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Prevalence of long-term health conditions in adults with autism: observational study of a whole country population

Journal article
Authors E. Rydzewska
L. A. Hughes-McCormack
Christopher Gillberg
A. Henderson
C. MacIntyre
J. Rintoul
S. A. Cooper
Published in BMJ Open
Volume 8
Issue 8
ISSN 2044-6055
Publication year 2018
Published at Gillberg Neuropsychiatry Centre
Language en
Links dx.doi.org/10.1136/bmjopen-2018-023...
Keywords autism, adults, prevalence, comorbidity, mental health, physical disabilities, spectrum disorders, asperger-syndrome, boys, General & Internal Medicine
Subject categories Neurology

Abstract

Objectives To investigate the prevalence of comorbid mental health conditions and physical disabilities in a whole country population of adults aged 25+ withand without reported autism. Design Secondary analysis of Scotland's Census, 2011 data. Cross-sectional study. Participants 94% of Scotland's population, including 6649/3 746 584 adults aged 25+ reportedto have autism. Main outcome measures Prevalence of six comorbidities: deafness or partial hearing loss, blindness or partial sight loss, intellectual disabilities, mental health conditions, physical disability and other condition; ORs (95% CI) of autism predicting these comorbidities, adjusted for age and gender; and OR for age and gender in predicting comorbidities within the population with reported autism. Results Comorbidities were common: deafness/hearing loss17.5%; blindness/sight loss12.1%; intellectual disabilities29.4%; mental health conditions33.0%; physical disability30.7%; other condition34.1%. Autism statistically predicted all of the conditions: OR 3.3 (95% CI 3.1 to 3.6) for deafness or partial hearing loss, OR 8.5 (95% CI 7.9 to 9.2) for blindness or partial sight loss, OR 94.6 (95% CI 89.4 to 100.0) for intellectual disabilities, OR 8.6 (95% CI 8.2 to 9.0) for mental health conditions, OR 6.2 (95% CI 5.8 to 6.6) for physical disability and OR 2.6 (95% CI 2.5 to 2.8) for other condition. Contrary to findings within the general population, female gender predicted all conditions within the population with reported autism, including intellectual disabilities (OR=1.4). Conclusions Clinicians need heightened awareness of comorbidities in adults with autism to improve detection and suitable care, especially given the added complexity of assessment in this population and the fact that hearing and visual impairments may cause additional difficulties with reciprocal communication which are also a feature of autism; hence posing further challenges in assessment.

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