Prevalence and profile of depressive mixed state in patients with autism spectrum disorder

Yu Zamami; Hotaka Shinzato; Kazuhiro Kurihara; Munenaga Koda; Akifumi Nakamura; Tsuyoshi Kondo

doi:10.1016/j.psychres.2021.113932

Prevalence and profile of depressive mixed state in patients with autism spectrum disorder

Psychiatry Res. 2021 Jun:300:113932. doi: 10.1016/j.psychres.2021.113932. Epub 2021 Apr 19.

Authors

Yu Zamami¹, Hotaka Shinzato², Kazuhiro Kurihara¹, Munenaga Koda³, Akifumi Nakamura⁴, Tsuyoshi Kondo¹

Affiliations

¹ Department of Neuropsychiatry, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.
² Department of Neuropsychiatry, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan; Department of Psychiatry and Neurosciences, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan. Electronic address: hshin530@hiroshima-u.ac.jp.
³ Department of Neuropsychiatry, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan; Graduate School of Technology, Industrial and Social Sciences, Tokushima University, Japan.
⁴ Department of Neuropsychiatry, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan; Department of Psychiatry, Akari Clinic, Okinawa, Japan.

PMID: 33887519
DOI: 10.1016/j.psychres.2021.113932

Abstract

Purpose: The present study aimed to clarify prevalence and profile of depressive mixed state (DMX) in depressed individuals with autism spectrum disorder (ASD).

Patients and methods: The Quick Inventory of Depressive Symptomatology Self-Report Japanese version (QIDS-SR-J) and global assessment of functioning (GAF) were administered to 182 consecutive patients (36 ASD and 146 non-ASD subjects) with a major depressive episode (MDE). DMX was categorically diagnosed according to the criteria for mixed depression (MD) by Benazzi and mixed features (MF) specifier by DSM-5. Severity of DMX was assessed by the self-administered 12-item questionnaire for DMX (DMX-12). Clinical backgrounds and incidence/severity of DMX were compared between the ASD and non-ASD groups.

Results: ASD patients showed higher prevalence of MD than non-ASD patients (36.1% versus 18.5%). Mood lability, distractibility, impulsivity, aggression, irritability, dysphoria and risk-taking behavior as mixed symptoms were more prevalent in ASD patients than those in non-ASD patients, together with higher scores of total DMX-12 and its disruptive emotion/behavior cluster. Multiple regression analysis revealed significant contribution of ASD to the disruptive emotion/behavior symptoms.

Conclusion: Careful monitoring and management of potential DMX are warranted in depressed ASD individuals.

Keywords: Autism spectrum disorders; Bipolarity; Major depressive episode; Mixed depression; Mixed features specifier.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Autism Spectrum Disorder* / complications
Autism Spectrum Disorder* / epidemiology
Bipolar Disorder* / diagnosis
Depressive Disorder, Major* / diagnosis
Depressive Disorder, Major* / epidemiology
Diagnosis, Differential
Humans
Prevalence