Risk for Premature Mortality and Intentional Self-harm in Autism Spectrum Disorders.
Elina Jokiranta-Olkoniemi, David Gyllenberg, Dan Sucksdorff and 4 others
PMID 33140146WHAT IT FOUND
Autism was linked to higher premature death, mainly from natural causes.
Once other psychiatric conditions were accounted for, suicide and self-harm were not independently increased.
Key findings
01ASD subjects had higher premature mortality after adjustment (p = .0085), and the only cause with increased adjusted risk was natural death (p < .0001).
02Adjusted mortality risk remained elevated among ASD females (p = .0040) and among ASD subjects with intellectual disability (p < .0001).
0318 ASD subjects (0.4%) and 27 non-ASD subjects (0.2%) were treated for intentional self-harm; after adjusting for comorbid psychiatric disorders, ASD was not associated with increased risk (HR 0.8, p = .4673).
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
ASD cases came from hospital discharge records, so people with milder symptoms who never reached specialized services may be missing. Follow-up ended in 2015 and participants were children, adolescents, or young adults, so results do not show mortality later in adulthood. Register data could not capture suicide thoughts, plans, or severity of self-harm beyond hospital-treated cases. Some diagnoses may be misclassified, and small event counts meant several analyses could not be estimated.
The easy way to misread this
Do not conclude that autism itself independently raises suicide or self-harm risk. The unadjusted risks were significant, but after adjustment for comorbid psychiatric disorders they were not.