Psychiatric conditions in autistic adolescents: longitudinal stability from childhood and associated risk factors

TY - JOUR

T1 - Psychiatric conditions in autistic adolescents

T2 - longitudinal stability from childhood and associated risk factors

AU - Hollocks, Matthew J

AU - Leno, Virginia Carter

AU - Chandler, Susie

AU - White, Pippa

AU - Yorke, Isabel

AU - Charman, Tony

AU - Pickles, Andrew

AU - Baird, Gillian

AU - Simonoff, Emily

N1 - Funding Information: The original QUEST sample was funded by Clothworkers' Foundation, brokered by Research Autism (R011217 Autism M10 2011/12). The IAMHealth research programme was funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research programme (ES: RP-PG-1211–20016). The authors also acknowledge funding from NIHR Senior Investigator Awards (ES: NF-SI-0514-10073, AP: NF-SI-0617-10120), and a Sir Henry Wellcome Postdoctoral Fellowship (VCL: 213608/Z/18/Z). The study was partially supported through the NIHR Maudsley Biomedical Research Centre at the South London and Maudsley NHS Foundation Trust in partnership with King’s College London. Publisher Copyright: © 2022, The Author(s).

PY - 2022/8/17

Y1 - 2022/8/17

N2 - Autistic people experience high rates of co-occurring psychiatric diagnoses. Current prevalence estimates vary considerably due to an over-reliance on clinical cohorts and the longitudinal stability of diagnoses from childhood into adolescence is poorly understood. This study aims to provide prevalence rates of co-occurring DSM-5 psychiatric diagnosis for autistic adolescence and investigate, for the first time, the stability of diagnoses from childhood. Using a longitudinal stratified sample of autistic youth (N = 77; 13–17 years; 60% male), selected from a larger community-derived sample of those with pre-existing autism diagnoses (N = 277) weighted prevalence estimates of emotional (anxiety, depression), behavioural (oppositional and conduct disorders) and ADHD diagnoses were calculated based on semi-structured psychiatric interview. Prediction of adolescent psychiatric diagnosis based on childhood diagnostic status, sex, childhood IQ (both assessed at age 4–10 years) was tested. Emotional and behavioural disorders in adolescence were particularly prevalent, and significantly predicted by childhood disorder status. Attention-deficit/hyperactivity-disorder (ADHD) was prevalent but not predicted by childhood ADHD diagnosis. Neither sex nor childhood IQ predicted diagnostic outcomes. Autistic youth have high levels of co-occurring psychiatric conditions, which are broadly persistent across childhood and adolescence. Emotional disorders are particularly prevalent and remain persistent from childhood to adolescence. Greater diagnostic variability was found for ADHD with more adolescents moving across diagnostic thresholds.

AB - Autistic people experience high rates of co-occurring psychiatric diagnoses. Current prevalence estimates vary considerably due to an over-reliance on clinical cohorts and the longitudinal stability of diagnoses from childhood into adolescence is poorly understood. This study aims to provide prevalence rates of co-occurring DSM-5 psychiatric diagnosis for autistic adolescence and investigate, for the first time, the stability of diagnoses from childhood. Using a longitudinal stratified sample of autistic youth (N = 77; 13–17 years; 60% male), selected from a larger community-derived sample of those with pre-existing autism diagnoses (N = 277) weighted prevalence estimates of emotional (anxiety, depression), behavioural (oppositional and conduct disorders) and ADHD diagnoses were calculated based on semi-structured psychiatric interview. Prediction of adolescent psychiatric diagnosis based on childhood diagnostic status, sex, childhood IQ (both assessed at age 4–10 years) was tested. Emotional and behavioural disorders in adolescence were particularly prevalent, and significantly predicted by childhood disorder status. Attention-deficit/hyperactivity-disorder (ADHD) was prevalent but not predicted by childhood ADHD diagnosis. Neither sex nor childhood IQ predicted diagnostic outcomes. Autistic youth have high levels of co-occurring psychiatric conditions, which are broadly persistent across childhood and adolescence. Emotional disorders are particularly prevalent and remain persistent from childhood to adolescence. Greater diagnostic variability was found for ADHD with more adolescents moving across diagnostic thresholds.

KW - Adolescent

KW - Child

KW - Male

KW - Humans

KW - Child, Preschool

KW - Female

KW - Autistic Disorder

KW - Comorbidity

KW - Attention Deficit Disorder with Hyperactivity/diagnosis

KW - Conduct Disorder/epidemiology

KW - Risk Factors

UR - http://www.scopus.com/inward/record.url?scp=85136231166&partnerID=8YFLogxK

U2 - 10.1007/s00787-022-02065-9

DO - 10.1007/s00787-022-02065-9

M3 - Article

C2 - 35976471

AN - SCOPUS:85136231166

SN - 1018-8827

VL - 32

SP - 2197

EP - 2208

JO - European Child and Adolescent Psychiatry

JF - European Child and Adolescent Psychiatry

IS - 11

ER -