Treatment of Depression in Individuals with Autism Spectrum Disorder: A Systematic Review

Menezes, Michelle; Harkins, Christina; Robinson, Melissa F.; Mazurek, Micah O.

doi:10.1016/j.rasd.2020.101639

Cited by 31 publications

(23 citation statements)

References 76 publications

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“…Furthermore, in line with existing literature, our review found that mindfulness therapy may decrease anxiety and depression scores in some autistic adults with previous mental health conditions ( Cachia et al, 2016 ; Hartley et al, 2019 ; Menezes et al, 2020 ). However, as per a previous review on this topic, our review found there is low certainty of evidence.…”

Section: Discussionsupporting

confidence: 88%

“…Lack of reporting around potential harms and meditation-related side effects is problematic in light of the fact that a large proportion of participants in mindfulness-based interventions can experience negative side effects ( Britton et al, 2021 ), even if they benefit from the intervention overall ( Cachia et al, 2016 ; Hartley et al, 2019 ). Existing evidence regarding the effectiveness of behavioural interventions for depression in autistic people is limited ( Menezes et al, 2020 ; White et al, 2018 ). Our review provides some indication that behavioural interventions may provide some benefit for depression in autistic children when compared to offering no intervention.…”

Section: Discussionmentioning

confidence: 99%

“…While there are multiple meta-analyses examining the prevalence of anxiety and depression in autistic people, no meta-analysis looking at interventions for depression has been published in over a decade ( Menezes et al, 2020 ). A recent systematic review of the evidence on treatment for depression in autistic people concluded that there is some suggestion that mindfulness-based therapy may be beneficial; however, the strength of evidence is poor and studies have inconsistent findings ( Menezes et al, 2020 ). A meta-analysis looking at evidence for the effectiveness of antidepressants in autistic people, which focused on outcomes other than depression, found that evidence for the use of antidepressants is also contradictory ( Deb et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Benefits and harms of interventions to improve anxiety, depression, and other mental health outcomes for autistic people: A systematic review and network meta-analysis of randomised controlled trials

Linden

Best

Elise

et al. 2022

Autism

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Mental health difficulties are prevalent in autistic people with ~14%–50% having experienced depression and ~40%–80% having experienced anxiety disorders. Identifying interventions that improve autistic people’s mental health is a top priority. However, at present, there is no high-quality network meta-analysis of benefits and harms of different interventions. We conducted a systematic review and network meta-analysis of randomised controlled trials, searching MEDLINE, EMBASE, other databases, and trial registers until 17 October 2020. We included randomised controlled trials reporting anxiety or depression in a suitable format. We calculated effect estimates and 95% credible intervals using Bayesian network meta-analysis. Our search identified 13,794 reports, of which 71 randomised controlled trials (3630 participants) were eligible for inclusion. All trials had high risk of bias. The follow-up period ranged from 1 to 24 months. Evidence indicates uncertainty about the effects of different interventions, with more high-quality evidence needed. Available evidence suggests that some forms of cognitive behavioural therapy may decrease anxiety and depression scores in autistic children and adults; mindfulness therapy may decrease anxiety and depression scores in autistic adults with previous mental health conditions; and behavioural interventions may provide some benefit for depression in autistic children. We recommend that autistic people are given access to mental health interventions available to non-autistic people, following principles of person-centred care. PROSPERO registration ID: CRD42019136093 Lay Abstract Nearly three out of four autistic people experience mental health problems such as stress, anxiety or depression. The research already done does not guide us on how best to prevent or treat mental health problems for autistic people. Our aim was to look at the benefits and harms of different interventions on mental health outcomes in autistic people. We searched all the published randomised controlled trials (RCTs) about interventions for mental health conditions in autistic people until 17 October 2020. We also searched for RCTs that were not published in peer-reviewed journals. These were obtained from registers of clinical trials online. We then combined the information from all these trials using advanced statistical methods to analyse how good the interventions are. Seventy-one studies (3630 participants) provided information for this research. The studies reported how participants were responding to the intervention for only a short period of time. The trials did not report which interventions worked for people with intellectual disability. In people without intellectual disability, some forms of cognitive behavioural therapy and mindfulness therapy may be helpful. However, further research is necessary. Many trials used medications to target core features of autism rather than targeting mental health conditions, but these medications did not help autistic people. Until we have more evidence, treatment of mental health conditions in autistic people should follow the evidence available for non-autistic people. We plan to widely disseminate the findings to healthcare professionals through medical journals and conferences and contact other groups representing autistic people.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Benefits and harms of interventions to improve anxiety, depression, and other mental health outcomes for autistic people: A systematic review and network meta-analysis of randomised controlled trials

