{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T03:04:05Z","timestamp":1779678245357,"version":"3.53.1"},"reference-count":32,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T00:00:00Z","timestamp":1778284800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: Obsessive\u2013compulsive disorder (OCD) frequently co-occurs with autism spectrum disorder (ASD), but the prevalence and clinical correlates of this comorbidity remain incompletely understood. Methods: We examined a clinical sample of 603 patients with a primary diagnosis of OCD, of whom 149 (24.7%) presented with comorbid ASD. Sociodemographic variables, clinical characteristics, comorbidities, and obsessive\u2013compulsive symptom dimensions were compared between patients with and without ASD. Results: Patients with OCD + ASD reported an earlier onset of both obsessive\u2013compulsive symptoms and full-blown disorder. While overall symptom severity (Y-BOCS, HAM-D, and HAM-A) was comparable, OCD + ASD patients were characterized by a higher exposure to stressful and traumatic life events, including severe trauma (e.g., death of a close family member, sexual abuse, physical violence, serious illness, and bullying). Severe traumatic events, in particular, were independently associated with ASD comorbidity in our OCD cohort (exploratory model). Comorbidities were also distinct: onychophagia (66.4% vs. 0.4%) and trichotillomania (8.7% vs. 0%) were markedly more prevalent in the OCD + ASD group. Phenomenologically, OCD + ASD patients more often exhibited religious and somatic obsessions, as well as repetition compulsions. Specifically, somatic obsessions were independently associated with ASD in our regression analysis. Conclusions: OCD with comorbid ASD represents a clinically distinct subgroup, characterized by greater vulnerability to trauma, earlier onset, unique symptom profiles, and specific comorbidities. Recognition of these features, and in particular a history of severe traumatic experiences and the presence of somatic obsessions, may support earlier consideration of ASD comorbidity during OCD assessment and may inform personalized treatment planning.<\/jats:p>","DOI":"10.3390\/life16050792","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T02:32:28Z","timestamp":1779676348000},"page":"792","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Obsessive\u2013Compulsive Disorder (OCD) and Autism Spectrum Disorder (ASD): Clinical Fingerprints of the Comorbidity"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2855-2865","authenticated-orcid":false,"given":"Luca","family":"Pellegrini","sequence":"first","affiliation":[{"name":"Department of Medicine, Surgery and Health Sciences, UCO Clinica Psichiatrica, University of Trieste, Via Guglielmo De Pastrovich 3, 34128 Trieste, Italy"},{"name":"Department of Mental Health, Psychiatric Clinic, Azienda Sanitaria Universitaria Giuliano-Isontina\u2014ASUGI, 34128 Trieste, Italy"},{"name":"School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK"},{"name":"Centre for Psychedelic Research and Neuropsychopharmacology, Imperial College London, London NW1 5QH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Di Salvo","sequence":"additional","affiliation":[{"name":"Department of Neurosciences \u201cRita Levi Montalcini\u201d, University of Turin, 10124 Turin, Italy"},{"name":"Psychiatric Unit, San Luigi Gonzaga University Hospital, Orbassano, 10124 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2308-9146","authenticated-orcid":false,"given":"Gianluca","family":"Rosso","sequence":"additional","affiliation":[{"name":"Department of Neurosciences \u201cRita Levi Montalcini\u201d, University of Turin, 10124 Turin, Italy"},{"name":"Psychiatric Unit, San Luigi Gonzaga University Hospital, Orbassano, 10124 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2533-140X","authenticated-orcid":false,"given":"Giuseppe","family":"Maina","sequence":"additional","affiliation":[{"name":"Department of Neurosciences \u201cRita Levi Montalcini\u201d, University of Turin, 10124 Turin, Italy"},{"name":"Psychiatric Unit, San Luigi Gonzaga University Hospital, Orbassano, 10124 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9781-4219","authenticated-orcid":false,"given":"Umberto","family":"Albert","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Health Sciences, UCO Clinica Psichiatrica, University of Trieste, Via Guglielmo De Pastrovich 3, 34128 Trieste, Italy"},{"name":"Department of Mental Health, Psychiatric Clinic, Azienda Sanitaria Universitaria Giuliano-Isontina\u2014ASUGI, 34128 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,9]]},"reference":[{"key":"ref_1","unstructured":"(2013). Diagnostic and Statistical Manual of Mental Disorders: DSM-5TM, American Psychiatric Publishing, Inc.. [5th ed.]