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Young adults with autism face additional health concerns

ASD young adults had 89% greater odds of at least one psychiatric disorder

Young adults with autism spectrum disorder (ASD) are more likely than other young adults to experience psychiatric and other health issues, researchers from Canada report.

“Psychiatric issues are very common for young adults with autism, and physicians should pay attention to early signs of anxiety disorder, depression, or other psychiatric comorbidities, and know where to refer patients if there are concerns,” said Dr Jonathan A. Weiss from York University, in Toronto, Canada.

“We know that people with autism have many complex health needs,” he said. “Most of this research is based on children, however, and the few studies that focus on adults tend to include adults of all ages, using convenience or clinical samples,” he told Reuters Health by email. “Our research is unique because we have managed to look specifically at young adults with autism, those 18-24 years of age, who are right in the period of transitioning to the adult sector.”

Dr Weiss’s team analyzed administrative health data from more than 5,095 young adults with ASD, about twice as many with other developmental disorders (DDs) and more than 393,000 with neither condition (non-DD group).

Compared with the non-DD group, young adults with ASD were significantly more likely to have all clinical health issues examined by the study

Compared with the non-DD group, young adults with ASD were significantly more likely to have all clinical health issues examined by the study, including 5.2-fold greater odds of at least one psychiatric diagnosis, the researchers report in the Journal of Autism and Developmental Disorders, online September 13.

ASD young adults were significantly less likely than young adults with other DD to have asthma, hypertension, and substance-related and addictive disorders, but had 89% greater odds of at least one psychiatric disorder.

These differences translated into variations in health service use: Young adults with ASD were more likely than non-DD young adults to have a least one visit with the family physician, pediatrician, psychiatrist, neurologist and gastroenterologist; were more likely to visit the emergency department for psychiatric reasons; and were more likely to be hospitalized overall and for psychiatric reasons.

In the comparison between ASD and DD youth, those with ASD were less likely than those with DD to have any type of emergency department visit and equally likely to be hospitalized for any reason or for psychiatric reasons.

“Higher health needs appears to be a pattern for all young adults with developmental disabilities, both with and without autism,” Dr. Weiss said. “This tells us that our efforts to improve health care for those with autism should be applied perhaps to this broader group of patients with developmental disabilities.”

“While we need to recognize the need for specialized health care for young adults with many kinds of developmental disabilities, we need to consider in particular how we can provide accessible and timely psychiatric supports for those with autism,” he said. “Transitioning to adulthood is hard for many young adults; our health care system needs to be particularly aware of the high rates of psychiatric issues for those with autism and those with other developmental disabilities.”

“We can expect that approximately half of young adults with ASD will have at least one psychiatric diagnosis, and given the increasing prevalence of children diagnosed with autism who will become young adults in the next decade, we can only expect mental health care demands to increase in the future,” Dr. Weiss concluded. “So, our health care system needs to be ready to meet this need.”

Dr. Lauren Bishop-Fitzpatrick from the University of Wisconsin-Madison’s School of Social Work told Reuters Health by email, “This study of health and health-service utilization is very important, but much more research is needed on health and health-service utilization in midlife and beyond, when subtler differences between individuals with autism and individuals with other developmental disabilities may manifest and become more apparent.”

“It is possible that individuals with autism have additional health challenges and use health services differently compared to individuals with other developmental disabilities, but that studying these issues in young adults may not reveal important differences that have a large impact on quality of life,” added Dr. Bishop-Fitzpatrick, who was not involved in the study.

Dr. Karen Kuhlthau from MassGeneral Hospital for Children in Boston, who has researched various aspects of ASD and its treatment, told Reuters Health by email, “We need to be sure that these differences (in health problems) are understood and addressed by physicians and that we have health systems in place to ensure that children and youth get the care they need.”

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