Psychiatric and Medical Profiles of Autistic Adults in the SPARK Cohort.

The team asked caregivers of 2,917 autistic adults in the SPARK cohort to fill out a survey. They wanted to know how many adults had psychiatric or medical conditions in their lifetime.

The survey also looked at whether rates differed by verbal ability, sex, or age group.

Two out of every three autistic adults had at least one psychiatric diagnosis. Anxiety and ADHD topped the list.

Adults who could not use fluent speech had lower recorded rates of these diagnoses.

Houghton et al. (2017) saw a similar two-thirds rate, but in insured claims data and for children and teens. The match shows the adult numbers are not a fluke.

Greene et al. (2019) warns that autistic adults often feel mislabeled. Their survey found many reject the mental-health tags given to them. Taken together, the high counts in SPARK may partly reflect over-diagnosis, not just true illness.

Green et al. (2020) gives you a tool to double-check: the PHQ-9 is valid for autistic adults. Use it to confirm depression before you write it in the chart.

When you see an autistic adult, expect medical and psychiatric extras on the menu. Screen for anxiety, ADHD, sleep, and GI issues as routine, not as after-thoughts. If the client uses few or no words, dig deeper—diagnoses are often missed in this group. Pair your interview with a validated tool like the PHQ-9 to avoid both missing and mis-assigning labels.