OTSLPCohortJournal of autism and developmental disorders2024

Heightened Anxiety and Depression Among Autistic Adolescents with ADHD: Findings From the National Survey of Children's Health 2016-2019.

Amy L Accardo, Nancy M H Pontes, Manuel C F Pontes

PMID 36327018

WHAT IT FOUND

Adolescents with both autism and ADHD have the highest rates of anxiety and depression.

Anxiety affects 72% of females and 69% of males with both conditions. Depression affects 39% of females and 38% of males. These rates are far higher than in those with only one condition or neither.

Key findings

01Anxiety prevalence was 71.6% in autistic females with ADHD and 69.2% in autistic males with ADHD, compared to 12.4% and 5.9% respectively in those with neither condition.

02Depression prevalence was 38.8% in autistic females with ADHD and 38.3% in autistic males with ADHD, compared to 7.8% and 3.6% respectively in those with neither condition.

03More than half of autistic females (57.4%) and nearly half of autistic males (49.1%) had a co-occurring ADHD diagnosis.

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 data relies on parent report of diagnoses made by a health care provider, which may lead to under-reporting or errors due to memory or social desirability bias. The study only included diagnoses that had been formally identified by a provider, so it may miss adolescents with undiagnosed anxiety or depression. The analysis was limited to binary sex categories (male and female), so it does not account for gender variance or non-binary identities, which may be more common in autistic and ADHD populations. As a secondary analysis, the study could not explore the severity of the anxiety or depression, only their presence.

Declared interests

The authors declared no conflicts of interest.

The easy way to misread this

Do not assume that the high rates of anxiety and depression are simply part of the autism or ADHD profile. The study treats these as separate, co-occurring mental health conditions that require their own identification and treatment. Also, do not overlook males with autism and ADHD; while females have higher rates overall, the prevalence of anxiety and depression in males with both conditions is still extremely high (69% and 38% respectively).

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