."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2307","DOI":"10.1007\/s10803-024-06357-8","article-title":"Repetitive Behaviors in Autism and Obsessive-Compulsive Disorder: A Systematic Review","volume":"55","author":"McKenzie","year":"2025","journal-title":"J. Autism Dev. Disord."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Meier, S.M., Petersen, L., Schendel, D.E., Mattheisen, M., Mortensen, P.B., and Mors, O. (2015). Obsessive-Compulsive Disorder and Autism Spectrum Disorders: Longitudinal and Offspring Risk. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0141703"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Aymerich, C., Pacho, M., Catalan, A., Yousaf, N., P\u00e9rez-Rodr\u00edguez, V., Hollocks, M.J., Parellada, M., Krebs, G., Clark, B., and Salazar de Pablo, G. (2024). Prevalence and Correlates of the Concurrence of Autism Spectrum Disorder and Obsessive Compulsive Disorder in Children and Adolescents: A Systematic Review and Meta-Analysis. Brain Sci., 14.","DOI":"10.3390\/brainsci14040379"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1080\/13651501.2017.1354029","article-title":"Autism Spectrum Disorders in Adult Outpatients with Obsessive Compulsive Disorder in the UK","volume":"22","author":"Wikramanayake","year":"2018","journal-title":"Int. J. Psychiatry Clin. Pract."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Dell\u2019Osso, L., Nardi, B., Bonelli, C., Amatori, G., Pereyra, M.A., Massimetti, E., Cremone, I.M., Pini, S., and Carpita, B. (2024). Autistic Traits as Predictors of Increased Obsessive-Compulsive Disorder Severity: The Role of Inflexibility and Communication Impairment. Brain Sci., 14.","DOI":"10.3390\/brainsci14010064"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"4158","DOI":"10.1007\/s10803-020-04474-8","article-title":"An Exploratory Study of a Dimensional Assessment of the Diagnostic Criteria for Autism","volume":"50","author":"Brosnan","year":"2020","journal-title":"J. Autism Dev. Disord."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1038\/s44220-025-00385-8","article-title":"Phenotypic Divergence between Individuals with Self-Reported Autistic Traits and Clinically Ascertained Autism","volume":"3","author":"Banker","year":"2025","journal-title":"Nat. Ment. Health"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1007\/s10882-011-9247-z","article-title":"Phenomenology of Comorbid Autism Spectrum and Obsessive-Compulsive Disorders Among Children","volume":"23","author":"Lewin","year":"2011","journal-title":"J. Dev. Phys. Disabil."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1002\/aur.108","article-title":"Autism Spectrum and Obsessive-Compulsive Disorders: OC Behaviors, Phenotypes and Genetics","volume":"2","author":"Jacob","year":"2009","journal-title":"Autism Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1177\/1362361315604271","article-title":"The Mental Health of Individuals Referred for Assessment of Autism Spectrum Disorder in Adulthood: A Clinic Report","volume":"20","author":"Russell","year":"2016","journal-title":"Autism"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1007\/s11920-020-01176-x","article-title":"Co-Occurrence, Assessment and Treatment of Obsessive Compulsive Disorder in Children and Adults with Autism Spectrum Disorder","volume":"22","author":"Bedford","year":"2020","journal-title":"Curr. Psychiatry Rep."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1007\/s10578-017-0714-3","article-title":"ASD Traits Among Youth with Obsessive-Compulsive Disorder","volume":"48","author":"Griffiths","year":"2017","journal-title":"Child. Psychiatry Hum. Dev."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.psychres.2015.03.012","article-title":"Outcomes of Cognitive Behaviour Therapy for Obsessive-Compulsive Disorder in Young People with and without Autism Spectrum Disorders: A Case Controlled Study","volume":"228","author":"Murray","year":"2015","journal-title":"Psychiatry Res."},{"key":"ref_15","first-page":"CD013173","article-title":"Behavioural and Cognitive Behavioural Therapy for Obsessive Compulsive Disorder (OCD) in Individuals with Autism Spectrum Disorder (ASD)","volume":"9","author":"Elliott","year":"2021","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1177\/1362361319856974","article-title":"Adapted Cognitive Behavior Therapy for Obsessive-Compulsive Disorder with Co-Occurring Autism Spectrum Disorder: A Clinical Effectiveness Study","volume":"24","author":"Flygare","year":"2020","journal-title":"Autism"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1159\/000056210","article-title":"An Exploratory Study on Obsessive-Compulsive Disorder with and without a Familial Component: Are There Any Phenomenological