Introduction: Anxiety disorders are highly prevalent in individuals with autism spectrum disorder (ASD), but knowledge is limited regarding identification and treatment of these disorders in individuals with ASD and more severe levels of intellectual disability (ID). The current case study aims to explore and describe the inpatient, psychiatric assessment in an adolescent male with ASD, severe ID and self-injurious behaviour (SIB) who was diagnosed with a co-occurring anxiety disorder. The study further aims to explore the implications of this diagnosis for subsequent intervention and care, including management of SIB.

Materials and methods: Case study including multimodal, psychiatric assessment and subsequent intervention.

Results: Following changes in care strategies attempting to incorporate the understanding of anxiety/trauma as contributing to SIB, a reduction of SIB was observed, and this reduced frequency was maintained when the patient was discharged from the inpatient setting.

Conclusions: Though no causal inferences are possible, these experiences indicate that further research is needed regarding possible associations between SIB and anxiety in individuals with ASD, including implications for treatment. Experiences from the current case further indicate that it is possible to recognize and diagnose anxiety disorder in complex cases involving ASD, severe ID, limited verbal language skills, and severe SIB.

简介：焦虑症在自闭症谱系障碍 (ASD) 患者中非常普遍，但对于自闭症谱系障碍 (ASD) 和更严重的智力障碍 (ID) 患者中这些疾病的识别和治疗方面的知识有限。当前的案例研究旨在探索和描述一名患有 ASD、严重 ID 和自残行为 (SIB) 的青少年男性的住院精神评估，该男性被诊断患有并发焦虑症。该研究进一步旨在探讨该诊断对后续干预和护理（包括 SIB 管理）的影响。

材料和方法：案例研究，包括多模式、精神病学评估和后续干预。

结果：随着护理策略的改变，试图将焦虑/创伤的理解纳入 SIB 的促成因素中，观察到 SIB 减少，并且当患者出院时，这种减少的频率得以维持。

结论：虽然不可能进行因果推论，但这些经验表明，需要进一步研究 SIB 与 ASD 患者焦虑之间可能存在的关联，包括对治疗的影响。当前病例的经验进一步表明，在涉及 ASD、严重 ID、有限言语能力和严重 SIB 的复杂病例中识别和诊断焦虑症是可能的。