Psychiatric comorbidity and functioning in a clinically referred population of adults with autism spectrum disorders: a comparative study.

Joshi et al. (2013) compared adults with autism to other clinic patients. They looked at how many psychiatric disorders each group had over a lifetime. They also checked how well each group functioned in daily life.

The study used records from a mental health clinic. All adults were already referred for care. The team counted diagnoses and rated social and work skills.

Adults with autism carried about twice as many lifetime psychiatric diagnoses. They also showed much poorer psychosocial functioning than the other clinic patients.

Joshi et al. (2010) saw the same pattern in youth. Kids with autism had six extra diagnoses on average. The adult and youth studies match: autism plus many comorbidities is typical across age.

Ellingsen et al. (2014) added a new detail one year later. Over half of autistic adults were already on psychotropic meds. The high drug use fits the high diagnosis count found in the target paper.

Park et al. (2019) looked at young autistic adults without intellectual disability. Their depression, anxiety, and life impairment were as severe as patients whose main problem was mental health. This extends the target finding: even without ID, autistic adults seeking help are very impaired.

Guisso et al. (2018) used UK primary-care data. One in three autistic adults there had psychotropic prescriptions—lower than US estimates. The UK numbers sit below the high US comorbidity load seen in Joshi et al. (2013), showing geography and care systems matter.

When an adult with autism walks into your clinic, plan for multiple disorders, not just autism. Screen for mood, anxiety, and psychotic symptoms right away. Expect social and work skills to be hit hard. Use broad checklists, not autism-only tools. Coordinate with prescribers since meds are common. If you work with teens, know that heavy comorbidity continues into adulthood, so start teaching coping skills early.