Autism and chronic ill health: an observational study of symptoms and diagnoses of central sensitivity syndromes in autistic adults.
Sarah Grant, Sam Norton, Ricarda F Weiland and 3 others
PMID 35164862WHAT IT FOUND
Sixty percent of autistic adults scored high on a central sensitization screen, but only 31% of those had a formal diagnosis.
Symptoms were strongly linked to anxiety and sensory sensitivity rather than autism traits alone, suggesting these factors drive physical health risks.
Key findings
0159.8% of participants scored at or above the clinical cut-off for central sensitization symptoms, but only 31% of this high-symptom group had a formal diagnosis of a central sensitivity syndrome.
02In exploratory models, the association between autistic traits and central sensitization symptoms was fully mediated by anxiety and sensory sensitivity, meaning autistic traits alone did not predict symptoms once these factors were included.
03Women were significantly over-represented in both the diagnosed central sensitivity syndrome group and the high-symptom group, reporting greater sensory sensitivity, anxiety, and lower subjective wellbeing than men.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study was cross-sectional, so it cannot prove that anxiety or sensory sensitivity cause central sensitization symptoms; they are associated. There was no control group of non-autistic adults, so it is difficult to know if the high prevalence of symptoms is unique to autism or reflects broader chronic illness trends. CSS diagnoses were self-reported and not medically verified, which may lead to over- or under-reporting. The sample was predominantly Dutch and white, limiting generalizability to other cultural or ethnic groups. The CSI includes items about sensory sensitivity and anxiety, which may overlap with autism traits, potentially inflating scores (construct overlap). Gender was self-reported as man/woman/other, with 'other' excluded, and sex assigned at birth was not distinguished from gender identity.
Declared interests
The authors declared no competing interests. The study was supported by grants from the Netherlands Organisation for Scientific Research (NWO) and the Autism Research Trust.
The easy way to misread this
Do not assume that autism traits directly cause central sensitization symptoms. The data shows that anxiety and sensory sensitivity are the stronger predictors. Treating the physical symptoms without addressing the underlying anxiety and sensory processing needs may miss the primary drivers of distress.