Structured clinical diagnostic assessment reveals autism spectrum disorder in adults with functional neurological disorder

Emerging evidence suggests a link between Autism Spectrum Disorder (ASD) and Functional Neurological Disorder (FND), underscoring the importance of considering neurodevelopmental traits in neurological care. This study examined the prevalence of clinically probable ASD (CP-ASD) in a specialist FND c...

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Authors: Gonzalez-Herrero, B, Coebergh, J, Pagonabarraga, J, Morgante, F, Deeley, Q, Edwards, MJ
Format: article
Status:Published version
Publication Date:2025
Country:España
Institution:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repository:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p20572
Online Access:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=20572
Access Level:Open access
Keyword:Functional Neurological Disorder
Autism Spectrum Disorder
Clinical overlap
Screening
Interoception.
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spelling Structured clinical diagnostic assessment reveals autism spectrum disorder in adults with functional neurological disorderGonzalez-Herrero, BCoebergh, JPagonabarraga, JMorgante, FDeeley, QEdwards, MJFunctional Neurological DisorderAutism Spectrum DisorderClinical overlapScreeningInteroception.Emerging evidence suggests a link between Autism Spectrum Disorder (ASD) and Functional Neurological Disorder (FND), underscoring the importance of considering neurodevelopmental traits in neurological care. This study examined the prevalence of clinically probable ASD (CP-ASD) in a specialist FND clinic and explored its associations with symptom presentation, mental health, alexithymia and interoceptive awareness. Sixteen consecutively recruited adults with FND underwent comprehensive ASD assessment, including self-report questionnaires (RAADS-R, AdAS Spectrum), observational interview (ADOS-IV), and evaluation against DSM-5 criteria. Additional validated psychometric measures assessed anxiety (GAD-7), depression (PHQ-9), dissociation (Cambridge Depersonalization Scale, CDS), alexithymia (TAS-20), camouflaging (CAT-Q), and interoceptive sensibility (MAIA-2). Half of the participants (n = 8) met criteria for CP-ASD. Compared with the non-CP-ASD group, the CP-ASD group had a younger age at symptom onset and a longer interval from onset to FND diagnosis. After correction for multiple comparisons, significant group differences remained for anxiety (GAD-7), dissociation (CDS), and camouflaging behaviours (CAT-Q total, Compensation, and Assimilation subscales). Several further differences reached uncorrected significance with large effect sizes, including alexithymia (TAS-20) and the MAIA-2 Not Worrying and Emotional Awareness subscales, but did not survive correction and should be considered exploratory. Among functional symptom types, only sensory symptoms differed, being more prevalent in the CP-ASD group (62.5% vs 12.5%, p =.021), while treatment response did not differ between groups. . These findings suggest that ASD may frequently co-exist with FND but remain under-recognised. Incorporating routine screening and neurodevelopmentally informed care could improve diagnostic accuracy and support more personalised interventions. Larger, adequately powered studies are needed to confirm these preliminary results and to clarify further the role of neurodevelopmental factors in the onset, persistence, and treatment response of FND.NATURE RESEARCH2025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=20572Scientific ReportsISSN: 20452322reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Inglésinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p205722026-06-14T12:41:47Z
dc.title.none.fl_str_mv Structured clinical diagnostic assessment reveals autism spectrum disorder in adults with functional neurological disorder
title Structured clinical diagnostic assessment reveals autism spectrum disorder in adults with functional neurological disorder
spellingShingle Structured clinical diagnostic assessment reveals autism spectrum disorder in adults with functional neurological disorder
Gonzalez-Herrero, B
Functional Neurological Disorder
Autism Spectrum Disorder
Clinical overlap
Screening
Interoception.
title_short Structured clinical diagnostic assessment reveals autism spectrum disorder in adults with functional neurological disorder
title_full Structured clinical diagnostic assessment reveals autism spectrum disorder in adults with functional neurological disorder
title_fullStr Structured clinical diagnostic assessment reveals autism spectrum disorder in adults with functional neurological disorder
title_full_unstemmed Structured clinical diagnostic assessment reveals autism spectrum disorder in adults with functional neurological disorder
title_sort Structured clinical diagnostic assessment reveals autism spectrum disorder in adults with functional neurological disorder
dc.creator.none.fl_str_mv Gonzalez-Herrero, B
Coebergh, J
Pagonabarraga, J
Morgante, F
Deeley, Q
Edwards, MJ
author Gonzalez-Herrero, B
author_facet Gonzalez-Herrero, B
Coebergh, J
Pagonabarraga, J
Morgante, F
Deeley, Q
Edwards, MJ
author_role author
author2 Coebergh, J
Pagonabarraga, J
Morgante, F
Deeley, Q
Edwards, MJ
author2_role author
author
author
author
author
dc.subject.none.fl_str_mv Functional Neurological Disorder
Autism Spectrum Disorder
Clinical overlap
Screening
Interoception.
topic Functional Neurological Disorder
Autism Spectrum Disorder
Clinical overlap
Screening
Interoception.
description Emerging evidence suggests a link between Autism Spectrum Disorder (ASD) and Functional Neurological Disorder (FND), underscoring the importance of considering neurodevelopmental traits in neurological care. This study examined the prevalence of clinically probable ASD (CP-ASD) in a specialist FND clinic and explored its associations with symptom presentation, mental health, alexithymia and interoceptive awareness. Sixteen consecutively recruited adults with FND underwent comprehensive ASD assessment, including self-report questionnaires (RAADS-R, AdAS Spectrum), observational interview (ADOS-IV), and evaluation against DSM-5 criteria. Additional validated psychometric measures assessed anxiety (GAD-7), depression (PHQ-9), dissociation (Cambridge Depersonalization Scale, CDS), alexithymia (TAS-20), camouflaging (CAT-Q), and interoceptive sensibility (MAIA-2). Half of the participants (n = 8) met criteria for CP-ASD. Compared with the non-CP-ASD group, the CP-ASD group had a younger age at symptom onset and a longer interval from onset to FND diagnosis. After correction for multiple comparisons, significant group differences remained for anxiety (GAD-7), dissociation (CDS), and camouflaging behaviours (CAT-Q total, Compensation, and Assimilation subscales). Several further differences reached uncorrected significance with large effect sizes, including alexithymia (TAS-20) and the MAIA-2 Not Worrying and Emotional Awareness subscales, but did not survive correction and should be considered exploratory. Among functional symptom types, only sensory symptoms differed, being more prevalent in the CP-ASD group (62.5% vs 12.5%, p =.021), while treatment response did not differ between groups. . These findings suggest that ASD may frequently co-exist with FND but remain under-recognised. Incorporating routine screening and neurodevelopmentally informed care could improve diagnostic accuracy and support more personalised interventions. Larger, adequately powered studies are needed to confirm these preliminary results and to clarify further the role of neurodevelopmental factors in the onset, persistence, and treatment response of FND.
publishDate 2025
dc.date.none.fl_str_mv 2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=20572
url https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=20572
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv NATURE RESEARCH
publisher.none.fl_str_mv NATURE RESEARCH
dc.source.none.fl_str_mv Scientific Reports
ISSN: 20452322
reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
instname_str Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
reponame_str r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
collection r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
repository.name.fl_str_mv
repository.mail.fl_str_mv
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