Introduction

Prevalence rates of panic attacks have been reported to be around 24-63% in psychotic patients. Common underlying biological substrates for panic and paranoia have been proposed, suggesting that delusional disorder (DD) may be preceded by the development of anxiety disorders.

Objectives

The main objective of this study was to investigate anxiety comorbidity in DD. As a second objective, we set ourselves to know prescription rates for the use of antidepressants and benzodiazepines in anxiety disorders in the context of DD.

Methods

A systematic literature search was performed using PubMed (1980- September 2020) according to the PRISMA guidelines. The following search terms were used: (delusional disorder) AND (anxiety OR anxiety disorder OR anxi*). Research studies and case reports were included if they met the following criteria: DD diagnosis (DSM, ICD), publication in peer-review journal and investigations containing information on anxiety comorbidity in DD.

Results

Four studies fulfilled our criteria, including 155 patients: 65 (42%) women, mean age 42.7 years (SD:14.96). Thirty-three of the 155 patients (21.29%) presented at least one comorbid anxiety disorder: 14 specific phobias, 9 panic attacks, 5 social phobias and 2 agoraphobias. Treatment was not reported for many patients (n= 28). Four patients received fluoxetine and 1 patient benzodiazepines. All of them showed partial improvement of symptoms.

Conclusions

Less than a third of DD patients showed an anxiety disorder. The effectiveness of antidepressant and benzodiazepine treatment has been poorly described. Future studies may be focused on the investigation of preceding comorbid anxiety disorders in patients with DD.

Introduction

Autism spectrum disorder (ASD) is a neurodevelopmental disorder with a biological basis overlapped with obsessive compulsive disorders and body dysmorphic disorder (BDD). The combination of pharmacological treatment and psychological interventions have been considered the gold-standard

Objectives

Our main objective was to present the case of a patient with ASD and comorbid BDD. As a second objective, we reviewed recent works on the common neurobiological substrate and therapeutic options for both conditions.

Methods

(1)Clinical case: Patient with ASD and BDD, treated with fluoxetine 60 mg/day and aripiprazole 30 mg/day.

(2)Non-systematic narrative review focused on neurobiological substrate and treatment of ASD and BDD. The electronic search was performed by the PubMed database (1990-2020) using the following key terms: “autism spectrum disorder”, “body dysmorphic disorder”, “dysmorphophobia”, “neurobiology”, “pharmacological treatment”, “psychological treatment” and “treatment”.

Results

Our patient is a 31-year-old single male fulfilling DSM-5 criteria for ASD, diagnosed in childhood, and BDD. He received pharmacological treatment and CBT. He also verbalized having been concerned with his lips and mouth for the last 10 years. This discomfort leads to passive ideas of death.

Review: All articles (n=4) supported the use of selective serotonin reuptake inhibitors (SSRIs) and CBT in this comorbidity. None of them reported the use of antipsychotics. Oone article described the use of Repetitive transcranial magnetic stimulation (rTMS) and oxytocin.

Conclusions

ASD and BDD share the basis of corticostriatal circuits. ISRS and CBT may be effective in treatment. Other options (oxytocin or rTMS) should be further investigated. Examining this comorbidity could be useful for discovering possible endophenotypes.

Introduction

Autism spectrum disorders (ASD), is a population that does not usually receive specific treatment.

Objectives

The main objective of the present study is to evaluate whether specific interventions within the TAVA program (transition program to adult life for patients with ADS), produce significant improvements in the quality of life of young adults with ASD.

Methods

This is a prospective randomized clinical study of patients with ASD (according to DSM-5 criteria) seen in outpatient of the Parc Tauli University Hospital in Sabadell (Barcelona) since September 2017. We compared the quality of life, functionality, caregiver burden, and comorbidity of patients in TAVA program (beneficiaries of group therapy and specific medical and psychosocial interventions), with that of control patients (treatment as usual), after 2 years of intervention.

Results

Our sample is composed of 12 patients with ASD. The average age is 18.4 years. 83% of the sample are men (n = 10). 5 of the patients belonged to TAVA and the other 7 were controls. Overall, TAVA patients presented improvement in the ZARIT and BAI scales compared to control patients. The control patients evolved less favorably in the AAA, SRS and RAAS levels compared to TAVA.

Conclusions

Specific interventions in adults with ASD, improve the caregiver's feeling of overload and the patients anxiety, compared to the usual interventions.

The lack of regulated interventions produces an unfavorable evolution of the core symptoms of autism.

More studies are needed to specify efficient interventions to improve the quality of life of adults with ASD.