Injections of Galanin-Like Peptide directly into the nucleus of the tractus solitarius (NTS) reduces food intake and body weight but increases metabolic rate and plasma leptin

Galanin-Like Peptide (GALP) is a hypothalamic neuromediator of metabolism and reproduction. GALP is known to stimulate reproduction and alter food intake and body weight in multiple species. The regulation of body weight involves control of both energy intake and energy expenditure. Since GALP is known to alter food intake - possibly via the autonomic nervous system - we first hypothesized that GALP would increase metabolic rate. First, male Sprague-Dawley rats were implanted with intracerebroventricular (ICV) cannulae and abdominal radiotelemetry temperature transmitters. Following ICV injection with either 5 nmol GALP or vehicle, the oxygen consumption of each rat was monitored for 8 h. Food intake, core temperature, and general motor activity were monitored for 24 h. GALP significantly increased oxygen consumption, an indirect estimator of metabolic rate, without having any significant effect on motor activity. Compared to controls, GALP increased core body temperature during the photophase and reduced food intake over the 24 h period following injection. ICV GALP also increased plasma levels of luteinizing hormone (LH). A second group of male Sprague-Dawley rats were implanted with abdominal transmitters and given injections of GALP directly into the nucleus of the tractus solitarius (NTS). These injections resulted in a significant reduction in food intake, and a significant increase in both oxygen consumption and core body temperature compared to vehicle injections. Direct injections of GALP into the NTS compared to vehicle also resulted in a significant increase in plasma leptin levels, but not LH levels. GALP appears to increase energy expenditure in addition to decreasing energy input by actions within the NTS and thus may play an important role in the hypothalamic regulation of body weight.     

The relationship between sexual functioning among couples undergoing infertility treatment: a pair of perfect gloves

ObjectiveThe study aimed to measure the relationship of sexual functioning between male and female partners, who sought infertility treatment in a university hospital setting in Malaysia.MethodsThis cross-sectional study was conducted on couples with infertility problems attending the Medically Assisted Conception Center (MACC). The female and male sexual functioning was measured using the Malay Version of Female Sexual Function Index (MVFSFI) and Malay Version of International Index of Erectile Function (IIEF), respectively. The relationship between the female and male sexual functioning was measured using correlation statistical analyses. A total of 269 subjects (150 females and 119 males) who met the requirement of the study, were recruited.ResultsThe female and male sexual functioning was moderately correlated (r = 0.574). Female sexual arousal and sexual satisfaction domains scores had the largest correlation (r = 0.522 and r = 0.507 respectively) to IIEF total score. On the other hand, male intercourse satisfaction (IS) domain score had the highest correlation (r = 0.574) to FSFI total score. A strong correlation between male and female sexual function was observed.ConclusionIt is speculated that possible interaction of male and female sexual functioning may be multifactorial and complex.     

Differential effects of central injections of D1 and D2 receptor agonists and antagonists on male sexual behavior in Japanese quail

A key brain site in the control of male sexual behavior is the medial pre‐optic area (mPOA) where dopamine stimulates both D1 and D2 receptor subtypes. Research completed to date in Japanese quail has only utilized systemic injections and therefore much is unknown about the specific role played by dopamine in the brain and mPOA in particular. The present study investigated the role of D1 and D2 receptors on male sexual behavior by examining how intracerebroventricular injections and microinjections into the mPOA of D1 and D2 agonists and antagonists influenced appetitive and consummatory aspects of sexual behavior in male quail. Experiments 1 and 2 investigated the effects of intracerebroventricular injections at three doses of D1 or D2 agonists and antagonists. The results indicated that D1 receptors facilitated consummatory male sexual behavior, whereas D2 receptors inhibited both appetitive and consummatory behaviors. Experiment 3 examined the effects of the same compounds specifically injected in the mPOA and showed that, in this region, both receptors stimulated male sexual behaviors. Together, these data indicated that the stimulatory action of dopamine in the mPOA may require a combined activation of D1 and D2 receptors. Finally, the regulation of male sexual behavior by centrally infused dopaminergic compounds in a species lacking an intromittent organ suggested that dopamine action on male sexual behavior does not simply reflect the modulation of genital reflexes due to general arousal, but relates to the central control of sexual motivation. Together, these data support the claim that dopamine specifically regulates male sexual behavior.     

