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Research Summary

Autism and Co-occurring Psychiatric and Medical Conditions: Adults More Likely to Have More than One Condition

Sureka Pavalagantharajah and Dr. Jonathan Lai | York University
This article summarizes a study that used electronic medical records to examine how common medical or psychiatric conditions were for adults on the autism spectrum, compared to neurotypical peers. Autistic adults were reported to more commonly have some psychiatric and chronic health conditions.

What you need to know?

Autistic adults have higher rates of several psychiatric and chronic medical conditions compared to adults without ASD. In order to provide a better quality of life for adults with ASD, it is important to be aware of the conditions that they are at risk for, thus allowing for an early diagnosis and treatment of these conditions. 

What is this research about?

ASD is usually a lifelong condition. While there has been more research on the health of children with ASD, very little is known about how common medical conditions are in autistic adults. Past studies report that children and adolescents with ASD commonly have more medical and psychiatric conditions, such as depression, schizophrenia, sleep disorders, and gastrointestinal disorders. This study aims to determine how common several conditions are among adults with ASD.

What did the researchers do?

The study sample included adults (over 18 years old), who were given ASD diagnoses on at least two separate occasions in their electronic medical records. Non-ASD ‘control’ patients were chosen from the same database and matched to ASD cases according to gender and age group (spanning 5 years ranges). Overall, there were 1507 cases with ASD and 15,070 control cases used. The researchers examined if certain medical or psychiatric conditions were more common in one group compared to the other.

What did the researchers find?

Most psychiatric and medical conditions were more common in adults with ASD. In fact, 54% of autistic adults were diagnosed with a psychiatric condition, most commonly anxiety (29%), bipolar disorder (11%), depression (26%), attention deficit disorder (11%), obsessive-compulsive disorder (8%), and schizophrenia (8%). Compared to those without ASD, adults with ASD were more likely to have many of those conditions, including anxiety (3.7x), depression (2.9x) and schizophrenia (22x). As well, suicide attempts were five times more likely in those with an ASD diagnosis compared to those without one. 

Compared to those without ASD, autistic adults were more likely to have many of those conditions, including anxiety (3.7x), depression (2.9x) and schizophrenia (22x). As well, suicide attempts were five times more likely in those with an ASD diagnosis compared to those without an ASD diagnosis.

Regarding medical conditions, the autistic adults were more likely to have hypertension (25.6% among patients with ASD vs 15.6%), autoimmune conditions (13.9% vs 10.8%), dyslipidemia (22.8% vs 15.1%), sleep disorders (17.6% vs 9.6%), and several other chronic medical conditions.

Regarding medical conditions, autistic adults were more likely to have hypertension (25.6% among patients with ASD vs 15.6%), autoimmune conditions (13.9% vs 10.8%), dyslipidemia (22.8% vs 15.1%), sleep disorders (17.6% vs 9.6%), and several other chronic medical conditions. However, those with ASD were less likely to display alcohol abuse/dependence, infections, genitourinary disorders, and have cancer. The researchers suggest these differences may be due to delayed diagnoses, genetics, medication use, and lack of supports, health education, and accommodations for social and language challenges. 

How can you use this research?

It is important to understand the likelihood of developing psychiatric and medical conditions to ensure awareness and appropriate delivery of care. Early diagnoses can aid in the prevention or early treatment of the conditions. Future research can focus on understanding the mechanisms that lead to these increased risks in order to improve the quality of life for adults with an ASD diagnosis. 

About the Researchers

Lisa Croen (PhD) is the director of the Autism Research Program and a scientist at the Division of Research, Kaiser Permanente Northern California. Ousseny Zerbo (PhD) is a post-doctoral fellow with the Autism Research Program. Yinge Qian (MS) is a senior data analyst and Maria L. Massolo (PhD) is a research project manager at Kaiser Permanente. Steve Rich (MD) is the Chief of Family Medicine for Kaiser Permanente Santa Rosa. Stephen Sidney (MD, MPH) is the Director of Research Clinics and a scientist with the Kaiser Permanente. Clarissa Kripke (MD) is a Professor of Family and Community Medicine and directs the Office of Developmental Primary Care. 

Citation

Croen, LA., Zerbo, O., Qian, Y., Massolo, ML., Rich, S., Sidney, S., Kripke, C. (2015). The health status of adults on the autism spectrum. Autism, 19(7), 814-823

This research summary was written by Sureka Pavalagantharajah and Dr. Jonathan Lai for the Chair in Autism Spectrum Disorders Treatment and Care Research. This research summary, along with other summaries, can be found at asdmentalhealth.ca/research-summaries

Reproduced with the permission of Dr. Jonathan Weiss (York University). This research summary was developed with funding from the Chair in ASD Treatment and Care Research. The Chair was funded by the Canadian Institutes of Health Research in partnership with Autism Speaks Canada, the Canadian Autism Spectrum Disorders Alliance, Health Canada, Kids Brain Health Network (formerly NeuroDevNet) and the Sinneave Family Foundation. This information appeared originally in the Autism Mental Health Blog (https://asdmentalhealth.blog.yorku.ca).

Photo by Clem Onojeghuo on Unsplash

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