The objective of this study is to examine the occurrence and characteristic features of obsessive–compulsive behaviours in
children and adolescents with Asperger syndrome (AS), with respect to a matched obsessive compulsive disorder group (OCD)
and a typically developing control group (CG). For this purpose, 60 subjects (20 OCD; 18 AS; 22 CG), aged 8–15 years, matched
for age, gender and IQ were compared. AS and OCD patients were diagnosed according to the DSM-IV-TR criteria. The
Autism Diagnostic Interview-Revised and the
Autism Diagnostic Observation Schedule were used to assist in the AS diagnosis; the WISC-R was administered to assess IQ. Obsessive and compulsive symptoms were
evaluated by using the
Children’s Yale-Brown Obsessive-Compulsive Scale (CY-BOCS). None of the AS children received a formal diagnosis of OCD. The AS group presented significantly higher frequencies
of
Hoarding obsessions and
Repeating,
Ordering and
Hoarding compulsions compared to CG. The OCD group, in turn, reported significantly higher frequencies of
Contamination and
Aggressive obsessions and
Checking compulsions compared to both the AS group and CG. As expected, the OCD group displayed a higher severity of symptoms (
Moderate level of severity) than did the AS group (
Mild level of severity). Finally, in our sample, neither the OCD group nor the AS group demonstrated a completely full awareness
of the intrusive, unreasonable and distressing nature of symptoms, and the level of
insight did not differ between the OCD group and CG, although an absence of
insight was observed in the AS group. Children with AS showed higher frequencies of obsessive and compulsive symptoms than did typically
developing children, and these features seem to cluster around
Hoarding behaviours. Additionally, different patterns of symptoms emerged between the OCD and AS groups. Finally, in our sample, the
level of insight was poor in both the OCD and the AS children. Further research should be conducted to better understand the
characteristics of repetitive thoughts and behaviours in autism spectrum disorders, and to clarify the underlying neurobiological
basis of these symptoms.
Keywords Asperger syndrome - Autism - Obsessive–compulsive disorder - Repetitive behaviours - Insight