The Comorbidity of Schizophrenia Spectrum and Mood Disorders in Autism Spectrum Disorder.
Autism triples schizophrenia risk and doubles mood-disorder risk, especially in girls and PDD-NOS profiles.
01Research in Context
What this study did
Chien et al. (2021) tracked 5,000 people with autism for ten years. They counted new cases of schizophrenia, bipolar, and major depression.
They split the group by autism type, sex, and added conditions like ADHD. A matched group without autism served as the baseline.
What they found
People with autism got schizophrenia 3.6 times more often. Bipolar disorder rose 2.7-fold and major depression 2.2-fold.
Girls with Asperger profiles and anyone with PDD-NOS faced the sharpest jump in mood and psychosis risk.
How this fits with other research
Supekar et al. (2017) saw the same climb, but only in older males. The new data show the surge starts in adolescence and hits females hardest.
Lugnegård et al. (2011) found a large share of Asperger adults had faced major depression. Yi-Ling now proves this isn’t just recall bias; the mood disorders truly accumulate faster.
Austin et al. (2015) showed extra psychiatric burden when autism pairs with intellectual disability. Yi-Ling widens the lens: even without ID, autism alone hikes risk.
Why it matters
Screen early and keep screening. Add mood and psychosis checklists to your ABA intake and yearly reviews. Watch girls with Asperger profiles most closely; their risk curve is steepest. Share the numbers with parents so they can flag first warning signs between visits.
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02At a glance
03Original abstract
Individuals with autism spectrum disorder are often diagnosed with at least one or more accompanying disorders. Most studies reported prevalence of the psychiatric comorbidities among these individuals; however, the incidence of developing comorbidities is unclear. This study used Taiwan's claims database and aimed to investigate the incidence of developing major psychiatric comorbidities in individuals with autism spectrum disorder and whether the incidence was moderated by gender, autism-spectrum disorder subtypes, and autism-associated neurodevelopmental conditions. A total of 3,837 individuals with autism spectrum disorder (2,929 autistic disorder, 447 Asperger syndrome, 461 pervasive developmental disorder-not otherwise specified) and 38,370 comparison subjects, who were matched by age and gender, were included. The incidences of schizophrenia spectrum, bipolar, and major depressive disorders was examined. The results showed that the incidences of schizophrenia spectrum (9.7 per 1,000 person-year), bipolar disorder (7.0 per 1,000 person-year), and major depressive disorder (3.2 per 1,000 person-year) were significantly higher than the comparison group across all three subtypes of autism-spectrum disorder. Individuals with pervasive developmental disorder-not otherwise specified had higher risk for major depressive disorder than autistic disorder. Females with Asperger syndrome had significant higher risk for schizophrenia spectrum than males. The comorbidity rate dramatically dropped when the autism-associated neurodevelopmental conditions were taken into account. Our findings suggested that the incidences of major psychiatric comorbidities were higher in autism spectrum disorder and influenced by autism subtypes, gender, and autism-associated neurodevelopmental conditions. LAY SUMMARY: We examined whether people with autism spectrum disorder (ASD) have higher incidence of schizophrenia, bipolar disorders, and major depression using a large claims database. The results showed the incidences of these mental illness among individual with ASD were significantly higher than those without ASD. In addition, the incidences were influenced by autism subtypes, gender, and comorbid neurodevelopmental conditions.
Autism research : official journal of the International Society for Autism Research, 2021 · doi:10.1002/aur.2451