Patient Expectations of an Autism Diagnosis: A Thematic Analysis.
Most adults sent for autism testing already carry anxiety or OCD, so always screen for both.
01Research in Context
What this study did
Marios and the team asked adults why they thought they might have autism. They talked with people waiting for an autism check-up. Some were later told yes, others no.
The workers wrote down every theme people shared. They grouped the answers into clear buckets. This is called thematic analysis.
What they found
More than half of the adults already had a second mental-health label. Anxiety and OCD showed up most often. This was true for both groups—those who got the autism label and those who did not.
The study says screen every referral for anxiety and OCD, no matter the final diagnosis.
How this fits with other research
Roberts et al. (2008) followed autistic adults for years. They saw one in six pick up a brand-new mental-health problem. Marios now shows the risk is already sky-high at the first visit.
Hilton et al. (2010) counted a 53% rate in adults who had both autism and intellectual disability. The new paper finds a similar 57% in adults who are simply referred. Together they say comorbidity is the norm, not the exception.
Wilmut et al. (2013) found over a third of autistic adults also meet ADHD cut-offs. Marios did not list ADHD as top, yet both papers push you to look past the autism label and check for more.
Why it matters
You will not waste time if you run quick anxiety and OCD screens the day someone walks in. Catching these extras early means you can add CBT, ERP, or meds sooner. Better plans mean faster relief and fewer crises later.
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02At a glance
03Original abstract
Growing awareness of autism spectrum disorders has increased the demand for diagnostic services in adulthood. High rates of mental health problems have been reported in young people and adults with autism spectrum disorder. However, sampling and methodological issues mean prevalence estimates and conclusions about specificity in psychiatric co-morbidity in autism spectrum disorder remain unclear. A retrospective case review of 859 adults referred for assessment of autism spectrum disorder compares International Classification of Diseases, Tenth Revision diagnoses in those that met criteria for autism spectrum disorder (n = 474) with those that did not (n = 385). Rates of psychiatric diagnosis (>57%) were equivalent across both groups and exceeded general population rates for a number of conditions. The prevalence of anxiety disorders, particularly obsessive compulsive disorder, was significantly higher in adults with autism spectrum disorder than adults without autism spectrum disorder. Limitations of this observational clinic study, which may impact generalisability of the findings, include the lack of standardised structured psychiatric diagnostic assessments by assessors blind to autism spectrum disorder diagnosis and inter-rater reliability. The implications of this study highlight the need for careful consideration of mental health needs in all adults referred for autism spectrum disorder diagnosis.
Journal of autism and developmental disorders, 2025 · doi:10.1177/1362361315604271