A 20-year study of suicide death in a statewide autism population.
Anne V Kirby, Amanda V Bakian, Yue Zhang and 3 others
PMID 30663277WHAT IT FOUND
Suicide deaths were more common among people with ASD than without in the most recent period, especially females.
Earlier years showed no difference. People with ASD who died by suicide were younger.
Key findings
01For the first 15 years, suicide incidence did not differ between people with and without ASD; in 2013 to 2017, 0.17% of people with ASD died by suicide compared with 0.11% of people without ASD, a significantly higher incidence.
02All seven females with ASD who died by suicide did so in 2013 to 2017, when their cumulative incidence was 0.17% compared with 0.05% for females without ASD, a significantly higher incidence.
03People with ASD who died by suicide were younger than people without ASD who died by suicide, with average ages of 32.4 years and 41.8 years.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study compared suicide incidence without individual demographic data for the non-ASD population, so the relative risks were unadjusted. Only seven females with ASD died by suicide, all in the final period, so the female finding rests on a very small number of deaths. ASD diagnoses may have been missed, especially in females and older people, because the study used medical records rather than special education records. Suicide determinations are made conservatively, so some deaths may not have been counted as suicide. Data on intellectual ability, socioeconomic status, and many occupational categories were missing or unavailable. The study cannot show why suicide risk changed over time or whether current diagnosis practices affected the counts.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read the recent higher incidence as proof that ASD causes suicide or that earlier years were safe. The difference appeared only in the final period, the female finding relied on seven deaths, and missed ASD or suicide classifications could have changed the counts.