%0 Journal Article
%T The Co-Morbidity Burden of Children and Young Adults with Autism Spectrum Disorders
%A Isaac S. Kohane
%A Andrew McMurry
%A Griffin Weber
%A Douglas MacFadden
%A Leonard Rappaport
%A Louis Kunkel
%A Jonathan Bickel
%A Nich Wattanasin
%A Sarah Spence
%A Shawn Murphy
%A Susanne Churchill
%J PLOS ONE
%D 2012
%I Public Library of Science (PLoS)
%R 10.1371/journal.pone.0033224
%X Objectives Use electronic health records Autism Spectrum Disorder (ASD) to assess the comorbidity burden of ASD in children and young adults. Study Design A retrospective prevalence study was performed using a distributed query system across three general hospitals and one pediatric hospital. Over 14,000 individuals under age 35 with ASD were characterized by their co-morbidities and conversely, the prevalence of ASD within these comorbidities was measured. The comorbidity prevalence of the younger (Age<18 years) and older (Age 18每34 years) individuals with ASD was compared. Results 19.44% of ASD patients had epilepsy as compared to 2.19% in the overall hospital population (95% confidence interval for difference in percentages 13.58每14.69%), 2.43% of ASD with schizophrenia vs. 0.24% in the hospital population (95% CI 1.89每2.39%), inflammatory bowel disease (IBD) 0.83% vs. 0.54% (95% CI 0.13每0.43%), bowel disorders (without IBD) 11.74% vs. 4.5% (95% CI 5.72每6.68%), CNS/cranial anomalies 12.45% vs. 1.19% (95% CI 9.41每10.38%), diabetes mellitus type I (DM1) 0.79% vs. 0.34% (95% CI 0.3每0.6%), muscular dystrophy 0.47% vs 0.05% (95% CI 0.26每0.49%), sleep disorders 1.12% vs. 0.14% (95% CI 0.79每1.14%). Autoimmune disorders (excluding DM1 and IBD) were not significantly different at 0.67% vs. 0.68% (95% CI ˋ0.14-0.13%). Three of the studied comorbidities increased significantly when comparing ages 0每17 vs 18每34 with p<0.001: Schizophrenia (1.43% vs. 8.76%), diabetes mellitus type I (0.67% vs. 2.08%), IBD (0.68% vs. 1.99%) whereas sleeping disorders, bowel disorders (without IBD) and epilepsy did not change significantly. Conclusions The comorbidities of ASD encompass disease states that are significantly overrepresented in ASD with respect to even the patient populations of tertiary health centers. This burden of comorbidities goes well beyond those routinely managed in developmental medicine centers and requires broad multidisciplinary management that payors and providers will have to plan for.
%U http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0033224