The predictive validity of common risk assessment tools in men with intellectual disabilities and problematic sexual behaviors

This CIHR-funded study examined whether certain current risk assessment tools were effective in appraising risk of recidivism in a sample of sex offenders with intellectual disabilities (ID). Fifty men with ID who had engaged in problematic sexual behavior (PSB) were followed for an average of 2.5 years. Recidivism was defined and measured as any illegal or problematic behavior, as well as any problematic but not necessarily illegal behavior. At the beginning of the study, each participant was rated on two risk assessment tools: the Violence Risk Appraisal Guide (VRAG) and the Sex Offender Risk Appraisal Guide (SORAG). During each month of follow-up, participants were also rated on the Short-Dynamic Risk Scale (SDRS), an assessment tool intended to measure the risk of future problematic behaviors. Data was analyzed using t-tests, Cohen’s d and area under the curve (AUC) to test predictive validity of the assessment tools. Using the AUC, results showed that the VRAG was predictive of sexual (AUC = 0.74), sexual and/or violent (AUC = 0.71) and of any criminally chargeable event (AUC = 0.69). The SORAG was only significantly predictive of sexual events (AUC = 0.70) and the SDRS was predictive of violent events (AUC = 0.71). The t-test and Cohen’s d analyses, which are less robust to deviations from the assumptions of normal and continuous distribution than AUC, did not yield significant results in each category, and therefore, while the results of this study suggest that the VRAG and the SORAG may be effective tools in measuring the short term risk of sexual recidivism; and the VRAG and SDRS may be effective tools in appraising long term risk of sexual and/or violent recidivism in this population, it should be used with caution. Regardless of the assessment tool used, risk assessments should take into account the differences between sex offenders with and without ID to ensure effective measurement.     

Topography in the preoptic region: differential regulation of appetitive and consummatory male sexual behaviors

Several studies have suggested dissociations between neural circuits underlying the expression of appetitive (e.g., courtship behavior) and consummatory components (i.e., copulatory behavior) of vertebrate male sexual behavior. The medial preoptic area (mPOA) clearly controls the expression of male copulation but, according to a number of experiments, is not necessarily implicated in the expression of appetitive sexual behavior. In rats for example, lesions to the mPOA eliminate male-typical copulatory behavior but have more subtle or no obvious effects on measures of sexual motivation. Rats with such lesions still pursue and attempt to mount females. They also acquire and perform learned instrumental responses to gain access to females. However, recent lesions studies and measures of the expression of the immediate early gene c-fos demonstrate that, in quail, sub-regions of the mPOA, in particular of its sexually dimorphic component the medial preoptic nucleus, can be specifically linked with either the expression of appetitive or consummatory sexual behavior. In particular more rostral regions can be linked to appetitive components while more caudal regions are involved in consummatory behavior. This functional sub-region variation is associated with neurochemical and hodological specializations (i.e., differences in chemical phenotype of the cells or in their connectivity), especially those related to the actions of androgens in relation to the activation of male sexual behavior, that are also present in rodents and other species. It could thus reflect general principles about POA organization and function in the vertebrate brain.     

An epidemological study of obsessive compulsive disorder in adolescents from India

ObjectivesThere is scarce data on the prevalence of OCD among adolescents in India. This study reports point prevalence of OCD among school students (age 12–18 years) in the Kerala state of India and examines its association with ADHD, psychological distress, tobacco/alcohol abuse, suicide risk and history of sexual abuse.Method7560 students of 73 schools were self-administered the OCD subsection of Clinical Interview Schedule–Revised, the Composite International Diagnostic Interview (CIDI) for obsessive compulsive symptoms and other relevant instruments to identify OCD and related clinical measures. A diagnosis of ICD-10 OCD was derived through the CIS-R algorithm which required duration of at least 2 weeks and at least a thought/behavior to be resisted along with a cut-off score for severity and impairment.ResultsIn the sample, 50.3% were males with a mean age of 15.2 years (range of 12–18 years). The response rate was 97.3% (7380 valid responses). 0.8% (n = 61) fulfilled criteria for OCD with a male predominance (1.1 vs. 0.5%, p = 0.005). Prevalence was higher among Muslims and increased with age. Taboo thoughts (62.3%) and mental rituals (45.9%) were the commonest symptoms. Those with OCD had significantly higher suicidal thoughts (59 vs. 16.3%, p < 0.01) suicide attempts (24.6 vs. 3.8%, p < 0.01), ADHD (28 vs. 4%, p < 0.001), sexual abuse (24.6 vs. 4.2%, p < 0.01), and tobacco use (23 vs. 6.8%, p = 0.01). They also reported greater psychological distress and poorer academic performance.ConclusionsOCD is common among adolescents in India. Its associations with ADHD, sexual abuse, psychological distress, poorer academic performance and suicidal behavior are additional reasons for it to be recognized and treated early.     

