Asperger syndrome in males over two decades: Quality of life in relation to diagnostic stability and psychiatric comorbidity.
Losing the ASD diagnosis predicts better adult outcomes, yet treating depression and anxiety boosts life satisfaction no matter the label.
01Research in Context
What this study did
Helles et al. (2017) followed males with Asperger syndrome for twenty years. They asked who still met autism criteria and who had lost the label. They tracked jobs, living situation, friendships, and mental-health diagnoses.
What they found
Men who no longer qualified for an ASD diagnosis held steady jobs, lived on their own, and had friends more often than men who still met criteria. Psychiatric illnesses such as depression or anxiety dragged down life satisfaction in both groups.
How this fits with other research
The finding extends Giserman-Kiss et al. (2020), who saw 88 % of preschoolers keep their ASD label. Adam shows the flip side: losing the label in adulthood links to better real-world outcomes.
It also updates Jennes-Coussens et al. (2006). Marieke found young Asperger men felt lonely and jobless; Adam shows these problems persist mainly in the subgroup that keeps the diagnosis and gains mental-health comorbidities.
Lugnegård et al. (2011) reported 70 % of Asperger adults had major depression. Adam agrees and adds a practical twist: treat the depression and you lift subjective quality of life even if autism traits remain.
Why it matters
For your adult clients, chase two targets at once. Push vocational and social skills, but also screen and treat psychiatric comorbidity. A clear ASD label is less important than concrete gains in work, housing, and mood.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Add a brief depression and anxiety screen to every adult ASD service plan.
02At a glance
03Original abstract
This study examined objective quality of life (work, academic success, living situation, relationships, support system) and subjective quality of life (Sense of Coherence and Short-Form Health Survey-36) in an adult sample of males ( n = 50, mean age: 30 years) with Asperger syndrome diagnosed in childhood and followed prospectively over two decades. The association between long-term diagnostic stability of an autism spectrum disorder and/or comorbid psychiatric disorders with quality of life was also examined. The results showed great variability as regards quality of life. The subsample that no longer fulfilled an autism spectrum disorder had full-time jobs or studies (10/11), independent living (100%), and reported having two or more friends (100%). In the stable autism spectrum disorder group, 41% had full-time job or studies, 51% lived independently, and 33% reported two or more friends, and a significant minority had specialized employments, lived with support from the government, or had no friends. Academic success was positively correlated with IQ. A majority of the total group scored average Sense of Coherence scores, and the mean for Short-Form Health Survey-36 was above average regarding psychical health and below average regarding mental health. Stability of autism spectrum disorder diagnosis was associated with objective but not subjective quality of life, while psychiatric comorbidity was associated with subjective but not objective quality of life.
Autism : the international journal of research and practice, 2017 · doi:10.1177/1362361316650090