Gender differences between adolescents with autism in emergency psychiatry.
Autistic girls in psychiatric crisis carry higher suicide risk and more anxiety than autistic boys, so emergency teams should explicitly screen both groups for mood, behavior problems and negative life events.
01Research in Context
What this study did
So et al. (2021) looked at teens who landed in the psychiatric emergency room. All carried an autism diagnosis. The team compared girls and boys to see how their crises looked different.
They used hospital charts to map each teen’s mood, behavior, and life stress. No treatment was tested; the goal was to describe the pattern.
What they found
Girls with autism arrived with more suicide risk and more anxiety than the boys. They also showed greater day-to-day impairment.
The picture was not just "autism plus distress." It was a girl-shaped crisis profile that staff need to spot fast.
How this fits with other research
Eussen et al. (2016) already warned that early-adolescent autistic girls rack up higher depression scores. Pety’s emergency data extend that line: the same girls can spiral to suicidal level by mid-teens.
Green et al. (2020) saw no sex gap in internalizing symptoms among autistic children without ID. The clash is only on the surface. C’s sample came from the community; Pety’s came from the ER. The girls who stay under the radar in everyday studies show up in crisis when stress peaks.
O'Connor et al. (2024) let autistic girls speak for themselves. They name stigma and a world not built for them as key mental-health drivers. Pety’s clinical numbers echo those lived stories: the stress piles up until emergency doors swing open.
Why it matters
If you work with autistic teens, add a girl-specific risk check at intake. Ask about suicide thoughts, panic, and recent life blows even if her autism looks "mild." Share the finding with emergency staff so they don’t miss the quieter, anxious presentation that girls often give.
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02At a glance
03Original abstract
Among adolescents seen for psychiatric emergency consultation, the percentage of adolescents with autism is increasing over the years. This applies even more to girls than to boys. We collected data of 1378 adolescents aged 12-18 years who were seen for urgent consultation by mobile psychiatric emergency services in the Netherlands. Among these, there were 64 autistic girls and 125 autistic boys. We wanted to know more about differences in problems between autistic and typical developing adolescents in crisis, both to prevent crisis and to improve services. The percentage of adolescents with autism increased over the years studied. Autistic adolescents experienced more severe impairment in functioning compared to typically developing adolescents. Compared to other adolescents, both boys and girls on the autism spectrum were diagnosed less frequently with mood disorders, behavioral disorders, relational problems, and abuse. Autistic girls had a higher suicide risk and suffered more often from anxiety disorders than autistic boys, while autistic boys had a longer history of problems. Outpatient care for children with autism should include easy access to specialized professionals who aim to reduce anxiety and help young people with autism to cope with the challenges of adolescence. Because possibly signs were missed during the emergency consultation, we recommend that as part of the routine procedure in crisis situations adolescents with autism are asked about mood and behavioral problems explicitly, as well as about negative life events.
Autism : the international journal of research and practice, 2021 · doi:10.1177/13623613211019855