Prevalence and risk factors of female sexual dysfunction among healthcare personnel in malaysia

ObjectiveTo determine the prevalence and risk factors of female sexual dysfunction (FSD) among healthcare personnel in selected healthcare facilities in Malaysia.MethodsThis was a cross-sectional study carried out at three large healthcare facilities that were selected by convenience sampling. Within each facility, stratified random sampling was used to select suitable candidates to participate in the study (n = 201). Validated questionnaires were used to assess depression, anxiety, sexual function in women and erectile dysfunction (ED) in their partners.ResultsThe prevalence of FSD was 5.5%. Women with sexual dysfunction were more likely to be married longer (OR = 4.08; 95% CI; 1.15–4.50), had lower frequency of sexual intercourse (OR = 5.00; 95% C; 1.05–23.76) and had a spouse with ED (OR = 24.35; 95% CI; 4.55–130.37). Multivariate analysis showed that ED was the strongest predictor for FSD (AOR = 27.30; 95% CI; 4.706–159.08).ConclusionOne in eighteen female healthcare personnel suffered from FSD and presence of ED in the partner strongly impacted her sexual function, negatively. The findings highlight the importance of including the male partner in clinical assessment of FSD.     

Reduced gray matter volume in psychotic disorder patients with a history of childhood sexual abuse

Childhood trauma is associated with smaller gray matter volume, similar to the pattern seen in psychotic disorders. We explored the relationship between childhood abuse, psychosis, and brain volume in a group of 60 individuals with a psychotic disorder and 26 healthy control subjects. We used voxel-based morphometry (VBM) to quantify gray and white matter volume and the Childhood Trauma Questionnaire (CTQ) to measure childhood abuse. Within the psychotic disorder group, total gray matter volume was inversely correlated with the severity of childhood sexual abuse (r = ? .34, p = .008), but not the other types of abuse. When the 24 patients with sexual abuse were compared with demographically matched samples of 23 patients without sexual abuse and 26 control subjects, only patients with a history of sexual abuse had reduced total gray matter volume (t(48) = 2.3, p = .03; Cohen's d = .63). Voxel-based analysis revealed a cluster in the prefrontal cortex where volume was negatively correlated with sexual abuse severity. Voxel based comparison of the three matched groups revealed a similar pattern of results, with widespread reductions in psychosis patients with sexual abuse relative to controls that were not found in psychosis patients without sexual abuse. These findings indicate that some of the variance of gray matter volume in psychotic disorders can be explained by a history of sexual abuse.     

Ibotenic acid lesions of the medial preoptic area disrupt the expression of partner preference in sexually receptive female rats

The present study evaluated the effects of ibotenic acid lesions of the medial preoptic area (mPOA) on the display of partner preference in ovariectomized, estrogen- and progesterone-primed rats. Preference for a sexually vigorous male or an estrous female rat was determined in one of two conditions: unlimited physical access to the stimulus rats (Contact condition) or access that was limited to olfactory, auditory and visual cues (No-contact condition). Lesions of the mPOA reduced the male preference, social preference, and arena crossings, independent of test condition. However, the reduction in male preference following mPOA lesions was most pronounced during tests with unlimited physical access. These results suggest that the mPOA may be involved in integrating somatosensory signals from coital stimulation with the motor responses associated with the appetitive aspects of female sexual behavior.     

