Personality disorder diagnoses in UK Autistic people: Evidence from a matched cohort study.
Elizabeth O'Nions, Jude Brown, Joshua Ej Buckman and 13 others
PMID 41757578WHAT IT FOUND
Autistic adults are significantly more likely to receive personality disorder diagnoses than non-Autistic people.
This risk is highest for Autistic women, especially those with intellectual disability, where new diagnoses were over eight times more likely.
Key findings
01Autistic adults without intellectual disability were roughly four to five times more likely to receive a new personality disorder diagnosis during follow-up compared to matched non-Autistic controls.
02Autistic women with intellectual disability had a markedly higher risk of new diagnoses, being 8.3 times more likely to receive any personality disorder diagnosis and 16.6 times more likely to receive an EUPD or BPD diagnosis.
03A substantial proportion of Autistic adults already had a personality disorder diagnosis recorded before their autism diagnosis was confirmed, with rates of 2.7% to 6.1% depending on sex and intellectual disability status.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study only included diagnosed Autistic adults, so findings may not apply to undiagnosed Autistic people who may have different support needs. Gender-diverse individuals were excluded because gender diversity was not coded in the primary care database. The specific type of personality disorder was not consistently available in the records, limiting analysis of which diagnoses were most common. Ethnicity data was often missing, preventing analysis of disparities among different ethnic groups. The young age at cohort entry meant there was less opportunity for personality disorder diagnoses to have been made compared to older populations.
Declared interests
The work was supported by grants from the Vivensa Foundation, ESRC/NIHR, NIHR, Royal College of Psychiatrists, and Medical Research Council. One author (J.M.) is a trustee of the Vivensa Foundation. Other authors declared no financial relationships with organisations having an interest in the submitted work.
The easy way to misread this
Do not assume that a personality disorder diagnosis in an Autistic client is accurate or helpful. The study shows these diagnoses are disproportionately common in Autistic people, particularly women, and may reflect autism characteristics being misinterpreted rather than a distinct personality pathology.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →