Association of Autistic Traits With Depression From Childhood to Age 18 Years

Rai, Dheeraj; Culpin, Iryna; Heuvelman, Hein; Magnusson, Cecilia; Carpenter, Peter; Jones, Hannah; Emond, Alan; Zammit, Stanley; Golding, Jean; Pearson, Rebecca

doi:10.1001/jamapsychiatry.2018.1323

Cited by 124 publications

(139 citation statements)

References 44 publications

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“…A number of studies have compared prevalence rates of psychiatric disorders between youth with ASD and either the general population or typically developing youth. A large population-based longitudinal study included 6091 adolescents with and without ASD and examined the association with depression over eight years [ 23 ]. Using the Short Mood and Feelings Questionnaire (SMFQ) as the measure for depressive symptoms, adolescents with ASD had higher average scores when compared to the general population at age 10 years, and scores remained elevated in an upward trajectory until age 18 [ 24 ].…”

Section: Prevalencementioning

confidence: 99%

Depression in Children and Adolescents with Autism Spectrum Disorder

DeFilippis

2018

Children

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Autism spectrum disorder (ASD) has a high rate of psychiatric comorbidity. The prevalence of comorbid depression seems to correlate with higher functioning forms of ASD and increasing age. Adolescence is a time when youth struggle with identity and interpersonal relationships, and a diagnosis of ASD further complicates this process. Adolescents with ASD may be more aware of the social communication deficits that come with the diagnosis than children with ASD, and it is theorized that higher functioning adolescents may experience this more acutely. While this may be true, the lack of reliable rating and diagnostic scales for depression in individuals with ASD makes it difficult to accurately measure rates of depression among individuals with more severe verbal deficits. While some research has focused on the prevalence of comorbid depression in children and adolescents with ASD and on the associated risk factors, there is very little evidence guiding treatment, including no empirical studies on psychopharmacology for depression in this population. Available evidence exists only in psychosocial approaches to treatment at this time and is mostly limited to adult studies. Current evidence will be presented in this review, including prevalence rates of depression in youth with ASD, various risk and protective factors, the use of diagnostic rating scales, and treatment studies. The lack of evidence supporting various treatment approaches will be highlighted, including challenges specific to the treatment of depression in ASD, which are not addressed in the current treatment studies in typically developing youth with depression.

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Section: Prevalencementioning

confidence: 99%

Depression in Children and Adolescents with Autism Spectrum Disorder

DeFilippis

2018

Children

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“…In recent years, an increasing number of studies have assessed the association of bullying involvement with mental health problems in children and adolescents with ASD (12. A longitudinal study found that social communication impairments at the age of 10 years were associated with depression at the age of 18 years, and bullying victimization explained a substantial proportion of this risk (13). Parent-reported bullying victimization was significantly associated with anxiety symptoms in youth with ASD (14,15).…”

Section: Introductionmentioning

confidence: 99%

Role of School Bullying Involvement in Depression, Anxiety, Suicidality, and Low Self-Esteem Among Adolescents With High-Functioning Autism Spectrum Disorder

et al. 2020

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This study aimed to compare the severities of psychopathologies and the level of selfesteem among 219 adolescents with high-functioning autism spectrum disorder (ASD) who were classified into pure perpetrators, pure victims, perpetrator-victims, and neutrals in Taiwan. The experiences of school bullying involvement in the previous 1 year were measured using the Chinese version of the School Bullying Experience Questionnaire. The severities of depression, anxiety, and suicidality were measured using the Center for Epidemiological Studies Depression Scale, the Multidimensional Anxiety Scale for Children, and the 5-item questionnaire from the epidemiological version of the Kiddie Schedule for Affective Disorders and Schizophrenia, respectively. The level of self-esteem was measured using the Rosenberg Self-Esteem Scale. The results indicated that compared with the self-reported neutrals, the self-reported perpetrator-victims and pure victims had more severe depression and anxiety. No difference in depression, suicidality, anxiety, and self-esteem was found among the four groups of various parentreported bullying involvement experiences. Mental health problems in adolescents with ASD who experienced bullying victimization should be routinely surveyed.