Why do young adolescents bully? Experience in Malaysian schools

IntroductionTo determine sociodemographic and psychological factors associated with bullying behavior among young adolescents in Malaysia.MethodsThis is a cross-sectional study of four hundred ten 12-year-old adolescents from seven randomly sampled schools in the Federal Territory of Kuala Lumpur, Malaysia. Sociodemographic features of the adolescents and their parents, bullying behavior (Malaysian Bullying Questionnaire), ADHD symptoms (Conners Rating Scales), and internalizing and externalizing behavior (Child Behaviour Checklist) were obtained from adolescents, parents and teachers, respectively.ResultsOnly male gender (OR = 7.071, p = 0.01*, CI = 1.642–30.446) was a significant sociodemographic factor among bullies. Predominantly hyperactive (OR = 2.285, p = 0.00*, CI = 1.507–3.467) and inattentive ADHD symptoms reported by teachers (OR = 1.829, p = 0.03*, CI = 1.060–3.154) and parents (OR = 1.709, p = 0.03*, CI = 1.046–2.793) were significant risk factors for bullying behavior while combined symptoms reported by young adolescents (OR = 0.729, p = 0.01*, CI = 0.580–0.915) and teachers (OR = 0.643, p = 0.02*, CI = 0.440–0.938) were protective against bullying behavior despite the influence of conduct behavior (OR = 3.160, p = 0.00*, CI = 1.600–6.241). Internalizing behavior, that is, withdrawn (OR = 0.653, p = 0.04*, CI = 0.436–0.977) and somatic complaints (OR = 0.619, p = 0.01*, CI = 0.430–0.889) significantly protect against bullying behavior.DiscussionsRecognizing factors associated with bullying behavior, in particular factors distinctive to the local population, facilitates in strategizing effective interventions for school bullying among young adolescents in Malaysian schools.     

Effects of parental gender and level of education on the quality of life and general health of pediatric patients with epilepsy: An outpatient cross-sectional survey

The quality of life (QOL) of children with epilepsy has been widely studied, and several problems related to cognition, behavior, social lives, and physical activity among these children have been reported. Family life and parental care are important aspects of the lives of these patients. The impact of parental education on the QOL of pediatric patients with epilepsy is an understudied topic, especially in developing countries. In this study, we investigated the QOL and general health (GH) of patients with epilepsy presenting at the pediatric neurology clinic at Baqiyatallah Hospital and a private clinic. The Quality of Life in Childhood Epilepsy (QOLCE) questionnaire, which is a 92-item epilepsy-specific questionnaire covering physical activity, well-being, cognition, behavior, social activity, overall QOL, and GH, was used for interviewing parents. A total of 106 patients (m = 61, 57.5% and f = 45, 42.5%) aged 5–17 years (mean: 10.31 ± 2.91) participated in the study. Overall, there was no significant difference between the QOL and GH results of male and female patients. However, the maternal education level had a significant impact on the overall QOL (high school: 3.02 ± 0.85 vs. B.Sc.: 3.67 ± 0.61, p < 0.05) and GH (high school: 2.81 ± 0.79 vs. B.Sc.: 3.8 ± 0.94, p < 0.05) of male patients, while paternal education had no significant effect. A multiple linear regression showed that the maternal education level had an independently significant association with the physical activity of the patients (p = 0.02, CI: 1.4–6.25), and the paternal education level had an independently significant association with the well-being of the patients (p = 0.02, CI: 0.43–5.36). In addition, the maternal education level (high school vs. B.Sc.) had a significant effect on physical activity, well-being, cognition, and behavior for all of the patients (p < 0.05), while the paternal education level (high school vs. B.Sc.) had no significant impact. However, in a comparison of high school vs. higher education, paternal education had a significant effect on patients' physical activity and well-being (p < 0.05). We conclude that parental levels of education play a significant role in various aspects of the lives and GH of children with epilepsy. Maternal education, in particular, plays a significant role in GH and the overall QOL of male patients. Further research is suggested to identify the socioeconomic and cultural factors responsible for these findings.     

Gestational flu exposure induces changes in neurochemicals,affiliative hormones and brainstem inflammation,in addition to autism-like behaviors in mice

The prevalence of neurodevelopmental disorders such as autism is increasing, however the etiology of these disorders is unclear and thought to involve a combination of genetic, environmental and immune factors. A recent epidemiological study found that gestational viral exposure during the first trimester increases risk of autism in offspring by twofold. In mice gestational viral exposures alter behavior of offspring, but the biological mechanisms which underpin these behavioral changes are unclear. We hypothesized that gestational viral exposure induces changes in affiliative hormones, brainstem autonomic nuclei and neurotransmitters which are associated with behavioral alterations in offspring. To address this hypothesis, we exposed pregnant mice to influenza A virus (H3N2) on gestational day 9 and determined behavioral, hormonal and brainstem changes in male and female offspring. We found that gestational flu exposure induced dose-dependent alterations in social and aggressive behaviors (p ⩽ 0.05) in male and female offspring and increases in locomotor behaviors particularly in male offspring (p ⩽ 0.05). We found that flu exposure was also associated with reductions in oxytocin and serotonin (p ⩽ 0.05) levels in male and female offspring and sex-specific changes in dopamine metabolism. In addition we found changes in catecholaminergic and microglia density in brainstem tissues of male flu exposed offspring only (p ⩽ 0.05). This study demonstrates that gestational viral exposure induces behavioral changes in mice, which are associated with alterations in affiliative hormones. In addition we found sex-specific changes in locomotor behavior, which may be associated with sex-specific alterations in dopamine metabolism and brainstem inflammation. Further investigations into maternal immune responses are necessary to unravel the molecular mechanisms which underpin abnormal hormonal, immune and behavioral responses in offspring after gestational viral exposure.     

