Abstract
BackgroundThe present study aims to examine if autism spectrum disorder (ASD) is a risk factor for suicide attempts among adult depressed patients and to elucidate the characteristics of suicide attempts in adult depressed patients with ASD.MethodsWe conducted a case–control study. Subjects consisted of 336 retrospectively recruited first-time visit patients to our outpatient clinic with a current major depressive episode; 31 of the 336 patients had attempted suicide. The demographic backgrounds (i.e., age, gender, personal/family history of suicidality); specific psychopathology like bipolarity, agitation, and psychotic features; and comorbidity such as physical diseases, alcohol abuse, cluster B personality disorder, and ASD including pervasive developmental disorder not otherwise specified (PDD-NOS) were examined as potential risk factors for suicide attempts. We compared these variables between the suicide attempters and non-attempters. In addition, we compared suicide attempters to non-attempters within the ASD group and non-ASD group. Binary logistic regression analysis was performed using the significant independent variables from the comparisons between the suicide attempters and non-attempters, and the odds ratios (OR) and 95% confidence intervals (CI) were calculated.ResultsLogistic regression analysis demonstrated that agitation during a depressive episode (OR = 7.15, 95% CI = 2.88–17.74), past suicidal behaviors (OR = 4.32, 95% CI =1.70–10.98), and comorbid PDD-NOS (OR = 4.04, 95% CI = 1.20–13.54) were significantly associated with suicide attempts. The most prevalent suicidal method was drug overdose (59.1%) among non-ASD attempters while hanging was the most prevalent (44.4%) in ASD attempters.ConclusionsDepressed adults with comorbid atypical autistic traits are at higher risk for suicide attempts and may engage in methods that are more lethal.
Highlights
The present study aims to examine if autism spectrum disorder (ASD) is a risk factor for suicide attempts among adult depressed patients and to elucidate the characteristics of suicide attempts in adult depressed patients with Autism spectrum disorders (ASDs)
There was no significant difference in the proportion of females between ASD (54%) and non-ASD subjects (63%)
The proportion of suicide attempters was significantly higher in ASD subjects (n = 9, 24.3%) than in non-ASD subjects (n = 22, 7.4%) (p
Summary
The present study aims to examine if autism spectrum disorder (ASD) is a risk factor for suicide attempts among adult depressed patients and to elucidate the characteristics of suicide attempts in adult depressed patients with ASD. Autism spectrum disorders (ASDs) are neurodevelopmental disorders characterized by deficits in social communication and social interaction and the presence of restricted, repetitive behaviors. ASDs include three of five disorders known as pervasive developmental disorders (PDDs) in the DSM-IV-TR [1]. These consist of autistic disorder, Asperger’s disorder (AS), and pervasive developmental disorder not otherwise specified (PDD-NOS). The prevalence of ASD in adults was estimated to be 0.98% [2]. ASD has nowadays become a more common disorder than previously recognized. It has been consistently pointed out that mood disorders are the most common lifetime comorbidity (53%–70%) among ASD adults [3,4,5]. Mood disorders are generally accompanied by suicide risk [6]
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