Therapeutic approaches to anxiety disorders comorbid to ASD

Autism spectrum disorders (ASD) are characterized by social communication difficulties and repetitive, stereotyped behavior. Comorbid features exist in children and adolescents with ASD in addition to the core symptoms and it is known that these patients are at increased risk for anxiety and anxiety disorders. 40% of children with ASD fulfill diagnostic criteria for an anxiety disorder which specific phobia, obsessive compulsive disorder and social anxiety disorder are suggested to be the most frequent ones. There is still disagreement over whether anxiety symptoms in ASD are related with core ASD aspects or they just constitute comorbid conditions. In addition, recognition and measurement of anxiety in children with ASD is another problem since low intellectual functioning, which is highly associated with ASD, restricts evaluation of these patients and might lead to underdiagnosis of comorbid conditions. Anxiety associated with ASD contributes to overall impairment in these patients and psychosocial and pharmacological treatment approaches are considered to improve the life quality of both patients and their parents. Although there are treatment options for anxiety disorders in typically developing children, treatment strategies for children with ASD are mostly the adaptation of these options. Antidepressants and antipsychotics are suggested to be effective to treat anxiety in ASD. Furthermore, cognitive-behavioral therapy appears as an effective treatment option for co-occurring anxiety in older and high-functioning children with ASD. We need more double blind controlled studies to test the efficiency of these psychopharmacological and psychosocial treatment options in ASD group. This part of the panel will focus on literature regarding therapeutic approaches to anxiety disorders prevalent in ASD.