Neurological and Psychiatric Comorbidities in Autism Spectrum Disorders: A Review

ABSTRACT RELEVANCE. Autism spectrum disorders represent a complex group of neurodevelopmental conditions with extremely heterogeneous clinical manifestations. A key feature of autism spectrum disorders is the high prevalence of co-occurring neuropsychiatric conditions that significantly affect cognitive development, quality of life, adaptation, and prognosis. AIM. To provide an extended review of current evidence regarding the prevalence, pathogenesis, and clinical significance of neurological and psychiatric comorbidities in autism spectrum disorder. MATERIALS AND METHODS. An analytical review of international publications indexed in PubMed, Scopus, Web of Science, and eLibrary databases between 2015 and 2025 was conducted. The following search terms were used: autism spectrum disorder, comorbidity, epilepsy, attention-deficit/hyperactivity disorder (ADHD), neuroinflammation, sleep disorders, anxiety, depression. RESULTS AND DISCUSSION. The prevalence of comorbid conditions in patients with autism spectrum disorders reaches 70–90 %. The most common were epilepsy, anxiety and depressive disorders, ADHD, sleep disturbances and sensory integration deficits. Their development is associated with synaptic dysfunction, excitatory–inhibitory imbalance, altered activity of neurotransmitter systems (GABA, glutamate, serotonin, dopamine), and chronic neuroinflammation. CONCLUSION. Comorbidity is a system-forming factor in the clinical phenotype of autism spectrum disorders. A personalized approach that includes comprehensive neurological and psychiatric assessment increases the effectiveness of diagnosis and treatment, reduces the severity of behavioral disturbances, and improves social adaptation. KEYWORDS: autism spectrum disorder, comorbidity, neuroinflammation, epilepsy, neurodevelopmental disorders

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