Diagnostic- and sex-based differences in depression symptoms in autistic and neurotypical early adolescents.
Jessica M Schwartzman, Zachary J Williams, Blythe A Corbett
PMID 34180264WHAT IT FOUND
Autistic early adolescents reported more severe depressive symptoms than neurotypical peers, with females reporting higher severity than males.
These effects were additive, meaning autistic females had the highest scores. Autistic youth specifically endorsed more interpersonal problems and negative self-esteem, including beliefs of worthlessness.
Key findings
01Autistic early adolescents had significantly higher total depressive symptom scores than neurotypical peers, and females had higher scores than males across both groups, with no interaction suggesting the effects are additive.
02Item-level analysis showed autistic youth endorsed significantly more severe symptoms in the Interpersonal Problems and Negative Self-Esteem subscales compared to neurotypical peers.
03In a subsample of adolescents with clinically elevated depression scores, autistic youth reported numerically higher severity on all 28 depression items compared to neurotypical peers, with beliefs of worthlessness being significantly higher.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
The sample was not racially or ethnically diverse, limiting generalizability. The CDI-2 has not been specifically validated for autistic youth, so differences may reflect response tendencies rather than true symptom severity. The study used a cross-sectional snapshot, so it cannot track changes in depression over time. There were unequal numbers of females in the diagnostic groups, which reduced statistical power for sex-based comparisons within groups. Clinical diagnoses of depression were not confirmed by structured interviews; the study relied on self-report scores.
Declared interests
Blythe Corbett is the founder of SENSE Theatre but derives no financial compensation. Zachary Williams serves on the Family Advisory Committee of the Autism Speaks Autism Treatment Network and consults for Roche. The study was supported by N.I.H. grants.
The easy way to misread this
Do not assume that the higher depression scores in autistic youth reflect a distinct symptom profile from neurotypical youth. The authors note that interpersonal difficulties and negative self-esteem may simply reflect common experiences of autism, such as social communication differences, rather than depression. Additionally, the CDI-2 was not validated for this population, so scores may be influenced by how autistic individuals respond to items.