Autism & Developmental

Disability, functioning, and quality of life among treatment-seeking young autistic adults and its relation to depression, anxiety, and stress.

Park et al. (2019) · Autism : the international journal of research and practice 2019
★ The Verdict

Young autistic adults without ID arrive at mental health clinics with depression, anxiety, and life impairment just as severe as patients whose main diagnosis is psychiatric.

✓ Read this if BCBAs doing intake assessments or therapy with verbal autistic teens and adults
✗ Skip if Practitioners serving only non-verbal clients or preschool children

01Research in Context

01

What this study did

Park et al. (2019) looked at young autistic adults who asked for mental health help. None had intellectual disability.

The team compared their daily life skills, mood, and stress to patients whose main problem was depression, anxiety, or another psychiatric disorder.

02

What they found

The autistic adults reported the same high levels of depression, anxiety, and stress as the other patients.

They also had equally poor health, work skills, and social life. Autism alone did not protect anyone from severe mood trouble.

03

How this fits with other research

Older papers saw the same pattern. Lugnegård et al. (2011) found 70% of autistic adults had faced major depression. Joshi et al. (2013) showed autistic clinic patients carried twice the lifetime psychiatric diagnoses of non-autistic patients.

Ridgway et al. (2024) widened the lens. They surveyed autistic young adults in the community, not just clinics, and still found lower wellbeing and more negative mood than peers.

One study seems to disagree. Brereton et al. (2006) reported autistic youth were worse off than youth with intellectual disability alone. The difference is the comparison group: ID-only versus full psychiatric caseload. Ho’s adults matched the severity seen in mood clinics, not ID services.

04

Why it matters

If a verbal autistic adult walks into your clinic, screen for mood disorders right away. Expect symptoms as serious as any primary psychiatric referral. Use evidence-based CBT or ACT protocols; don’t assume social skills training is enough. Share the data with families so they understand why mental health treatment is part of the autism plan.

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Add a standard depression and anxiety screener to every adult autism intake packet.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
96
Population
autism spectrum disorder
Finding
negative
Magnitude
large

03Original abstract

In this study, we consecutively recruited treatment-seeking young autistic adults without intellectual impairment aged 16-30 years who presented to a mental health service and evaluated general health (distress, quality of life, and disability), functioning (work loss days and social functioning), and mood symptoms (depression, anxiety, and stress) in those diagnosed with autism spectrum disorder (n = 96). This group was compared to young adults presenting to the same service with primary mental health disorders (depression, n = 343; bipolar, n = 132; psychosis, n = 166; and anxiety, n = 303). This study also investigated the influence of mood symptoms on general health and functioning in the autism spectrum disorder group. Young autistic adults reported significant general health and functioning impairments that were of similar degree to those presenting with primary mental health disorders. Interestingly, the autistic group also reported similarly high levels of mood symptoms to those with primary depressive and anxiety disorders. In the autistic group, depressive symptoms were strongly associated with distress, quality of life, and work loss days, while stress symptoms were strongly associated with disability. This study highlights further research, and mental health services are required specifically targeting young autistic adults to address their significant unmet needs.

Autism : the international journal of research and practice, 2019 · doi:10.1177/1362361318823925