The prevalence of autism spectrum traits and autism spectrum disorders in children and adolescents with obsessive compulsive disorder: systematic review and meta-analysis

BACKGROUND: Autism spectrum disorder (ASD) and obsessive-compulsive disorder (OCD) may coexist in children and adolescents and present with several overlapping features. AIMS: We aimed to assess the prevalence of ASD traits and diagnosis in children and adolescents with OCD, explore the correlation between OCD severity and ASD traits/diagnosis, and examine the impact of ASD traits/diagnosis on global functioning in this population. METHOD: Electronic searches were carried out on Pubmed, Embase and PsycINFO, using selected keywords and specified inclusion and exclusion criteria. Meta-analysis was performed with R Version 4.3.1. RESULTS: Of 1410 studies initially identified, 29 reported on the prevalence of ASD traits or diagnosis. Pooled mean prevalence rate was 8.0% (95% CI 5.0-13%). ASD questionnaire scores were higher in OCD versus control groups (standardised mean difference: 1.23; 95% CI 0.76-1.69). There was limited significant correlation between ASD questionnaire scores and OCD questionnaire scores, and no significant differences in these scores were demonstrated between OCD samples and samples diagnosed with comorbid OCD and ASD (mean difference -0.41; 95% CI -1.23 to 0.40). Functional impairment appeared elevated with ASD traits/diagnosis in OCD, but meta-analysis feasibility was limited. CONCLUSIONS: This review indicates higher ASD traits and diagnosis in children and adolescents with OCD compared with the general population. Limited data and methodological constraints in trials limit generalisability, warranting further research.