Mental health care use of autistic adults: Identifying longitudinal patterns using sequence analysis.
Iris Selten, Tim Ziermans, Iris Rapoport and 2 others
PMID 39692051WHAT IT FOUND
Over 5 to 7 years, 445 autistic adults without intellectual disability most often used counseling or medication, often together.
Therapy was less common. Patterns clustered by sex, employment and co-occurring mental health conditions; outcomes were not measured.
Key findings
01Five trajectory groups were identified; four were meaningful: least intervention, mostly counseling, mostly medication, and mixed counseling and medication, while a fifth was highly variable.
02No cluster was mostly characterized by therapy use; people who used therapy most often used it with counseling or medication and were divided across clusters.
03Cluster 1 had a larger proportion of males and a smaller proportion of people with a co-occurring psychiatric condition than all other clusters; it also had more partners than Clusters 2 and 4, and more paid employment than Cluster 4.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study described reported use only; it did not test whether therapy, counseling, or medication helped. Intervention use was recorded once per year as yes or no, so short-term changes, intensity, and reasons for use were not captured. Many participants had missing years, and the researchers filled some missing years manually from surrounding years rather than using multiple imputation. The analysed sample was 445 of 2166 registry participants, and it was older, had longer time since diagnosis, and had fewer co-occurring psychiatric conditions than the total sample. Participants were autistic adults without intellectual disability in the Netherlands, so patterns may not apply to autistic children, autistic people with intellectual disability, or other health systems. The specific types of therapy, counseling, and medication were not described in the supplied text, so the study cannot say which services were used. Cluster 5 was not a well-defined group; it contained highly variable trajectories and could not be labelled confidently. Several interventions were often used together, so the study cannot say what any one component contributed.
Declared interests
The authors declared no potential conflicts of interest. The research was funded by a ZonMW grant and by Dutch government sector plans for scientific research and university education.
The easy way to misread this
Do not read these clusters as evidence that counseling, medication, or therapy improved health or participation. The study recorded yearly use only, not outcomes, and many people used several supports at once, so the contribution of any single support cannot be separated.