Nearly two-thirds of individuals with a mental disorder start experiencing symptoms during adolescence or early adulthood, and the onset of a mental disorder during this critical life stage strongly predicts adverse socioeconomic and health outcomes. Subthreshold manifestations of autism spectrum disorders (ASDs), also called autistic traits (ATs), are known to be associated with a higher vulnerability to the development of other psychiatric disorders. This study aimed to assess the presence of ATs in a population of young adults seeking specialist assistance and to evaluate the study population across various psychopathological domains in order to determine their links with ATs.

We recruited a sample of 263 adolescents and young adults referring to a specialized outpatient clinic, and we administered them several self-report questionnaires for the evaluation of various psychopathological domains. We conducted a cluster analysis based on the prevalence of ATs, empathy, and sensory sensitivity scores.

The cluster analysis identified three distinct groups in the sample: an AT cluster (22.43%), an intermediate cluster (45.25%), and a no-AT cluster (32.32%). Moreover, subjects with higher ATs exhibited greater symptomatology across multiple domains, including mood, anxiety, eating disorder severity, psychotic symptoms, and personality traits such as detachment and vulnerable narcissism.

This study highlights the importance of identifying ATs in young individuals struggling with mental health concerns. Additionally, our findings underscore the necessity of adopting a dimensional approach to psychopathology to better understand the complex interplay of symptoms and facilitate tailored interventions.

Autism spectrum disorders have recently encountered a change in how they are perceived, since what used to be a narrowly defined rare disorder of childhood is now recognized as a fairly common heterogeneous disorder, which may receive a first-diagnosis during adolescence and adulthood, yet, a common scenario within this age group is that either the diagnosis is missed or misdiagnosed with other psychiatric disorders. Nevertheless, relatively little has been published about the prevalence of autistic traits in adolescent and young adults, and specifically in those investigated for psychiatric conditions.In the present study, we explore the prevalence of autistic traits among 170 adolescents and young adults who were referred to the outpatient psychiatry clinic “Centro Giovani Ponti” in Milan, Italy between September 2021 and March 2022.

Socio-demographic information was collected and all participants completed the following questionnaires; (1) The Autism Quotient (AQ), (2) The Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R), (3) The Sensory Perception Quotient (SPQ) and (4) The Empathy Quotient (EQ).

Out of 170 participants, a striking 103 (60.6%) of the subjects scored above the cut-off in RAADS-R, and 31 (18.2%) of the subjects scored above the cut-off in AQ. Furthermore, 99 (58.2%) participants were in the medium range and 47 (27.6%) were in the low empathy category according to EQ results. A significant sensory sensitivity was measured with an SPQ total score of 55.25 (SD = 17.76). Finally, gender difference was of significance in the RAADS-R, EQ and SPQ, but not in the AQ. In the RAADS-R, non-binary subjects (128.60) scored higher than females (78.68). Whereas, in the SPQ female (57.39) participants scored higher than non-binary subjects (40.30). Furthermore, females scored significantly higher compared to males in the EQ total score with values of 42.56 and 35.89, respectively.

To conclude, we report that a significant proportion of adolescents and young adults seeking psychiatric care have unrecognized autistic traits and that an impact of gender is observed. This so called ‘lost generation’ is attributed to be created by the complex phenotypic presentations, changes in diagnostic criteria and associated diagnostic difficulties. It is of utmost importance to clarify the prevalence of autistic traits within this age range and to increase awareness among clinicians, since establishing the true diagnosis, which is commonly complicated by the high rates of psychiatric comorbidity or overlapping mental health symptoms, will reduce the burden on patients, their families, clinicians, and the society.

Highlighting the relationship between obsessive–compulsive disorder (OCD) and tic disorder (TD), two highly disabling, comorbid, and difficult-to-treat conditions, Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) acknowledged a new “tic-related” specifier for OCD, ie, obsessive–compulsive tic-related disorder (OCTD). As patients with OCTD may frequently show poor treatment response, the aim of this multicenter study was to investigate rates and clinical correlates of response, remission, and treatment resistance in a large multicenter sample of OCD patients with versus without tics.

A sample of 398 patients with a DSM-5 diagnosis of OCD with and without comorbid TD was assessed from 10 different psychiatric departments across Italy. For the purpose of the study, treatment response profiles in the whole sample were analyzed comparing the rates of response, remission, and treatment-resistance as well as related clinical features. Multivariate logistic regressions were performed to identify possible factors associated with treatment response.

The remission group was associated with later ages of onset of TD and OCD. Moreover, significantly higher rates of psychiatric comorbidities, TD, and lifetime suicidal ideation and attempts emerged in the treatment-resistant group, with larger degrees of perceived worsened quality of life and family involvement.

Although remission was associated with later ages of OCD and TD onset, specific clinical factors, such as early onset and presence of psychiatric comorbidities and concomitant TD, predicted a worse treatment response with a significant impairment in quality of life for both patients and their caregivers, suggesting a worse profile of treatment response for patients with OCTD.

Obsessive-compulsive disorder (OCD) and tic disorder (TD) represent highly disabling, chronic and often comorbid psychiatric conditions. While recent studies showed a high risk of suicide for patients with OCD, little is known about those patients with comorbid TD (OCTD). Aim of this study was to characterize suicidal behaviors among patients with OCD and OCTD.

Three hundred and thirteen outpatients with OCD (n = 157) and OCTD (n = 156) were recruited from nine different psychiatric Italian departments and assessed using an ad-hoc developed questionnaire investigating, among other domains, suicide attempt (SA) and ideation (SI). The sample was divided into four subgroups: OCD with SA (OCD-SA), OCD without SA (OCD-noSA), OCTD with SA (OCTD-SA), and OCTD without SA (OCTD-noSA).

No differences between groups were found in terms of SI, while SA rates were significantly higher in patients with OCTD compared to patients with OCD. OCTD-SA group showed a significant male prevalence and higher unemployment rates compared to OCD-SA and OCD-noSA sample. Both OCTD-groups showed an earlier age of psychiatric comorbidity onset (other than TD) compared to the OCD-SA sample. Moreover, patients with OCTD-SA showed higher rates of other psychiatric comorbidities and positive psychiatric family history compared to the OCD-SA group and to the OCD-noSA groups. OCTD-SA and OCD-SA samples showed higher rates of antipsychotics therapies and treatment resistance compared to OCD-noSA groups.

Patients with OCTD vs with OCD showed a significantly higher rate of SA with no differences in SI. In particular, OCTD-SA group showed different unfavorable epidemiological and clinical features which need to be confirmed in future prospective studies.