Depression In Autism Spectrum Disorder Research Articles

Gray Matter Volume Correlates of Co-Occurring Depression in Autism Spectrum Disorder.

Autism Spectrum Disorder (ASD) involves neurodevelopmental syndromes with significant deficits in communication, motor behaviors, emotional and social comprehension. Often, individuals with ASD exhibit co-occurring depression characterized by a change in mood and diminished interest in previously enjoyable activities. Due to communicative challenges and a lack of appropriate assessments in this cohort, co-occurring depression can often go undiagnosed during routine clinical examinations and, thus, its management neglected. The literature on co-occurring depression in adults with ASD is limited. Therefore, understanding the neural basis of the co-occurring psychopathology of depression in ASD is crucial for identifying brain-based markers for its timely and effective management.Using structural MRI and phenotypic data from the Autism Brain Imaging Data Exchange (ABIDE II) repository, we examined the pattern of relationship regional grey matter volume (rGMV) has with co-occurring depression and autism severity within regions of a priori interest in adults with ASD (n = 44; age = 17-28 years). Further, we performed an exploratory analysis of the rGMV differences between ASD and matched typically developed (TD, n = 39; age = 18-31 years) samples. The severity of co-occurring depression correlated negatively with the rGMV of the right thalamus. Additionally, a significant interaction was evident between the severity of co-occurring depression and core ASD symptoms towards explaining the rGMV in the left cerebellum crus II. The results further the understanding of the neurobiological underpinnings of co-occurring depression in adults with ASD towards exploring neuroimaging-based biomarkers in the same cohort.

EMOTION REGULATION IN AUTISM SPECTRUM DISORDER: EFFECTS ON ANXIETY AND DEPRESSION- A SCOPING REVIEW

Comorbid conditions, such as anxiety and depression, pose diagnostic challenges due to their complex interaction with core autism spectrum disorder features. Emotion regulation is a key concept in the transdiagnostic framework which suggests shared cognitive and behavioral processes among mental disorders. The review aims to examine the emotion regulation effects on anxiety and depression in autism spectrum disorder. A systematic search was conducted from December 2022. to May 2023., using SCOPUS and Google Scholar, with predefined eligibility criteria. Analysis of the twelve included publications unveiled emotion regulation challenges in individuals with autism spectrum disorder. Importantly, these maladaptive strategies were found to be significantly linked to symptoms of anxiety and depression. These findings emphasize the need for interventions that specifically target and improve emotion regulation in individuals with autism spectrum disorder. By enhancing their emotional regulation skills, it may be possible to reduce the symptoms of anxiety and depression in this population.

Current Treatment of Depression in Children with Autism and Intellectual and Developmental Disabilities

There are no evidence-based guidelines for the treatment of depression in Autism Spectrum Disorder (ASD). We describe prescribing practices for youth with depression

The role of intellectual disability and emotional regulation in the autism-depression relationship.

Many people with autism and intellectual disability have significant levels of depressive symptoms. However, this relationship is not clear. For this reason, knowing the factors that are associated with having depression in autism and intellectual disability is important. Emotion regulation is associated with depression in autism spectrum disorder and intellectual disability. After evaluating a group of people with autism and intellectual disability, we found that people with mild intellectual disability have problems regulating their emotions which lead them to develop depressive symptoms. These findings suggest that interventions designed to prevent or reduce depressive symptoms in people with autism spectrum disorder and mild intellectual disability should include among their goals emotional regulation.

Practitioner Review: Attention-deficit hyperactivity disorder and autism spectrum disorder - the importance of depression.

Young people with neurodevelopmental disorders, such as attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), show high rates of mental health problems, of which depression is one of the most common. Given that depression in ASD and ADHD is linked with a range of poor outcomes, knowledge of how clinicians should assess, identify and treat depression in the context of these neurodevelopmental disorders is much needed. Here, we give an overview of the latest research on depression in young people with ADHD and ASD, including possible mechanisms underlying the link between ADHD/ASD and depression, as well as the presentation, assessment and treatment of depression in these neurodevelopmental disorders. We discuss the implications for clinicians and make recommendations for critical future research in this area.

3.4 TACKLING ANXIETY, DEPRESSION, AND SUICIDALITY IN AUTISM SPECTRUM DISORDER

Research over the past decade has confirmed that anxiety and depression are highly prevalent and potentially severe mental health conditions in children, adolescents, and young adults with autism spectrum disorder (ASD). Additionally, in the past 5 years, suicidality has also been recognized as more prevalent and likely to manifest at earlier ages in ASD compared to individuals without ASD. Assessment of anxiety and depression are complicated by difficulties with self-report and symptom overlap with ASD. Similarly, suicidality can be easily overlooked and is sometimes the presenting symptom of longstanding serious underlying mental health difficulties. The objectives of this session are to: 1) review the prevalence and risk factors contributing to depression in ASD; 2) provide strategies to assess depression in ASD and illustrate the various clinical phenotypes of depression in this population; and 3) discuss emerging research on psychosocial and psychopharmacological treatments for depression in ASD. Data for this talk will be obtained from a PubMed and PsycINFO search of published studies, particularly studies published in the last 18 months, as well as the presenter’s extensive clinical experience in working with this population. This talk will provide psychiatrists with new approaches to recognize and treat anxiety, depression, and suicidality in children with ASD, which draw from the available evidence and while recognizing that the mental health systems of care have not been fully developed to serve this population. Clinical cases and video clips will be presented to bring the presentation alive. Anxiety, depression, and suicidality are common conditions in individuals with ASD. Appropriate and timely treatment is recommended in order to improve outcomes for youth with ASD.