Evolution of sexual functioning of men through treated and untreated depression

ObjectivesDepression as well as a treatment by antidepressant are factors that may interfere with sexuality. Due to this complex relationship between depression, antidepressant and sexuality, it is difficult to incontestably establish the exclusive accountability of a treatment or of a psychiatric disorder on sexual dysfunctions. The main purpose of the SADD (for Sexuality, Anti-Depressant and Depression) study is to evaluate sexual dysfunctions in depressed men treated with antidepressant or not.MethodsParticipants of this transversal, observational study were men aged over 18 years old, suffering from unipolar major depressive disorder and treated by a psychiatrist, with or without antidepressant. Assessment of sexual functioning through three times: euthymia (before depression), untreated depression and treated depression if applicable was performed based on the ASEX scale.ResultsSeventy patients were included. Eight percent of euthymic patients presented a sexual dysfunction (average score on the ASEX = 12.4) whereas 56% of untreated patients presented a sexual dysfunction (average total score on the ASEX = 17.7) and 62% (34/55) of patients treated with antidepressant (average total score on ASEX = 18.5) (P < 0.001). Sexual functioning of men receiving treatment is not significantly different to that among men not receiving any antidepressant, even if patients treated with antidepressant reported that they had a better mood than those untreated.ConclusionsOur results reveal a high prevalence of sexual dysfunction within the framework of major depressive disorder and its treatment and underlines the complex relationship between major depressive disorder, antidepressant and sexuality.     

Use of perampanel in children and adolescents with Lennox–Gastaut Syndrome

AimReport the use of perampanel treatment in children with Lennox–Gastaut syndrome (LGS).MethodWe conducted a prospective study of 13 LGS patients (seven male; mean age, 12.8 years) treated with adjunctive perampanel therapy. Perampanel was initiated at 2 mg/day and titrated to a median maximum dose of 6 mg/day.ResultsAfter a mean follow-up duration of 10.8 months (range, 1–24 months), nine patients (69.2%) were responders (≥ 50% reduction in total seizure frequency) and nine (69.2%) were rated by their physician as “much improved” or “very much improved”. Four patients (30.8%) discontinued perampanel due to the lack of efficacy (n = 2) and seizure aggravation (n = 2). No patients discontinued due to other adverse events (AEs). AEs were reported for six patients (46.2%) and comprised decreased activity/social interaction (n = 3), behavior disturbance with agitation (n = 2), and/or fatigue (n = 2). All AEs became manageable after perampanel dosing was decreased. Improvements in cognitive function and/or behavior were reported for seven patients (53.8%). Introduction of perampanel allowed the dose reduction and/or discontinuation of other treatments in seven patients (53.8%).InterpretationPerampanel was efficacious and generally well tolerated as an adjunctive treatment for seizures associated with LGS, supporting further research in this area.     

Heart rate variability of young men with idiopathic hypogonadotropic hypogonadism

BackgroundThere is little data available regarding the effects of male sex hormones on cardiac autonomic function. The aim of this study is to evaluate the association between hormones of male hypothalamo–pitiutary–gonadal axis and cardiac autonomic function by comparing heart rate variability (HRV) parameters of young male idiopathic hypogonadotropic hypogonadism patients with those of healthy controls.MethodsThe study consisted of 22 male idiopathic hypogonadotropic hypogonadism patients (mean age 20.8 ± 1.2 years) and the same number of age-matched healthy male controls (mean age 21.0 ± 1.5 years). A 24-hour Holter monitoring was performed to assess the time and frequency-domain parameters. The HRV parameters of patients and control groups were compared, and possible associations between levels of tested hormones and HRV parameters were evaluated.ResultsThe standard deviation of all NN intervals (SDNN), standard deviation of the averages of NN intervals in all 5 min segments (SDANN), power in low frequency range (LF, ms²) and power in high frequency range (HF, ms²) values of patients were significantly lower compared to those of controls (147.47 ± 56.16 vs. 193.63 ± 40.89; 138.31 ± 57.64 vs. 190.15 ± 43.94; 397.8 ± 236.7 vs. 491.5 ± 208.4; and 133.6 ± 97.4 vs. 198.5 ± 91.6 respectively; p < 0.05 for all). Significant negative correlations were observed between serum FSH, LH and testosterone levels and most of the HRV parameters.ConclusionsDeficiency in the male hypothalamo–pituitary–gonadal axis seems to adversely affect cardiac autonomic modulation with increased sympathetic and decreased parasympathetic components of HRV.     

