Review articleDepression and mood disorders among persons with Autism Spectrum Disorders
Section snippets
Assessment
Conventional wisdom is that ASD should be identified as early as possible (Matson et al., 2009c, Matson et al., 2008b, Matson et al., 2009f, Narzisi et al., 2013). Similarly, given the high prevalence rates of comorbid conditions such as challenging behaviours and comorbid psychopathology, they should be assessed earlier rather than later (Matson, Gonzalez, & Rivet, 2008). In addition to being assessed early, an individual with ASD should also be evaluated periodically as the individual ages (
Depression and mood disorders
The research on depression and mood disorders can be categorized into at least five general topics. These issues include mood and depression, suicidal ideation, comorbidity, the relationship of anxiety and mood, and research on treatment. A review of each topic follows.
Researchers generally recognize that depression is more common among persons with ASD relative to the general population. One such study was described by Mazzone et al. (2013), who evaluated 20 children and adolescents between 7
Suicidal ideation
Suicidal thoughts, which of course are related to depression and mood disturbances, have also been studied. A particularly impressive study was published by Mayes, Gorman, Hillwig-Garcia and Syed (2013). They evaluated 791 children with autism, 1–16 years of age. These children were compared to 186 typically developing children. The dependent variable was suicidal ideation. Mothers reported that 14% of the ASD group evinced suicidal ideation. This rate was 28 times greater than what was
Comorbid psychopathologies
A number of papers have been published looking at how psychopathology in general relates to ASD. Often, mood and depression issues are embedded in a broader comorbidity. For example, La Malfa et al. (2007) evaluated 90 adults with intellectual disability plus the co-occurrence of ASD and various forms of psychopathology. Their overall finding was that mental health issues were common in this group, and the co-occurrence of autism and mood disorders was high. In a second paper, Stahlberg,
Factors associated with mood disorders
While considerably more research is needed regarding mood disorders as they relate to ASD, some efforts have been made in this regard. For example, Ingersoll and Hambrick (2011) studied the effects of ASD on depressive symptoms on parental behaviour. Compared to the general population of parents, caregivers of children with ASD reported higher levels of stress and depression. More severe symptoms of ASD were predictors of more stress and depression among parents. Meltzer (2011) reported similar
Depression and anxiety
To date, one of the largest areas of studies on comorbidity with ASD and depression also involves anxiety. Kim et al. (2000) report on this co-occurring phenomenon among 9–14 year olds with Asperger Syndrome and High Functioning Autism. Fifty-nine children with an ASD were compared to a community sample of 1751 children. Greater rates of anxiety and depression were noted in the ASD sample.
Pine, Guyer, Goldwin, Towbin, and Leibenluft (2008) also studied these comorbidities. They tested 352
Treatment
Treatment research is lagging relative to describing and assessing comorbidity among persons with ASD. This situation is understandable at present since the problem must be accurately identified before treatment can proceed. Most intervention to date has been extrapolated from the research on persons without ASD, but more research is urgently needed to improve and target assessment and treatment for those with ASD, as symptoms may present differently among persons with ASD, or they may be
Conclusions
Comorbid psychopathology among persons with ASD has begun to receive attention from the scientific community. This fact is extremely important if the best quality care for persons with ASD is to be realized. The recognition of these comorbidities has been one of the most significant developments in the field of ASD. These developments have markedly changed how the disorder is conceptualized. For example, there will be a need to subtype the ASD syndrome, add more axes, or employ severity and
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