Differences?","volume":"35","author":"Albert","year":"2002","journal-title":"Psychopathology"},{"key":"ref_18","first-page":"28","article-title":"Assessing Suicide Risk in Patients with Obsessive-Compulsive Disorder: A Dimensional Approach","volume":"45","author":"Bramante","year":"2023","journal-title":"Braz. J. Psychiatry"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"152619","DOI":"10.1016\/j.comppsych.2025.152619","article-title":"Single-Dose (10 Mg) Psilocybin Reduces Symptoms in Adults with Obsessive-Compulsive Disorder: A Pharmacological Challenge Study","volume":"142","author":"Pellegrini","year":"2025","journal-title":"Compr. Psychiatry"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1001\/archpsyc.1989.01810110048007","article-title":"The Yale-Brown Obsessive Compulsive Scale. I. Development, Use, and Reliability","volume":"46","author":"Goodman","year":"1989","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/S0165-0327(00)00328-1","article-title":"Psychopathological Dimensions of Depression: A Factor Study of the 17-Item Hamilton Depression Rating Scale in Unipolar Depressed Outpatients","volume":"68","author":"Pancheri","year":"2002","journal-title":"J. Affect. Disord."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/0165-0327(88)90072-9","article-title":"The Hamilton Anxiety Scale: Reliability, Validity and Sensitivity to Change in Anxiety and Depressive Disorders","volume":"14","author":"Maier","year":"1988","journal-title":"J. Affect. Disord."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/0165-0327(85)90027-8","article-title":"Inter-Rater Reliability of the Italian Version of the Paykel Scale of Stressful Life Events","volume":"8","author":"Baratta","year":"1985","journal-title":"J. Affect. Disord."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1016\/j.rasd.2010.06.020","article-title":"Posttraumatic Stress Disorder in Individuals with Diagnosis of Autistic Spectrum Disorders","volume":"5","author":"Mehtar","year":"2011","journal-title":"Res. Autism Spectr. Disord."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1016\/j.janxdis.2007.10.003","article-title":"Autism Spectrum Traits in Children and Adolescents with Obsessive-Compulsive Disorder (OCD)","volume":"22","author":"Ivarsson","year":"2008","journal-title":"J. Anxiety Disord."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1192\/bjp.186.6.525","article-title":"Obsessions and Compulsions in Asperger Syndrome and High-Functioning Autism","volume":"186","author":"Russell","year":"2005","journal-title":"Br. J. Psychiatry"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Pellegrini, L., Di Salvo, G., Rosso, G., Maina, G., and Albert, U. (2025). Onychophagia in Obsessive-Compulsive Disorder (OCD): Prevalence and Clinical Characterisation. Brain Sci., 15.","DOI":"10.20944\/preprints202509.1464.v1"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1513","DOI":"10.1016\/j.comppsych.2014.05.020","article-title":"Comorbidity in Obsessive-Compulsive Disorder (OCD): A Report from the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS)","volume":"55","author":"Lochner","year":"2014","journal-title":"Compr. Psychiatry"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1017\/S1092852914000662","article-title":"The Neuropsychology of Obsessive-Compulsive Personality Disorder: A New Analysis","volume":"20","author":"Fineberg","year":"2015","journal-title":"CNS Spectr."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1007\/s10803-009-0922-1","article-title":"Autism and ADHD Symptoms in Patients with OCD: Are They Associated with Specific OC Symptom Dimensions or OC Symptom Severity?","volume":"40","author":"Anholt","year":"2010","journal-title":"J. Autism Dev. Disord."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1186\/1745-0179-4-26","article-title":"Comorbidity of Asperger\u2019s Syndrome and Bipolar Disorder","volume":"4","author":"Raja","year":"2008","journal-title":"Clin. Pract. Epidemiol. Ment. Health"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1080\/13651501.2019.1638939","article-title":"Overlap of Obsessive-Compulsive Personality Disorder and Autism Spectrum Disorder Traits among OCD Outpatients: An Exploratory Study","volume":"23","author":"Gadelkarim","year":"2019","journal-title":"Int. J. Psychiatry Clin. Pract."}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/16\/5\/792\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T02:51:47Z","timestamp":1779677507000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/16\/5\/792"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,9]]},"references-count":32,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["life16050792"],"URL":"https:\/\/doi.org\/10.3390\/life16050792","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,9]]}}}