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Children with autism more likely to have depression as adults

Children and teenagers with autism spectrum disorder — especially those without intellectual disability — were more likely to have depression by young adulthood than the general population, according to findings recently published in JAMA Network Open.

“Mental health problems, such as depression, are considered to be common in individuals with [autism spectrum disorder]. However, most studies to date have been conducted in pediatric populations, with findings difficult to extrapolate to adulthood,” Dheeraj Rai, MRCPsych, PhD, Centre for Academic Mental Health at the University of Bristol, England, and colleagues wrote. “Furthermore, the mechanisms behind any increased risk of depression in people with [autism spectrum disorder] are not well understood.”

Researchers followed up with 223,842 participants of The Stockholm Youth Cohort, of whom 4,073 were diagnosed with autism spectrum disorder. Of those, 2,927 did not have an intellectual disability.

Rai and colleagues found that 19.8% of individuals with autism spectrum disorder were diagnosed with depression by age 27 years vs. 6% of the general population (adjusted RR = 3.64; 95% CI, 3.41-3.88). The risk for depression was higher in patients with autism spectrum disorder and no intellectual disability (adjusted RR = 4.28; 95% CI, 4-4.58) than in those with intellectual disability (adjusted RR = 1.81; 95% CI, 1.51-2.17).

In addition, non-autistic half-siblings (adjusted RR = 1.42; 95% CI, 1.23-1.64) and full-siblings (adjusted RR =1.37; 95% CI, 1.23-1.53) of those with autism spectrum disorder also had a higher risk for depression vs. the general population. When compared with non-autistic full-siblings, individuals with autism spectrum disorder had more than a twofold risk for depression (adjusted OR = 2.5; 95% CI, 1.91-3.27) in young adulthood.

“While the increased risk of depression in siblings may still suggest the role of common genetic vulnerability, siblings of children with [autism spectrum disorder] may also be prone to psychiatric disorders through other mechanisms. For example, they may receive less parental attention because of their autistic sibling with greater needs or may experience other stressors or discord in the household, or they may be more likely to have closer monitoring because their sibling has a diagnosis of autism,” Rai and colleagues wrote.

Children and teenagers with autism spectrum disorder — especially those without intellectual disability — were more likely to have depression by young adulthood than the general population, according to findings recently published in JAMA Network Open.

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“We also directly compared the risks of depression in [autism spectrum disorder] cases vs. matched non-autistic sibling controls, which is a powerful design to control for unmeasured confounding factors shared between siblings, such as shared genetic and familial socioeconomic factors. It was clear that individuals with [autism spectrum disorder] had a greater risk of depression than their non-autistic siblings, suggesting a mechanism other than shared familial characteristics,” they continued.

Rai and colleagues added that the results suggest more emphasis is needed on identifying and managing depression in those with autism in a timely manner, given the adverse events tied to the condition. – by Janel Miller

Disclosures : Rai reports receiving grants from The Baily Thomas Charitable Foundation, the National Institute for Health Research, and the Swedish Research Council for Health, Working Life and Welfare during the conduct of the study. None of the other authors report any relevant financial disclosures.