Linden

Best

Elise

et al. 2022

Autism

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“…Recently published literature reviews document the nature and type of difficulties experienced by persons with autism [1], intellectual disabilities [2] and those with physical impairments and chronic illnesses [3], such as depression, anxiety conditions, attention-deficit/hyperactivity (ADHD), depression and oppositional defiant disorders [4]. Consequently, higher proportions of persons with these disabilities are prescribed medications compared to their non-disabled peers [5,6].…”

Section: Introductionmentioning

confidence: 99%

Promoting the Wellbeing of Youth with Disabilities through Music Mentoring

McCarron

Curran

McConkey

2022

Youth

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Youth with disabilities have a higher risk of experiencing mental health problems than their non-disabled peers. In part, this results from their social exclusion and dearth of social networks. An intervention informed by positive psychology principles and peer mentoring approaches was developed and evaluated with 12 youths with disabilities who had musical interests and talents as musicians. It included the real-world experience of applying the training in a school-based music project with over 200 typically developing pupils aged nine years in four schools. Evaluation data were obtained from project staff, self-ratings by the mentors and through group interviews with them, as well as from reactions of school pupils and interviews with six teachers. The study confirmed the benefit of music and peer mentoring as a means of promoting the self-esteem and self-confidence of youth with disabilities. Further research is needed to determine the longer-term mental health benefits musically based interventions can offer to youth with disabilities and, more generally, to young children in schools.

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“…A meta-analytic review revealed that cognitive behavioral therapy effectively treats anxiety in children with ASD [ 8 ]. However, the effects of cognitive-behavioral therapy on depression in children and adults [ 9 ] and anxiety [ 10 , 11 ] in adults with ASD are inconsistent. Several studies have shown that ASD after puberty is characterized by strong self-stigmatization due to chronic social isolation [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

A preliminary study of schema therapy for young adults with high-functioning autism spectrum disorder: a single-arm, uncontrolled trial

et al. 2021

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Objective Psychological problems associated with isolation and mistrust are common among young adults with autism spectrum disorder (ASD). Schema therapy (ST) has recently been shown to be effective against chronic personality problems of various mental disorders, including personality disorders. This pilot clinical trial aimed to explore the feasibility and acceptability of ST in young adults with high-functioning ASD. Results Following the intervention, a significant reduction in early maladaptive schemas and improvements in quality of life and social adjustment were observed. ST may be feasible and is applicable to young adults with HF-ASD. Trial registration UMIN000014535; registered on July 11, 2014

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Treatment of Depression in Individuals with Autism Spectrum Disorder: A Systematic Review

Cited by 31 publications

References 76 publications

Benefits and harms of interventions to improve anxiety, depression, and other mental health outcomes for autistic people: A systematic review and network meta-analysis of randomised controlled trials

Benefits and harms of interventions to improve anxiety, depression, and other mental health outcomes for autistic people: A systematic review and network meta-analysis of randomised controlled trials

Promoting the Wellbeing of Youth with Disabilities through Music Mentoring

A preliminary study of schema therapy for young adults with high-functioning autism spectrum disorder: a single-arm, uncontrolled trial

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