Assessment & Research

Experience of mental health diagnosis and perceived misdiagnosis in autistic, possibly autistic and non-autistic adults.

Au-Yeung et al. (2019) · Autism : the international journal of research and practice 2019
★ The Verdict

Autistic adults often feel their autism is misread as mental illness—screen for autism before assigning psychiatric labels.

✓ Read this if BCBAs working with adults who carry multiple mental-health diagnoses.
✗ Skip if Clinicians who only serve clients with clear, early autism diagnoses.

01Research in Context

01

What this study did

Greene et al. (2019) asked autistic and possibly-autistic adults about every mental-health label they had ever received.

They used an online survey so people could answer from home.

The team wanted to know how many of these adults felt the labels were wrong.

02

What they found

Most people had been given at least one psychiatric diagnosis.

Many said the label did not fit them.

They felt doctors were calling autism traits something else, like anxiety or bipolar disorder.

03

How this fits with other research

Fombonne et al. (2020) surveyed almost three thousand autistic adults and also saw piles of psychiatric labels.

Their big numbers back up the worry: autism traits are often re-named as mental illness.

Wetterneck et al. (2006) built a kid interview that separates autism from add-on disorders.

That early tool shows the same mix-up can start in childhood and last into adult services.

Houghton et al. (2017) found two-thirds of insured autistic people take psych meds, sometimes without any extra diagnosis.

Together these papers say the field keeps treating autism as a mental-health problem instead of a different neurotype.

04

Why it matters

Before you write "anxiety disorder" or "mood disorder" in a report, stop and screen for autism first.

Ask the client if past labels ever felt wrong.

A quick autism checklist can save years of useless treatments and side-effects.

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Pull the last three adult intakes and re-run an autism screener on anyone labeled with both ASD and several psychiatric disorders.

02At a glance

Intervention
not applicable
Design
survey
Sample size
420
Population
autism spectrum disorder, mixed clinical
Finding
negative

03Original abstract

Previous research shows that autistic people have high levels of co-occurring mental health conditions. Yet, a number of case reports have revealed that mental health conditions are often misdiagnosed in autistic individuals. A total of 420 adults who identified as autistic, possibly autistic or non-autistic completed an online survey consisting of questions regarding mental health diagnoses they received, whether they agreed with those diagnoses and if not why. Autistic and possibly autistic participants were more likely to report receiving mental health diagnoses compared to non-autistic participants, but were less likely to agree with those diagnoses. Thematic analysis revealed the participants' main reasons for disagreement were that (1) they felt their autism characteristics were being confused with mental health conditions by healthcare professionals and (2) they perceived their own mental health difficulties to be resultant of ASC. Participants attributed these to the clinical barriers they experienced, including healthcare professionals' lack of autism awareness and lack of communication, which in turn prevented them from receiving appropriate support. This study highlights the need for autism awareness training for healthcare professionals and the need to develop tools and interventions to accurately diagnose and effectively treat mental health conditions in autistic individuals.

Autism : the international journal of research and practice, 2019 · doi:10.1177/1362361318818167