Sexual dysfunction in obese women: Does obstructive sleep apnea play a role?

BackgroundFemale sexual dysfunction (FSD) is diagnosed when an impairment in the sexual response cycle is associated with distress in women. The association between obstructive sleep apnea (OSA) and FSD has been poorly investigated with conflicting results.AimTo assess the role of OSA in determining FSD in pre menopausal obese women.MethodsForty-six women underwent standard polysomnography. Data on sexual function and sexual-related distress were obtained using the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale (FSDS). Women with both abnormal FSFI and FSDS scores were classified as having FSD.ResultsThirty-one women were classified as having OSA. Fourteen (30.4%) women had both sexual difficulties and sexual distress resulting in FSD; they showed higher values of sleep time spent with SpO₂ <90% (T₉₀ 16.8 ± 24.4 vs. 3.2 ± 5.2%; p=0.004). FSD was present in 10 women with OSA (32.2%); in this group T₉₀ was higher (23.5 ± 26.3) in women with FSD than in those without FSD (4.8 ± 5.8; p = 0.003). In a logistic multiple regression analysis, T₉₀ was the only factor associated with an increased risk for FSD (odds ratio [OR] 1.07) (confidence interval [CI]) 1.006–1.13]; p=0.03).ConclusionsIn premenopausal obese women the presence of FSD is correlated with OSA only when nocturnal hypoxia is present.     

Adaptive skill trajectories in infants with fragile X syndrome contrasted to typical controls and infants at high risk for autism

BackgroundAdaptive behaviors are essential for optimal outcomes and independence in individuals with developmental disabilities. This study examined longitudinal trajectories of adaptive behavior in infants with fragile X syndrome (FXS), compared to typical development (TD) and infant siblings of children diagnosed with autism (ASIBs).MethodParticipants included 76 male infants (FXS = 25, ASIBs = 27, TD = 24) assessed up to 4 times between 6 and 24 months of age for a total of 215 assessments of adaptive behavior. A sample of 12 females with FXS was included for a comparative sex analysis.ResultsResults indicate that infant males with FXS displayed lower initial adaptive behavior across all domains that emerged by 9 months-of-age with slower growth rates than both comparison groups. A flat profile across the domains at 24 months was evident. Increased severity of autism symptoms was related to reduced adaptive skills at 24 months-of-age. Females with FXS displayed higher scores than males on the Socialization and Motor domains and equivalent scores on the Communication and Daily Living domains at 9 months-of-age with different rates of growth across domains.ConclusionsThis is the first study to provide evidence of etiological specificity in adaptive behavior profiles during infancy across two populations at high risk for ASD. These findings support targeted adaptive behavior interventions in young children with FXS beginning as early at 9 months of age to reduce identified deficits and the cascading impacts of these early impairments.     

Challenging behavior and co-morbid psychopathology in adults with intellectual disability and autism spectrum disorders

We investigated the relationship between challenging behavior and co-morbid psychopathology in adults with intellectual disability (ID) and autism spectrum disorders (ASDs) (N = 124) as compared to adults with ID only (N = 562). All participants were first time referrals to specialist mental health services and were living in community settings. Clinical diagnoses were based on ICD-10 criteria and presence of challenging behavior was assessed with the Disability Assessment Schedule (DAS-B). The analyses showed that ASD diagnosis was significantly associated with male gender, younger age and lower level of ID. Challenging behavior was about four times more likely in adults with ASD as compared to non-ASD adults. In those with challenging behavior, there were significant differences in co-morbid psychopathology between ASD and non-ASD adults. However, after controlling for level of ID, gender and age, there was no association between co-morbid psychopathology and presence of challenging behavior. Overall, the results suggest that presence of challenging behavior is independent from co-morbid psychopathology in adults with ID and ASD.