Adults With Autism Have an Increased Lifetime Risk for Suicidality

The lifetime risk for suicidality is significantly elevated among adults with autism spectrum disorder (ASD) relative to adults without ASD, according to study results published in Autism. These findings may offer insights that could guide targeted mental health interventions for adults with ASD.

Increasing evidence indicates that adults with ASD are at increased risk for suicidal thoughts and behavior. However, relatively little is known about the unique contributors to suicidality adults with ASD may experience. Therefore, researchers set out to identify the incidence and predictors of suicidality in adults with ASD, to understand whether and how they differed from the general population.

The researchers conducted a cross-sectional study of longitudinal data from the Netherlands Autism Register and the current sample was limited to adult participants (aged 16 years and older) with ASD who completed the Suicidal Behaviors Questionnaire (SBQ-R) and the Suicidal Ideation Attributes Scale (SIDAS) from an annual survey. Diagnoses of ASD were confirmed via the Diagnostic and Statistical Manual of Mental Disorders (DSM).

A total of 1164 participants responded to the first item of the SBQ-R that was part of the standard database study. These respondents were then asked to complete the remaining sections of the SBQ-R and the entire set of questions in the SIDAS, resulting in a final sample of 421 participants with ASD. On average, participants were 45.5 (SD, 12.9) years of age, 38.5% were women, and 60.6% reported a psychiatric comorbidity.

In the initial cohort of participants who completed the first item of the SBQ-R (n=1164), over 80% of adults with ASD had considered or attempted suicide in their lifetime. Specifically, 27% experienced suicidal thoughts, 38.7% had a suicide plan, and 15% had attempted suicide.

Investigators then conducted linear regression analyses with the final sample (n=421) data to identify potential predictors of lifetime suicidal behavior and recent suicidal thoughts. Candidate variables included age, sex, employment status, loneliness, the number of autistic traits, and psychiatric comorbidity. The investigators found that suicidal behavior was significantly predicted by psychiatric comorbidity (B, -2.11; 95% CI, -2.87 to -1.34; P <.01), loneliness (B, 0.08; 95% CI, 0.04-0.12; P <.01), and a higher number of autistic traits (B, 0.06; 95% CI, 0.02-0.09; P <.01). For suicidal thoughts in the past month, significant predictors included psychiatric comorbidity (B, -6.16; 95% CI, -8.50 to -3.82; P <.01) and a higher number of autistic traits (B, 0.17; 95% CI, 0.04-0.12; P <.01).

The results indicate that adults with ASD have a 10-fold higher risk for suicidality relative to the general Dutch population. Furthermore, the study identifies distinct predictors of suicidality among individuals with ASD, which could be used to inform suicide prevention strategies specific to the ASD community. Study authors concluded, “Future research should focus on adapting suicide prevention interventions for autistic individuals for them to better address the specific challenges these individuals face.”

This study was limited by the reliance on self-reported data, a lack of validation for the SBQ-R among adults with ASD, missing data from participants, and an inability to determine causality due to the cross-sectional design.

This article originally appeared on Psychiatry Advisor