Hellings
The development of many new classes of medications, as well as the range of pharmacologically different drugs within each class, is broadening the options for understanding and treating individuals with autism and comorbid psychiatric illness.
Jessica Hellings
Children with SAD are fearful of social or performance situations in which embarrassment may occur. When exposed to these situations, they become extremely anxious and may exhibit crying, tantrums or avoidance.
Karen Dineen Wagner
People with ASD's often have the added handicap of mental illness, albeit anxiety states, depression or obsessions. Though medication does not appear to help the core handicaps of autism, it can often help with this additional handicap.
Peter Carpenter
Andrea Malizia
The children reported the most number of worries about health, school, and personal harm; they worried most frequently about family, classmates, and friends; and they worried most intensely about war, money, and disasters.
Carl F. Weems, Wendy Silverman, Annette La Greca
This article presents a model using basic medical and DSM IV-based comorbidity groups to guide clinicians in selecting an effective treatment approach.
Jessica Hellings

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