Children with autism at increased risk for several mental health conditions

Caregiver-reported mental health conditions were prevalent among children with autism spectrum disorder in the United States from a young age, according to study results published in Journal of Clinical Psychiatry.

“Though cumulative evidence from multiple sources suggests an increasing prevalence of [mental health conditions] in general population children, a current population-based estimate of [mental health conditions] in children with ASD is lacking,” Connor M. Kerns, PhD, of the department of psychology at the University of British Columbia in Canada, and colleagues wrote.

To address this research gap, the investigators analyzed data of 42,283 caregivers of children aged 3 to 17 years who were included in the 2016 population-based National Survey of Children’s Health. They estimated prevalence of correlates of mental health conditions reported by caregivers among children with ASD and compared these with those of children with intellectual disability, children with special health care needs and all others, the latter of whom did not have any of the former conditions.

Results showed one or more mental health condition among 77.7% of children with ASD, as well as two or more among 49.1% of this population. Behavior/conduct problem (60.8%), ADD/ADHD (48.4%), anxiety problem (39.5%) and depression (15.7%) were the most common mental health conditions, with substance abuse the only one less common among those with ASD. Youth with ASD had higher rates of mental health conditions than those with special health care needs, “all other” youth and those with intellectual disability. By ages 3 to 5 years, mental health conditions were common in ASD and increased with age, with 85.9% having one or more condition by ages 12 to 17 years. Girls were twice as likely to have an anxiety problem, those with intellectual disability were four times as likely to have a behavior/conduct problem and those with childhood adversity were at increased risk for an anxiety problem and ADD/ADHD.

Evidence-based assessment and treatment of [mental health conditions] in ASD should be used to reduce this demand by clarifying which children are most in need of and likely to benefit from available treatments,” Kerns and colleagues wrote. “Nonetheless, there is an incongruence between the ubiquity of [mental health conditions] in ASD and the disconnected disciplines and support systems for developmental disability and mental health that exist. Advances in research are likely to be realized only if steps are also taken to implement health care policies and training initiatives that support integrated developmental and mental health care going forward.”