Just been looking at multiple complex developmental disorder

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I remember seeing this disorder before, and it has always puzzled me. Many of the symptoms can just be accounted for by having an autism spectrum disorder, but the main focus in MCDD seems to be the presence of psychosis and extreme aggression. To be honest, I’m not sure if I believe this is a real thing, and I certainly would hope that people aren’t diagnosed with it as it isn’t in the DSM or ICD. This kind of reminds me of the thread started on “Schizotypal Autism” here one time that turned out to be a hoax.

I have no doubt that ASD can occur with psychosis, but I don’t think it is a separate disorder with a single cause. Some of the more common instances where the two disorders would be commorbid are if the person used certain substances or suffered a brain injury, if the psychosis occurred as a result of a major depressive disorder, or in cases of things like DiGeorge Syndrome, which increases the risk for autism, behavioral problems, and psychosis. In cases where the cause of psychosis is unknown but occurs alongside autism, I do not think it is one disorder, but the two disorders blending together to create a certain subtype that could be seen by some as a single disorder (MCDD). The underlying mechanisms aren’t different though, and it is likely that there was a separate cause for each disorder. That’s just my opinion, though.

Differentiation between autism and multiple complex developmental disorder in response to psychosocial stress.
Jansen LM1, Gispen-de Wied CC, van der Gaag RJ, van Engeland H.
Author information
Abstract

Multiple Complex Developmental Disorder (MCDD) represents a distinct group within the autistic spectrum based on symptomatology. Unlike autistic children, part of MCDD children develop schizophrenia in adult life. Despite the differences, patients of both disorders are mainly characterized by abnormal reactions to their social environment. At the biological level, we showed in a previous study that MCDD children have a reduced cortisol response to psychosocial stress. Given the fact that autistic children clinically show more social impairments, it was hypothesized that they may have even further decreased cortisol responses to psychosocial stress than MCDD patients. Therefore, 10 autistic children were compared to 10 MCDD children and 12 healthy control children in their response to a psychosocial stressor, consisting of a public speaking task. In order to test whether any impairments in the biological stress response are specific for psychosocial stress, the autistic children were compared with 11 MCDD children and 15 control children in their response to a physical stressor, consisting of 10 min of bicycle exercise. Heart rate and salivary cortisol levels were used as indicators of response to the stress tests. Autistic children showed a relatively elevated cortisol response to psychosocial stress, in contrast to MCDD children who showed a reduced cortisol response. No differences in heart rate or cortisol responses to the physical stress test were found. The specific difference between autistic and MCDD children in their cortisol response to psychosocial stress indicates that the disturbed reactions to the social environment observed in these disorders may have different biological backgrounds.

https://www.ncbi.nlm.nih.gov/pubmed/12629541

^^^The thing is, how can the researchers be sure that these kids had MCDD in the study? There may be a diagnostic criteria, but it is far from official. Wouldn’t they need children with a psychotic disorder diagnosis along with those who would go on to develop a psychotic disorder in the study as well?

This is far from becoming a clinical diagnosis.