What Do We Know About Suicidality in Autism Spectrum Disorders? A Systematic Review

Abstract

Suicidality is a common and concerning issue across development, and there is a plethora of research on this topic among typically developing children and youth. Very little is known, however, about the nature of suicidality among individuals with autism spectrum disorders (ASDs). The purpose of the current study was to undertake a systematic literature review to assess the current state of the research literature to examine the prevalence of suicidality among individuals with ASD, related demographic and clinical profiles, and associated risk and protective factors. A literature search using key terms related to suicidality and ASD yielded 10 topical studies that were evaluated for the study objectives. Suicidality was present in 10.9-50% of the ASD samples identified in the systematic review. Further, several large-scale studies found that individuals with ASD comprised 7.3-15% of suicidal populations, a substantial subgroup. Risk factors were identified and included peer victimization, behavioral problems, being Black or Hispanic, being male, lower socioeconomic status, and lower level of education. Only one study reported on protective factors, and this is identified as a significant gap in the literature. Several methodological weaknesses were present in the current literature, such as lack of appropriate comparison groups and little to no use of empirically validated measures for ASD diagnosis and suicide assessment. Additional research is necessary to understand better how this unique population experiences and expresses suicidal tendencies. Recommendations for future research are discussed.

Assessment of suicidality in children and adolescents with diagnosis of high functioning autism spectrum disorder in a Turkish clinical sample

“…It can be concluded that children and adolescents with high functioning ASD have a higher risk of suicide compared to their typically developing peers. The result of our study reconciles with results of previous studies which reported a high rate of suicidality in groups with a diagnosis of ASD 14–17…”

“…Recently, two reviews were published on this topic 16,17. First Hannan and Taylor’s review of four different studies revealed that prevalence of suicidality among adolescents and young adults with ASD varied from 7% to 42% 16.…”

Epidemiology of Injury-Related Emergency Department Visits in the US Among Youth with Autism Spectrum Disorder

“…Unfortunately, the ICD E-codes 950–959 include both self-inflicted injury with and without suicidal intent so we are unable to precisely sort out suicidal intent for specific visits. Nevertheless, this is the third study to report these findings for self-inflicted injury (Schelnz et al, 2015; McDermott et al, 2008), which converges with increasing concern in the literature and media about suicidal behavior in youth with ASD (Segers & Rawana, 2014; Hannon & Taylor, 2013). Many pediatric emergency department physicians, however, are unfamiliar with the best course of action for individuals with ASD or ID who are deemed to be at high risk.…”

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

“…Therefore, findings cannot be generalised with confidence, and additionally most study samples are small in size, and very few have drawn comparisons with the general population. It has been suggested that depression,3 bipolar disorder,4 suicidal thoughts/behaviour,5 non-affective psychosis6 and attention-deficit hyperactivity disorder7 8 may be more common in adults with autism. A further study in North California, USA used medical records from a single health delivery provider of inpatient and outpatient medical and mental health services to identify 1507/1 578 658 (0.1%) adults with autism, who were age and gender matched with controls without recorded autism 9.…”