Editorial: Autism Spectrum Disorder and Obsessive-Compulsive Disorder

In this issue of the Journal, Pereira et al.¹ conduct a systematic review, exploring the complex, often confusing, association between autism spectrum disorder (ASD) and obsessive-compulsive disorder (OCD), 2 commonly occurring neuropsychiatric disorders affecting youth, using cognitive, genetic, and neurobiological data to map shared and unique features. We applaud this effort to extract and analyze the limited extant literature in these domains in these cohorts precisely because the shared and unique features of each are a frequently encountered dilemma for clinicians. This review is both timely and therapeutically relevant. Meta-analytic data suggest that 9%² to 12%³ of autistic individuals meet criteria for OCD compared with approximately 2% in the general population. Conversely, ASD is present in approximately 10% of youth with OCD.³ The poor response of autism-related repetitive behaviors to selective serotonin reuptake inhibitors-despite their well-established efficacy in treating OCD^4,5-underscores the importance of distinguishing restricted repetitive behaviors (RRBs) of autism from those in OCD. Given the clinical challenge of parsing these overlapping symptoms, the identification of neural and genetic biomarkers may facilitate more accurate differentiation and guide appropriate therapeutic interventions.