Do DSM-5 and ICD-11 Provide Enough Guidance on Comorbid Conditions in Autism?

PostedNovember 17, 2025

UpdatedNovember 17, 2025

ByMy Patient Advice

Author: Lucia Alvarez, MSc | Reviewed by: Dr. Rebecca Fernandez, MBBS

No, DSM-5 and ICD-11 do not provide exhaustive guidance on autism comorbid conditions. While both diagnostic systems recognise the high prevalence of co-occurring conditions like ADHD, anxiety, and depression in individuals with autism, they offer limited direction on how to assess and manage these comorbidities within the framework of an autism diagnosis. This can lead to underdiagnosis or misdiagnosis of co-occurring conditions, particularly when symptoms overlap.

Key Challenges in Addressing Comorbidity in Autism

Managing co-occurring conditions in autism presents several important challenges:

Limited Focus on Comorbidity in Diagnostic Criteria

While DSM-5 and ICD-11 acknowledge the presence of comorbid conditions, they do not provide detailed guidance on how to distinguish between autism traits and those of other disorders, leading to challenges in creating a comprehensive diagnosis.

Overlap of Symptoms

Symptoms of autism often overlap with those of other conditions, such as social anxiety or obsessive-compulsive behaviours, making it difficult to accurately identify comorbidity.

Impact of Late Diagnosis

In many cases, comorbid conditions may not be diagnosed until later in life when the individual faces increasing social and academic challenges. This can delay appropriate intervention and support.

Lack of Specific Treatment Guidelines

While autism comorbid conditions like depression or ADHD are commonly observed, both DSM-5 and ICD-11 offer little specific direction on how these conditions should be managed alongside autism. This gap can affect treatment planning and the provision of holistic care.

Summary

While both DSM-5 and ICD-11 acknowledge autism comorbid conditions, they do not provide comprehensive guidance on how to diagnose, assess, or treat these conditions in conjunction with autism. This lack of detail creates challenges for clinicians in offering fully integrated care.

For personalised advice and guidance on autism assessments, visit providers like Autism Detect for personal consultations.

For a deeper dive into the science, diagnosis, and full treatment landscape, read our complete guide to Autism Diagnostic Criteria (DSM-5, ICD-11).

Lucia Alvarez, MSc

Author

Lucia Alvarez is a clinical psychologist with a Master’s in Clinical Psychology and extensive experience providing evidence-based therapy and psychological assessment to children, adolescents, and adults. Skilled in CBT, DBT, and other therapeutic interventions, she has worked in hospital, community, and residential care settings. Her expertise includes grief counseling, anxiety management, and resilience-building, with a strong focus on creating safe, supportive environments to improve mental well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the author's privacy.

Dr. Rebecca Fernandez, MBBS

Reviewer

Dr. Rebecca Fernandez is a UK-trained physician with an MBBS and experience in general surgery, cardiology, internal medicine, gynecology, intensive care, and emergency medicine. She has managed critically ill patients, stabilised acute trauma cases, and provided comprehensive inpatient and outpatient care. In psychiatry, Dr. Fernandez has worked with psychotic, mood, anxiety, and substance use disorders, applying evidence-based approaches such as CBT, ACT, and mindfulness-based therapies. Her skills span patient assessment, treatment planning, and the integration of digital health solutions to support mental well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the reviewer's privacy.