Anxiety Disorders in Adults with Autism Spectrum Disorder: A Population-Based Study.
Victoria Nimmo-Smith, Hein Heuvelman, Christina Dalman and 5 others
PMID 31621020WHAT IT FOUND
Adults with ASD in Sweden were diagnosed with anxiety disorders more often than non-autistic adults: 20.13% versus 8.72%.
Rates were highest in those without intellectual disability, and adults with ASD still had more diagnoses than their non-autistic full siblings.
Key findings
01In adults aged 18-27, 20.13% of people with ASD had a diagnosis of an anxiety disorder, compared with 8.72% of non-autistic adults; the adjusted relative risk was 2.62.
02Adults with ASD without intellectual disability had anxiety disorder diagnoses more often (23.11%) than adults with ASD with intellectual disability (12.53%); adjusted relative risks were 2.96 and 1.71 compared with non-autistic adults.
03When adults with ASD were compared directly with their non-autistic full siblings, the adjusted odds ratio for anxiety was 2.48 overall, 3.10 for ASD without intellectual disability, and 1.04 for ASD with intellectual disability.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Anxiety diagnoses came from health records, so some people with anxiety may not have been recorded, and some diagnoses may not have been verified. There were no standardised tools for measuring anxiety in ASD, and clinicians may have differed in recognising anxiety in people with ASD or intellectual disability. The study could not measure early life trauma, which may affect anxiety, especially PTSD. Rare disorders such as dissociative disorder had few cases, so estimates are unstable. Half-sibling comparisons could not fully account for family circumstances such as parental separation. The study counted diagnoses, not symptoms, so it cannot tell whether anxiety is more common in real life or whether ASD causes anxiety.
Declared interests
The study was funded by Baily Thomas Charitable Fund, Vetenskapsrådet, and the National Institute for Health Research. The supplied text gives no author disclosure of competing interests.
The easy way to misread this
Do not read these findings as evidence that any therapy reduces anxiety in ASD, or that every adult with ASD has anxiety. The study counted diagnoses recorded in registers, did not assess people directly, and did not test treatment.