Therapy and Antidepressant Use in 8- to 29-Year-Old Autistic Medicaid Enrollees With Depression.
Meghan E Carey, Laura Graham Holmes, Lindsay L Shea and 4 others
39% of autistic Medicaid enrollees aged 8 to 29 received no or minimal depression treatment in the 5 months after a new MDD diagnosis.
Among those who did get treatment, most fell short of minimally adequate levels.
Key findings
139% of autistic Medicaid enrollees received no or limited depression treatment in the 5 months following a new MDD claim.
2The proportion achieving minimally adequate psychotherapy or pharmacotherapy was low across all treatment trajectory groups.
3Autistic young people with co-occurring ID had 16% lower odds of continuous treatment, and Hispanic/Latino enrollees had 42% lower odds compared to White individuals.
Still to come
How it was doneWhat they found
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What it does not show
Medicaid claims contain no measure of depression severity, so it is impossible to tell whether the no-treatment group had milder episodes that resolved on their own. Depression was identified by provider diagnosis codes, and the authors note that standard screening tools imperfectly assess depression in autistic youth. The study could not examine which specific antidepressants were used or whether side effects drove early discontinuation. The sample required continuous Medicaid enrollment and excluded anyone with private insurance, so findings reflect the Medicaid population specifically. Group-based trajectory modeling involves subjective model selection, and the authors chose a four-group model over a five-group model for parsimony.
Declared interests
Supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development and the National Institute of Mental Health (NIH Award Numbers P50HD111142, T32MH109433, R01MH117653). Authors declared no conflicts of interest.
The easy way to misread this
Do not read the 39% no-treatment group as evidence that these young people did not need or want depression care. The authors attribute this gap to system-level barriers such as limited providers who accept Medicaid and are trained to support autistic patients, not to patient preference.
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 →