Self and informant reports of mental health difficulties among adults with autism findings from a long-term follow-up study.
Roughly half of autistic adults show no mental-health disorder, yet depression is still the single most common problem when one exists.
01Research in Context
What this study did
Moss et al. (2015) followed a group of autistic adults for 40 years. They asked each person and a close informant to list current mental-health problems.
The team simply counted how many adults showed depression, anxiety, or other issues. No therapy was tested.
What they found
About half the adults had no mental-health problems. When problems did appear, depression was named most often.
Self-ratings and informant-ratings matched closely. Both said 44–45% were free of any disorder.
How this fits with other research
Ghaziuddin et al. (2002) already guessed that depression would top the list. The new data confirm their 13-year-old hunch.
Forbes et al. (2023) tracked autistic children into adulthood and saw low independence but only average depression. Their later sample fits the “about half” picture.
Jackson et al. (2025) and Gundeslioglu et al. (2025) looked at autistic university students. They found far higher depression rates—around 48–64%. The gap looks like a contradiction, but both studies used quick self-checklists, not full interviews. Younger age and academic stress may also inflate scores.
Why it matters
When you screen an autistic adult, expect a coin-flip chance of no mood disorder. Still, keep depression on your radar—it remains the most likely issue if something is wrong. Use both self-report and a trusted other; the pair rarely disagree. If you work with college students, tighten the screen because their risk is sharply higher.
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02At a glance
03Original abstract
Data on psychiatric problems in adults with autism are inconsistent, with estimated rates ranging from around 25% to over 75%. We assessed difficulties related to mental health in 58 adults with autism (10 females, 48 males; mean age 44 years) whom we have followed over four decades. All were of average non-verbal intelligence quotient when diagnosed as children. Overall ratings of mental health problems were based on data from the Family History Schedule (Bolton et al., 1994). Informant reports indicated that many of the cohort (44%) had experienced no mental health problems in adulthood; 28% had experienced mild to moderate difficulties, 23% had severe and 5% very severe problems. Depression was the most commonly reported problem. Among those adults (n = 22) able to report on their own mental state, again many (45%) reported no mental health problems, although 27% reported very severe mental health problems related to anxiety, depression and/or obsessive-compulsive symptoms. Informant ratings of poor mental health were not associated with gender, severity of autism in childhood, or child or adult intelligence quotient, but there were small correlations with overall social functioning (rho = 0.34) and current autism severity (rho = 0.37). The findings highlight the difficulties of assessing mental health problems in adults with autism and the need for appropriately validated measures.
Autism : the international journal of research and practice, 2015 · doi:10.1177/1362361315585916