Introduction: Bladder and bowel dysfunction (BBD) in pts with autism spectrum disorder (ASD) have been recognized in children/teens but no information exists in adults. Aims of the study were to evaluate prevalence and types of BBD in young and adults with ASD and to assess the impact of neuropsychiatric features on these dysfunctions. A comparison with a control group of typically developing (TD) subjects has been performed.
Methods: Thirty-five pts with ASD were enrolled. A group of TD subjects acted as control. Pts and TD subjects underwent the assessment of urinary incontinence, nocturnal enuresis (NE) and bowel disturbances with the 3-day voiding and bowel diary. For pts who voided spontaneously, caregivers were asked to detect the following symptoms: straining, intermittency, and post-micturition dribble. Pts underwent urinalyses and cultures and the ultrasound measurement of the post-void residual volume (PVR) after micturition. Neuropsychiatric assessment including: intelligence quotient (IQ) evaluation for intellectual disability (ID), the Neuropsychiatric Inventory Scale (NPI) to identify psychiatric disorders, the Vineland Adaptive Behaviour Scale 2nd Edition (Vineland-II) to assess patient’s adaptive behaviour. The relationships between BBD and neuropsychiatric features were examined.
Results: Twenty-two adults and 13 children/teens with ASD (29M, 6F, mean age±SD: 23.1±11 yrs) were studied. The results of IQ, Vineland-II and NPI scales are showed in Table 1. About 82% of adults and 84.6% of young pts presented with some type of UI or faecal incontinence (FI), with continuous UI being more frequent in children/teens and intermittent UI more frequent in adults. High PVR (>300 ml) was detected in 3 adults (Table 2). Significant relationships were identified between intermittent UI and some Vineland-II domains, as communication ability (p<0.005), reduced daily living skills (p<0.04), and reduced motor skills (p<0.002). Intermittent and continuous UI, NE and FI were significantly related with poor daily living skills (p<0.01).
Conclusions: Young and adult ASD patients, with greater ID and mood disorders, present with a high prevalence of BBD. A shared pathogenetic mechanism could underlie the co-occurrence of ASD, mood disorders and BBD. Source of
