An autistic dimension: a proposed subtype of obsessive-compulsive disorder.
Susanne (2007) warns that unrecognized mild autism traits can hide inside severe OCD and wreck treatment outcomes.
01Research in Context
What this study did
Bejerot (2007) wrote a position paper, not an experiment.
The author argues that hidden mild autism traits can sit inside severe OCD.
When that happens, the OCD becomes harder to treat.
What they found
No new data were collected.
The paper claims that odd, paranoid or schizotypal quirks are red flags.
These flags may point to an "autistic dimension" that worsens OCD prognosis.
How this fits with other research
Grzadzinski et al. (2011) extends the idea to ADHD. They found a subgroup of kids with ADHD who carry distinct autistic traits, showing the dimension cuts across more than OCD.
Berna et al. (2016) give the idea numbers. In a survey, high autistic traits predicted weaker self-concept clarity, offering one reason why treatment may stall.
Levy (2021) and Fein et al. (2021) act as later voices in the same conversation. Both push autism research to drop categorical boxes and use dimensional or prototype methods, echoing Susanne’s 2007 call.
O'Connor et al. (2008) seems to contradict by saying autistic social quirks are just a different processing style, not a severe subtype. The gap is focus: Susanne worries about prognosis, Kate reframes the trait as neutral cognitive style.
Why it matters
If your OCD client sounds odd, paranoid or rigid in an atypical way, pause. Screen for autism traits with a quick tool like AQ-10. Share results with the medical team so they can adjust exposure scripts, build predictability and target self-concept. Catching the dimension early may save months of stalled therapy.
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02At a glance
03Original abstract
This article focuses on the possibility that autism spectrum disorder (ASD: Asperger syndrome, autism and atypical autism) in its milder forms may be clinically important among a substantial proportion of patients with obsessive-compulsive disorder (OCD), and discusses OCD subtypes based on this proposition. The hypothesis derives from extensive clinical experience of OCD and ASD, and literature searches on MEDLINE. Neuropsychological deficits are more common in OCD than in panic disorder and depression. Moreover, obsessive-compulsive and schizotypal personality disorders are over-represented in OCD. These may constitute mis-perceived clinical manifestations of ASD. Furthermore, repetitive behaviours and hoarding are common in Asperger syndrome. It is suggested that the comorbidity results in a more severe and treatment resistant form of OCD. OCD with comorbid ASD should be recognized as a valid OCD subtype, analogous to OCD with comorbid tics. An odd personality, with paranoid, schizotypal, avoidant or obsessive-compulsive traits, may indicate these autistic dimensions in OCD patients.
Autism : the international journal of research and practice, 2007 · doi:10.1177/1362361307075699