Based on a 20-year population study in Utah, researchers have discovered that among individuals with autism spectrum disorder (ASD), suicides, though rare, have increased over time compared to the general public.
The findings, published in the journal Autism Research, show that much of this increase occurred within the last five years, particularly among females.
“There has been an unfortunate assumption that people with autism are in their own world and are not affected by social influences commonly associated with suicidality,” said Anne Kirby, Ph.D., OTRL, assistant professor of occupational therapy at the University of Utah (U of U) Health and first author on the paper.
“There is now growing realization among clinicians and families that suicidal thoughts and behaviors can be a real concern for autistic individuals.”
In particular, during the study period (1998 to 2017), a total of 49 individuals (7 female and 42 male) with autism died by suicide in Utah.
The researchers broke the study into four five-year periods: 1998-2002: 2 males/0 females; 2003-2007: 5 males/ 0 females; 2008-2012: 14 males/ 0 females; and 2013-2017: 21 males/ 7 females.
For the first three periods of the study, the relative risk of suicide between autistic and non-autistic individuals was similar. Beginning in the final period, however, the cumulative incidence of suicide among ASD individuals was significantly higher than non-ASD peers (0.17 percent compared to 0.11 percent).
The increase is driven by suicide among women with autism, which was higher than the non-ASD population (0.17 percent compared to 0.05 percent). Unlike their non-ASD peers, individuals with autism were less likely to use firearms.
While these findings suggest a slightly elevated risk, the authors noted that suicide is rare and is not necessarily a concern for all people with an autism diagnosis.
“While these results show us that those with autism are not immune from suicide risk, we are still working to understand the extent of this risk,” said Hilary Coon, Ph.D., professor in Psychiatry at U of U Health and senior author on the paper.
“We do not yet have enough information to understand specific characteristics or co-occurring conditions associated with increased risk, so more research in this area is urgently needed to identify warning signs.”
The new findings are similar to a 2016 study out of Sweden, the only other population-based study that presented data on suicide death and autism. The Swedish study found suicide was a leading causes of premature mortality among people with autism.
Kirby noted the study may be limited by the continual evolution of the definition and characterization of autism as well as the fact that the determination of suicide is made conservatively by the medical examiner. The study also lacks additional data to control confounding factors like anxiety and depression, which could affect the results.
One out of every 59 children in the United States is diagnosed with autism spectrum disorder (ASD), according to the Centers for Disease Control and Prevention.
Source: University of Utah Health