Kids With Autism and ADHD at Higher Risk for Anxiety and Depression

April 3, 2018

By Lisa Rapaport

Children with autism who also have attention deficit hyperactivity disorder (ADHD) are more likely to develop anxiety and depression than autistic kids without ADHD, a U.S. study suggests.

Researchers examined data on 3,319 children ranging in age from 6 to 17 years old who had been diagnosed with autism spectrum disorders (ASD). Overall, 1,503 of these kids, or 45 percent, had also been diagnosed with ADHD.

Compared to children with autism alone, kids who also had ADHD were more than twice as likely to be diagnosed with depression and anxiety, researchers report in Pediatrics, online March 30.

“Anxiety disorder and mood disorder, while very common in autism spectrum disorder, are even more common when children also have ADHD,” said lead study author Dr. Eliza Gordon-Lipkin, a researcher at Kennedy Krieger Institute and Johns Hopkins School of Medicine in Baltimore.

“Recognizing and treating anxiety and mood disorders can lead to improved quality of life for patients and their families,” Gordon-Lipkin said by email.

Approximately 1 in 68 U.S. kids have ASD and about 1 in 10 have ADHD. While it’s long been recognized that ADHD is much more common among kids with autism than among other children, research to date hasn’t offered a clear picture of how living with both conditions at once impacts the risk of other behavioral or mental health problems, the research team writes.

In the current study, children with both conditions were 2.2 times more likely than those with only ASD to have anxiety and 2.7 times more likely to have depression. The risk of developing anxiety and depression also increased with age.

The study wasn’t a controlled experiment designed to prove whether or how having ADHD in addition to autism might make kids develop anxiety or depression.

Some children with autism and ADHD could have symptoms of anxiety or depression but not necessarily have these mental health disorders, said Dr. Jeremy Veenstra-VanderWeele, a researcher at Columbia University and the NewYork-Presbyterian Hospital Center for Autism and the Developing Brain in New York City.

“As a classic example, some children with autism are very bothered by a change in routine, such as taking a different route to school in the morning, and will show extreme anxiety if their routine is disrupted,” Veenstra-VanderWeele, who wasn’t involved in the study, said by email.

“This is very different from anxiety disorders in the general population and will probably not respond to the same treatments that work in the general population,” Veenstra-VanderWeele added.

At the same time, it’s also possible that true anxiety and mood disorders might sometimes go undiagnosed.

“Sometimes we fail to think about other disorders and instead blame all symptoms on ASD,” Veenstra-VanderWeele said. “Instead, these (study results) suggest that we should be particularly attentive to anxiety and mood problems in kids who may have a more difficult time in general due to the breadth of their developmental difficulties.”

For parents of kids with autism, the best course of action is to be on the lookout for symptoms of anxiety and mood disorders, said Geraldine Dawson, director of the Center for Autism and Brain Development at Duke University Medical Center in Durham, North Carolina.

“Both medications and behavioral interventions, such as cognitive behavioral therapy, can be very helpful for children with autism who have anxiety or mood disorder,” Dawson, who wasn’t involved in the study, said by email.


Pediatrics 2018.

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