Obsessive Compulsions and Autism

Hands under a tap Obsessive compulsive disorder (OCD) is a mental health condition where a person has obsessive thoughts and compulsive behaviour.

An obsession is an unwanted, unpleasant thought, image or urge that repeatedly enters a person's mind, causing them anxiety.

The word "obsession" usually describes something enjoyable, but in OCD the obsession is unpleasant and frightening.

A compulsion is a repetitive behaviour or mental act that someone feels they need to carry out to try to prevent an obsession coming true.

For example, someone who is obsessively scared they will catch a disease may feel the need to wash their hands every time they touch something.

Research shows that many people on the autism spectrum have obsessive compulsions.

Statistics

Szatmari et al (1989) studied a group of 24 children. He discovered that 8% of the children with Asperger syndrome and 10% of the children with high-functioning autism were diagnosed with OCD. This compared to 5 per cent of the control group of children without autism but with social problems. Thomsen el at (1994) found that in the children he studied, the OCD continued into adulthood.

Causes

The exact cause of Obsessional Compulsive Disorder (OCD) in people who are on the autism spectrum is unknown, but it is probably caused by a combination of factors.

OCD, like some forms of autism spectrum disorder, tends to run in families. There is evidence that OCD is more prevalent in the families of some people with autism spectrum disorders. (Abramson, 2005; Bolton, 1995; Delorme, 2007; Hollander, 2003; Kanno, 2004)

OCD may be due to a lack of the brain chemical serotonin. Low levels of serotonin may also be related to some autistic spectrum disorders. (Gross-Isseroff R, 2001).

Stress does not appear to cause OCD. However, a stressful event or trauma seems to trigger the condition in some people. (NAS, 2006 – 2).

Personality type may also be a factor. For example, perfectionists seem to be more prone to developing OCD. (NAS, 2006 – 2)

Effects

OCDs affects each individual in a different way but is likely to cause severe problems. For example, it may lead to

problems with behaviour management
problems with learning
problems with social relationships

Interventions

Clinical Guidance

The National Institute for Health and Care Excellence (NICE) has produced clinical guidance on the management and support of people on the autism spectrum.

This includes guidance on the management of mental health problems, such as obsessive compulsions, in adults and in children and young people.

Further information: NICE Guidance on Coexisting Mental Disdorder in Adults on the Autism Spectrum

Further information: NICE Clinical Guidance on Coexisting Problems in Children and Young People with Autism.

Research

This page provides details of some of the most significant reviews on obsessive compulsions and autism which have been published in English-language, peer-reviewed journals. If you know of any other studies we should include please email info@researchautism.net with the details. Thank you.

If you are a UK resident you may be able to obtain full copies of some of the items listed here from your local public library, your college library, or the National Autistic Society's Information. Centre. You may also be able to obtain copies from the publisher of the items.

Related Research

Baron-Cohen S. (1989) Do autistic children have obsessions and compulsions? British Journal of Clinical Psychology. 28(99), Read Abstract (New Window)
Bejerot S. (2007) An autistic dimension: a proposed subtype of obsessive-compulsive disorder. Autism. 11(2), Read Abstract (New Window)
Gross-Isseroff R., Hermesh H., Weizman A. (2001) Obsessive compulsive behaviour in autism towards an autistic-obsessive compulsive syndrome? World Journal of Bilogical Psychiatry. 2(4), Read Abstract (New Window)
Hollander E. (1998) Treatment of obsessive-compulsive spectrum disorders with SSRIs. British Journal of Psychiatry Supplement. 35 Read Abstract (New Window)
Marina Jiujias, Kelley E., Layla Hall (2017) Restricted, repetitive behaviors in autism spectrum disorder and obsessive–compulsive disorder: A comparative review. Child Psychiatry and Human Development. Read Abstract (New Window)
Matson J. L., Dempsey T. (2009) The nature and treatment of compulsions, obsessions, and rituals in people with developmental disabilities. Research in Developmental Disabilities. 30(3), Read Abstract (New Window)
McDougle C. J., Kresch L. E., Posey D. J. (2000) Repetitive thoughts and behavior in pervasive developmental disorders: treatment with serotonin reuptake inhibitors. Journal of Autism and Developmental Disorders. 30(5), Read Abstract (New Window)

Reading

This page provides details of other publications on obsessive compulsions and autism. If you know of any other publications we should include please email info@researchautism.net with the details. Thank you.

If you know of any other publications we should list on this page please email info@informationautism.org

Please note that we are unable to supply publications unless we are listed as the publisher. However, if you are a UK resident you may be able to obtain them from your local public library, your college library or direct from the publisher.

Additional Information

OCD in Autism, Dr Amita Jassi - 19 November 2013, 12.30-1.30pm

Dr Amita Jassi will be answering your questions in Research Autism's first ever live online Q&A, Tuesday 19 November 2013, 12.30pm (GMT).

Amita will also be speaking at our upcoming Autism Plus conference on 4 December 2013.

Related Additional Information

Updated: 20 Mar 2017