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“…9 The onset of depressive symptoms in autism appears to be early. A UK-based cohort study 10 reported that autistic children and children with higher autism traits have higher depressive symptoms at the age of 10 years and that these remain elevated with an upwards trajectory until the age of 18 years. Robust epidemiological research, particularly longitudinal studies, has been lacking until relatively recently.…”

Section: Introductionmentioning

confidence: 99%

“…Verbal abilities significantly influence the presentation or at least the identification of depression in this group. In addition, there is some evidence that better cognitive abilities and relatively low social impairment, 14 the tendency to make social comparisons 15 and a history of adverse experiences such as bullying 10 may be features of autistic young people with co-occurring depression.…”

Section: Introductionmentioning

confidence: 99%

Guided self-help for depression in autistic adults: the ADEPT feasibility RCT

Russell

Gaunt

Cooper

et al. 2019

Health Technol Assess

Self Cite

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Background Co-occurring depression frequently occurs in autism. Evidence-based psychological interventions have been successfully adapted to treat co-occurring anxiety, but there is little evidence about the usefulness of adapted cognitive–behavioural therapy for depression. To the authors’ knowledge, to date there have been no randomised trials investigating the usefulness of low-intensity cognitive–behavioural therapy for depression in autism. Objectives The objectives of the study were to (1) develop a low-intensity psychological intervention for depression adapted for autism, (2) assess the feasibility and patient and therapist acceptability of the intervention, (3) estimate the rates of recruitment and retention for a full-scale randomised controlled trial and (4) identify an appropriate measure of depression to be used in a full-scale randomised controlled trial. Design The study comprised a randomised controlled trial (n = 70) with a nested qualitative evaluation (n = 21). Seventy eligible and consenting participants were randomly allocated to guided self-help or to treatment as usual. Setting Adult autism services in two NHS regions. Participants Adults with a diagnosis of autism spectrum disorder with depression, that is, a Patient Health Questionnaire-9 items score of ≥ 10. People who had attended more than six sessions of cognitive–behavioural therapy in the previous 6 months were excluded. Interventions The low-intensity intervention (guided self-help) comprised materials for nine individual sessions, based on behavioural activation adapted for autism, facilitated by therapist guides (coaches) who were graduate-level psychologists who attended training and regular supervision. Treatment as usual was standard NHS care for depression. Main outcome measures Outcomes were measured 10, 16 and 24 weeks post randomisation using self-report and interview measures of depression, anxiety, obsessive–compulsive symptoms, social function and quality of life, and a health-care and service use questionnaire. As this was a feasibility study also designed to identify the most appropriate measure of depression, it was not possible to specify the primary outcome measure or outcome point a priori. Results The aims of the study were met in full. The guided self-help intervention was feasible and well received by participants and coaches. The majority of allocated participants attended the intervention in full. The most practical outcome point was determined to be 16 weeks. There were differential rates of attrition across the treatment groups: 86% of the guided self-help group remained in the study at 24 weeks, compared with 54% of treatment as usual group. The qualitative study suggested that guided self-help had enhanced credibility with participants at the point of randomisation. Inter-rater reliability of the interview measure of depression was less than adequate, limiting the conclusions that can be drawn from the prespecified sensitivity to change analyses. Conclusions The intervention was feasible and well received. Although this feasibility study was not a fully powered trial, it provided some evidence that the guided self-help intervention was effective in reducing depressive symptoms. A full-scale clinical effectiveness and cost-effectiveness trial of the intervention is warranted. Future work Improvements to the intervention materials as a result of qualitative interviews. Stakeholder consultation to consider future trial design, consider strategies to improve retention in a treatment as usual arm and select a self-report measure of depression to serve as the primary outcome measure. Trial registration Current Controlled Trials ISRCTN54650760. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 68. See the NIHR Journals Library website for further project information. This study was also supported by the NIHR Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol.

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Association of Autistic Traits With Depression From Childhood to Age 18 Years

Cited by 124 publications

References 44 publications

Depression in Children and Adolescents with Autism Spectrum Disorder

Depression in Children and Adolescents with Autism Spectrum Disorder

Role of School Bullying Involvement in Depression, Anxiety, Suicidality, and Low Self-Esteem Among Adolescents With High-Functioning Autism Spectrum Disorder

Guided self-help for depression in autistic adults: the ADEPT feasibility RCT

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