Autism and substance use comorbidity: Screening, identification and treatment

Abstract

Objective

Autism spectrum disorders (ASD) are well-known for high prevalences of comorbid conditions especially anxiety, obsessions, depression, challenging behaviours.

In this presentation, we will consider the evidence for comorbidity between ASD and addiction [substance use disorders (SUD)] and explore the possible underlying explanations.

Methods

A literature study on similarities between addiction and ASD (at a phenotypical and neurobiological level) as well as a case note review on a year cohort of 120 consecutive admissions in an adult addiction psychiatry unit and 120 admissions in an adult ASD unit.

Results

In our addiction psychiatry cohort, 8 (men) on 118 patients were diagnosed with autism spectrum disorder. This is much higher than in the general population (1%). In the ASD cohort, the results are measured at the moment and the results will be presented in the presentation.

Autism spectrum disorders and addiction can both be perceived as developmental disorders in which a genetic predisposition and vulnerability interact with environmental factors. They can be induced by early stress thus affecting the proper functioning of the cortico-striatal dopaminergic regulation systems (and also the HPA axis). In “pure” ADHD this is attributed to a deregulation in the cognitive loops and the “impulsivity” endophenotype. Whereas in cases of ASD without an ADHD component the limbic and sensimotore cortico-striatal regulations loops are also involved.

Conclusions

There are clear indications that a possible comorbidity of substance abuse disorder should be considered in cases of individuals with autism spectrum disorders. This finding is important for clinicians to take into account in assessing patients with addiction problems and ASD.

Disclosure of interest

The author has not supplied his declaration of competing interest.