How do core autism traits and associated symptoms relate to quality of life? Findings from the Longitudinal European Autism Project.
Bethany Fm Oakley, Julian Tillmann, Jumana Ahmad and 9 others
PMID 33023296WHAT IT FOUND
Depression symptoms, not core autism traits, were the strongest predictor of reduced quality of life in autistic adults.
In children, anxiety and social difficulties also lowered satisfaction. Many autistic individuals reported good quality of life, so screen for subthreshold mental health issues rather than assuming poor well-being based on diagnosis alone.
Key findings
01Depression symptom severity was the only significant predictor of reduced quality of life in autistic adults after accounting for core autism traits and anxiety.
02A substantial proportion of autistic individuals did not experience reduced quality of life, with 34.9% to 54.7% of adults scoring within one standard deviation of neurotypical peers.
03In children and adolescents, anxiety and depression symptoms predicted lower comfort and satisfaction, while core social-communication difficulties specifically predicted lower school achievement.
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
Adults self-reported quality of life while parents reported for children, so results cannot be directly compared across age groups. The study was cross-sectional, so it cannot determine if depression causes lower quality of life or if poor quality of life leads to depression. There may be overlap between the mental health measures and quality of life measures, meaning some associations could reflect similar constructs rather than distinct relationships. The adult group excluded individuals with intellectual disability (IQ < 75), limiting generalisability to autistic adults with higher support needs.
Declared interests
The study was supported by the Innovative Medicines Initiative (EU-AIMS). Several authors reported grants from pharmaceutical companies (Servier, Roche, Novartis, Lilly, Lundbeck) and consultancies for these companies, though the authors state these relationships were outside the submitted work or not associated with this specific project.
The easy way to misread this
Do not assume that an autism diagnosis predicts poor quality of life. A significant proportion of autistic individuals in this study reported quality of life within the normal range. Reduced quality of life was driven primarily by co-occurring depression and anxiety symptoms, not core autism traits alone.