Most men with autism have psychiatric disorders such as depression, finds a study of 50 men diagnosed with the disorder roughly 20 years ago. The findings highlight the range of challenges for adults with autism, many of whom lack the help they need.
Among the men who have another disorder, depression and attention deficit hyperactivity disorder (ADHD) in particular went unrecognized and untreated. The study was published 26 July in the Journal of Autism and Developmental Disorders1.
“The focus on autism alone has led to undertreatment of both depression and ADHD,” says lead researcher Christopher Gillberg, professor of child and adolescent psychiatry at the University of Gothenburg in Sweden. “Everyone who works with people with Asperger’s or autism needs to be aware that they should be looking out for these problems.”
The study is remarkable because it follows the same individuals over an extended period of time, says Matthew Siegel, assistant professor of psychiatry and pediatrics at Tufts University in Massachusetts. The findings also highlight the need for better diagnostic tools for adults with autism, Siegel says.
The study is a follow-up to an analysis of 100 Swedish boys and teens diagnosed with Asperger syndrome between 1985 and 1991. (The syndrome, characterized by high language ability, has since been folded into an autism diagnosis.)
Gillberg and his colleagues succeeded in contacting 76 of the men when they averaged 20 years of age2. For the new study, the researchers met 50 men, now with an average age of 30, from the original 100.
They found that all but three of the men have had at least one psychiatric disorder, such as depression, ADHD, anxiety or obsessve-compulsive disorder, at some point in their lives. Of the 50, currently 27 have symptoms of at least one psychiatric disorder. Depression and ADHD are predominant: 14 men had ADHD and 14 had depression at the time of the study, and 29 had been depressed at some point in their lives.
The researchers also assessed how well these individual cope with their particular sets of challenges. Having both autism and ADHD seems to pose the most difficulty, according to the measure the researchers used. Overall, men with more than one disorder fare worse than those who have only autism.
The new study is small, but the findings are consistent with those of larger studies, including one published in Autism earlier this year. In that study, researchers surveyed adults with autism via the Interactive Autism Network, an Internet-based registry. Of the 225 men and women who responded, 86 percent reported that they had at least one other psychiatric disorder. Anxiety, depression and ADHD were the most prevalent. More than 120 caregivers filled out the same survey, reporting similar results3.
Together, the studies highlight the blurred boundaries between different disorders, which in some cases may stem from the same biological glitch, says Tinca Polderman, assistant professor of complex trait genetics at VU University Amsterdam in the Netherlands. “We made these categories, and they’re really useful, but underlying biological factors might not be so strictly limited to each disorder,” she says.
Gillberg and his colleagues uncovered some other interesting information about their participants. For example, they noticed that as adolescents, many of the men were clumsy and uncoordinated. Of those included in the latest study, 34 had met the criteria for developmental coordination disorder — a neurological condition that affects that brain’s ability to control the body. Many of the men never learned to ride a bike, for instance. In one extreme case, a participant had difficulty avoiding obvious obstacles, such as a pole on the street.
These motor deficits might make social interactions even more challenging, Gillberg says, noting that some of the men avoided sports and other group activities as teens. “We need to be looking much more carefully in all individuals given a diagnosis of autism or Asperger’s given all these problems.”