Co-occurring Conditions in Autistic Adults
A large meta-analysis found that roughly 4 in 5 autistic adults meet criteria for at least one co-occurring psychiatric condition in their lifetime (Lai et al., 2019).
The most common
- Anxiety disorders — approximately 42% lifetime prevalence.
- Depressive disorders — approximately 37%.
- ADHD — 30-80% overlap in clinic samples (Hours et al., 2022).
- PTSD — autistic adults report traumatic events at higher rates and may not fit DSM criteria that assume neurotypical trauma responses (Rumball et al., 2020).
Why standard treatment sometimes misses
CBT protocols may need adaptation for autistic thinking styles, interoception differences, and alexithymia (Spain et al., 2015).
What to look for in a clinician
- Willing to modify pace and use written summaries.
- Familiar with the autistic sensory profile.
- Does not treat autistic traits as symptoms to eliminate.
Sources
- Lai, M.-C., et al. (2019). Prevalence of co-occurring mental health diagnoses in the autism population: A systematic review and meta-analysis. The Lancet Psychiatry, 6(10), 819-829. https://doi.org/10.1016/S2215-0366(19)30289-5
- Hours, C., Recasens, C., & Baleyte, J.-M. (2022). ASD and ADHD comorbidity: What are we talking about? Frontiers in Psychiatry, 13, 837424. https://doi.org/10.3389/fpsyt.2022.837424
- Rumball, F., Happé, F., & Grey, N. (2020). Experience of trauma and PTSD symptoms in autistic adults. Autism Research, 13(12), 2122-2132. https://doi.org/10.1002/aur.2306
- Spain, D., et al. (2015). Cognitive behaviour therapy for adults with autism spectrum disorders and psychiatric co-morbidity: A review. Research in Autism Spectrum Disorders, 9, 151-162. https://doi.org/10.1016/j.rasd.2014.10.019