Putting the pieces of the puzzle together: Patient with Autism Spectrum Disorder with major affective symptoms and tics

Abstract

Autism spectrum disorders affect social communication with the presence of stereotyped interests, behaviors or language and sensory abnormalities that begin in early childhood and continue throughout life. The prevalence of ASD is 1-2%, with a boy to girl ratio of 3:1. 50-70% of patients with ASD have comorbidity with ADHD, 40% with anxiety disorders, 11% with tics and 10% with depressive disorders. It is also essential to consider the possibility of a person with ASD suffering from a depressive disorder and to be alert to symptoms that may be included in this disorder, bearing in mind that people with ASD have difficulties in detecting and expressing their emotions. It is essential not to consider that everything expressed behaviorally and cognitively is directly related to autism. Depression may not manifest itself in the same way as in people with typical development. Tics are repetitive, non-rhythmic, stereotyped movements resulting from sudden, abrupt, involuntary, non-purposive muscle contractions. The DSM-5 includes tic disorders within neurodevelopmental disorders and integrates them into motor disorders. The presence of chronic tics has been described in 9% of children with ASD, while their association with Tourette Syndrome occurs in 4.8% of cases. In many cases, tics coexist with other involuntary movements or behaviors. Patients with ASD and tics may meet the diagnostic criteria for TS, which can make their differential diagnosis considerably more difficult.