Characteristics associated with presence of depressive symptoms in adults with autism spectrum disorder.

Sterling et al. (2008) looked at adults with autism. They asked who among them says they feel depressed.

The team checked IQ, social skills, and other mental-health labels. They wanted to see which traits ride along with sad mood.

The adults who had higher IQ and milder social problems were the ones most likely to report depression.

More psychiatric labels on their chart also raised the odds of saying they felt low.

Matson et al. (2009) extends this picture. That study shows that as diagnostic load grows—ID, then ID+ASD, then ID+ASD+Axis-I illness—daily living skills drop. Together the papers say: more labels, more trouble.

Rosa et al. (2016) seems to disagree. In kids with ASD, lower IQ predicted more ADHD and other comorbidities. Lindsey finds the opposite: higher IQ predicted more depression reports in adults. The gap is about age and method. Children were rated by parents; adults rated themselves. Higher-IQ adults can name feelings; lower-IQ children show acting-out signs that parents notice.

Kim et al. (2023) lines up with Lindsey. Both find that within ASD, brighter clients report more comorbid symptoms—tics in kids, depression in adults.

If you serve verbal adults with ASD, do not let their good eye contact or high test scores fool you. Give them a quick depression screener at intake and at six-month check-ins. A simple mood chart or PHQ-9 takes five minutes and can catch the clients who are savvy enough to describe feeling empty or tired. Early referral keeps them in ABA instead of dropping out due to low energy.