Overrepresentation of mood and anxiety disorders in adults with autism and their first-degree relatives: what does it mean?
Adults with autism and their first-degree relatives carry high rates of mood and anxiety disorders—routine family screening is essential.
01Research in Context
What this study did
Porter et al. (2008) looked at 35 adults with autism and their parents and siblings. They asked each person about past and current mental health. The team wanted to see if mood and anxiety problems cluster in these families.
This was a small case-series study. No control group. Just careful interviews and record checks.
What they found
More than one in three adults with autism had a mood disorder. More than three in four had an anxiety disorder. Those numbers are far above general population rates.
Relatives carried extra risk too. Elevated rates of both mood and anxiety problems showed up in parents and brothers and sisters. The pattern hints at shared family risk, not just individual stress.
How this fits with other research
Lugnegård et al. (2011) found almost the same thing in adults with Asperger syndrome: 70% had faced major depression and 50% an anxiety disorder. The labels differ but the message repeats—screen every adult on the spectrum for mood and anxiety issues.
Ellingsen et al. (2014) extended the picture. In a larger sample they confirmed that 57% of adults with ASD had a current psychiatric diagnosis and 59% were on at least one psychotropic drug. Their data add real-world service use to the basic rate count.
Chien et al. (2021) went bigger still. Using national insurance records they showed that adults with ASD develop schizophrenia, bipolar and major depression at markedly higher rates than matched controls. The 2008 case-series warning now stands on epidemiological ground.
Eriksson et al. (2012) and Patton et al. (2020) moved the lens to different ages. Anders saw the same familial psychiatric lift in relatives of preschool children with ASD. R et al. found it again in adults over 50 who have an autistic child or sibling. The familial signal appears across the lifespan.
Why it matters
If you assess an adult with autism, ask about mood and anxiety every time. If the client says yes, ask the parents and siblings too. Use quick tools like the GAD-7 and PHQ-9. When you see a pattern, refer for therapy or medication consults early. Treating the autism without treating the anxiety or depression leaves huge quality-of-life gains on the table.
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02At a glance
03Original abstract
Research indicates that relatives of individuals with autism have higher rates of affective disorders than both the general population and families of children with other developmental disabilities. In addition, individuals with autism have high rates of co-morbid mood and anxiety disorders. This study sought to identify possible reasons for these previous findings by documenting the presence of affective disorders in both probands (the individuals with autism) and their family members. A sub-sample of 17 adults with autism and their first-degree relatives from the Baltimore Family Study of Autism completed a structured psychiatric interview. The results indicated that the rates of mood and anxiety disorders were 35 and 77%, respectively, for probands, and these disorders were present in at least one first-degree relative at rates of 71 and 29%, respectively. Exploring patterns within families revealed that 80% of probands with a mother who had a mood disorder history also had a mood disorder themselves, compared to only 16% of probands whose mothers did not have a mood disorder history. The results must be considered preliminary given the small sample size. Replicating these findings in a larger sample would help clarify whether a true increased risk of mood disorder exists, which would have potential implications for prevention efforts and understanding possible genetic mechanisms.
Autism research : official journal of the International Society for Autism Research, 2008 · doi:10.1002/aur.23