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Suicide risk among people with ASD increases over 20 years in Utah

The risk for death by suicide in people with autism spectrum disorder from Utah —especially females — increased over time and was greater than in those without ASD between 2013 and 2017, according to results from a 20-year population-based study.

The data, published in Autism Research, showed that females with ASD were over three times more likely to complete suicide than those without ASD over the 20-year period.

"There has been an unfortunate assumption that people with autism are in their own world and are not affected by social influences commonly associated with suicidality," Anne Kirby, PhD, OTRL, assistant professor of occupational therapy at University of Utah, said in a press release. "There is now growing realization among clinicians and families that suicidal thoughts and behaviors can be a real concern for autistic individuals."

Most prior research has focused on clinical samples reporting varying rates of suicidality; therefore, Kirby and colleagues reported population-based data on risk for death by suicide among people with ASD living in Utah. Using surveillance data, the researchers evaluated the incidence of suicide among individuals with ASD over a 20-year period (1998 to 2017) and characterized those who died. They also divided the study into four 5-year periods: 1998 to 2002; 2003 to 2007; 2008 to 2012; and 2013 to 2017.

Between 1998 and 2017, 49 people with autism (7 female and 42 male) died by suicide in Utah, according to the release. Although the cumulative incidence rates of suicide did not significantly differ between people with and without autism from 1998 to 2012, the cumulative incidence of suicide was significantly higher in the ASD population between 2013 and 2017 (0.17% vs. 0.11%; P < .05).

This difference was driven by suicide among females with ASD, the study showed. Among females with autism, suicide risk was more than three times higher than in those without ASD (RR = 3.42; P < .01).

The researchers found that the average age at death and manner of death did not differ significantly between males and females with autism who died by suicide and the ages at death by suicide ranged from 14 to 70 years. In addition, the data revealed that people with ASD were significantly less likely to use firearms as a suicide method (adjusted OR = 0.33; P < .001).

"While these results show us that those with autism are not immune from suicide risk, we are still working to understand the extent of this risk," senior author Hilary Coon, PhD, professor of psychiatry at University of Utah, said in the release. "We do not yet have enough information to understand specific characteristics or cooccurring conditions associated with increased risk, so more research in this area is urgently needed to identify warning signs." – by Savannah Demko

Disclosure: The authors report no relevant financial disclosures.