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Bipolar Disorder and ASD

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Psychopathology in Adolescents and Adults with Autism Spectrum Disorders

Abstract

Background: Bipolar disorder (BD) co-occurs with autism spectrum disorder (ASD) in adults in the 10–30% of the cases, and the prevalence rates are similar in high- (HFA) and low-functioning autism (LFA). Familial studies also showed a link between the two conditions, especially for HFA forms, suggesting a possible common genetic liability. In clinical practice HFA and LFA may present different diagnostic issues. In HFA adults, autistic symptoms may have been misinterpreted as “character” or “personality.” When mood symptoms co-occur, the peculiar clinical picture may easily be misdiagnosed with significant implications for the management. In LFA the restricted repertoire of communication and behavior brings to atypical presentations of mood symptoms, which are often not recognized and attributed to the underlying neurodevelopmental condition. Controlled data on pharmacological treatments in BD-ASD comorbidity are virtually absent, and the information derives from open observations, case series, and chart reviews. Mood stabilizers should be considered the first choice, and antipsychotics with 5-HT2a antagonism have been shown useful in controlling psychotic and behavioral symptoms. Some evidence of efficacy for the treatment of anxiety, obsessive-compulsive symptoms, and depression is reported for SSRI antidepressants. The use of these drugs should be carefully monitored, because hypomanic or manic switches have been observed in up to 54% of the treated subjects.

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Authors and Affiliations

  1. CREA, Research and Clinical Center, San Sebastiano Foundation, Florence, Italy

    Giulia Vannucchi

  2. NEUROFARBA Department, University of Florence, Florence, Italy

    Giulia Vannucchi

  3. Psychiatry Unit 2, Clinical and Experimental Medicine Department, University of Pisa, Pisa, Italy

    Giulia Vannucchi

  4. Department of Clinical and Experimental Medicine, Spedali Riuniti Santa Chiara, Psychiatry Unit 2, AOUP-Pisa, University of Pisa, Pisa, Italy

    Giulio Perugi

  5. Department of Child Psychiatry and Psychopharmacology, IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Pisa, Italy

    Gabriele Masi

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  1. Giulia Vannucchi
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  3. Gabriele Masi
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Correspondence to Gabriele Masi .

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  1. Adult Autism Centre, Mental Health Department, Local Health Unit ASL Città di Torino, Turin, Italy

    Roberto Keller

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Vannucchi, G., Perugi, G., Masi, G. (2019). Bipolar Disorder and ASD. In: Keller, R. (eds) Psychopathology in Adolescents and Adults with Autism Spectrum Disorders. Springer, Cham. https://doi.org/10.1007/978-3-030-26276-1_7

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