Co morbid Psychiatric Disorders in Pervasive Developmental Disorders

Background: From a theoretical point of view, the issue of diagnosing co-morbidity in Pervasive Developmental Disorder (PDD) is controversial, with some researchers favouring the practice and others questioning it. From the clinical point of view, however, it is perhaps a useful practice, as specific strategies can be directed towards alleviation of these disorders once they are identified. Some recent studies have been able to recognise several disorders such as depressive disorder, anxiety disorder, bipolar disorder etc. Aim: To systematically assess a sample of children and adolescents with PDD for diagnosable comorbid disorders using ICD-10/ DSM-IV. Methods: Subjects from the Child & Adolescent Psychiatry services of NIMHANS diagnosed to have PDD as per ICD-10 were evaluated using the Missouri Assessment of Genetic Interview for Children (MAGIC), Children’s Yale-Brown Obsessive Compulsive Scale, Childhood Autism Rating Scale and Conners Abbreviated Rating Scale. Diagnosis (DSM-IV) was arrived by using MAGIC, supplemented by ratings on the other instruments and clinical evaluation. Results: There were 45 males and 5 female subjects with age ranging from 1 year 8 months to 16 years. Co-morbidity was evident in 46% of the sample in the form of ADHD, anxiety disorders including obsessive compulsive disorder, bipolar affective disorder and circadian rhythm disturbance of sleep. Comorbidity was found to be associated with more (normal and mildly impaired) or less developed (severely impaired) language system. Conclusion: Almost half of the sample in the study had a diagnosable co-morbidity. There was a significant group of cases with subsyndromal diagnoses.