Is a Negative Attentional Bias in Individuals with Autism Spectrum Disorder Explained by Comorbid Depression? An Eye-Tracking Study

Heightened attention towards negative information is characteristic of depression. Evidence is emerging for a negative attentional bias in Autism spectrum disorder (ASD), perhaps driven by the high comorbidity between ASD and depression. We investigated whether ASD is characterised by a negative attentional bias and whether this can be explained by comorbid (sub) clinical depression. Participants (n = 116) with current (CD) or remitted depression (RD) and/or ASD, and 64 controls viewed positively and negatively valenced (non-)social pictures. Groups were compared on three components of visual attention using linear mixed models. Both CD individuals with and without ASD, but not remitted depressed and never-depressed ASD individuals showed a negative bias, suggesting that negative attentional bias might be a depressive state-specific marker for depression in ASD.

Higher depressive symptoms in early adolescents with Autism Spectrum Disorder by self- and parent-report compared to typically-developing peers

BackgroundDepression is more prevalent among male early adolescents with Autism Spectrum Disorder (ASD) than their typically- developing (TD) peers, but findings are limited to two male-only studies. Therefore, a broader understanding of depressive symptoms among both male and female early adolescents with ASD in larger samples is needed. Self- and parent-ratings are frequently used, yet rater differences may emerge and provide unique insights. MethodRatings of adolescent depressive symptoms were examined among 230 early adolescents (10:0−13:5 years) with and without ASD using self- (Children’s Depression Inventory, Second Edition; CDI-2) and parent- report (Child Behavior Checklist; CBCL) measures. The influence of diagnostic group (ASD vs. TD) and rater (early adolescent vs. parent) on ratings were examined with Full Scale IQ and sex as covariates. Additionally, the reliability and strength of agreement between raters were examined. ResultsHigher depressive symptoms were reported by both raters in the ASD group (Borderline range) compared to the TD group (Average range). The interaction of diagnostic group and rater was nonsignificant, but significant main effects emerged. Sex was a significant covariate, but Full Scale IQ was not. The reliability and strength of agreement between raters in the ASD group only were not significant. ConclusionsFindings suggest that depressive symptoms may be higher in both male and female early adolescents with ASD across self- and parent- reports. However, measurement of depression in ASD may be complicated by nonsignificant reliability and strength of agreement between raters. Results have implications for screening and intervention for early adolescents with ASD.

Depressive symptomatology in adults with autism spectrum disorder and intellectual disability: correlates and predictors

Autism Spectrum Disorder (ASD) usually appears associated with other comorbid psychopathology. For this reason, the present research aimed to study the comorbid conditions in ASD paying more attention to depressive symptoms. The investigation included a sample of 37 adults with ASD and intellectual disability (M = 27.49; SD = 9.2), users of various associations of the Community of Madrid. Autistic severity was assessed with the Diagnostic Behavioral Assessment for Autism Spectrum Disorder-Revised (Dibas-R) and comorbidity was assessed through Autism Spectrum Disorders-Comorbidity for Adults (ASD-CA). The results showed a significant correlation between autism symptomatology and general comorbidity. Moreover, autistic symptoms were associated with depressive symptomatology. A hierarchical regression analysis was also conducted; and its data suggested that irritability/behavioral excesses were significant predictors of depression in ASD.

Association Between Autism Spectrum Disorders With or Without Intellectual Disability and Depression in Young Adulthood

Depression is a frequently occurring mental disorder and may be common in adults with autism spectrum disorders (ASD), but there is a lack of longitudinal population-based studies examining this association. Whether any increased risk of depression in ASD has a shared familial basis and whether it differs by co-occurring intellectual disability is not well known. To examine whether individuals with ASD are more likely to be diagnosed as having depression in adulthood than the general population and their nonautistic siblings and to investigate whether these risks differ by the presence or absence of intellectual disability. Population-based cohort study with a nested sibling comparison. The Stockholm Youth Cohort is a total population record linkage study that includes all children and young people (age range, 0-17 years) who were ever resident in Stockholm County, Sweden, between January 2001 and December 2011 (n = 735 096). Data analysis was conducted between January 5 and November 30, 2017, in Stockholm County, Sweden. Clinical diagnosis of depressive disorders was identified using the Stockholm County Adult Psychiatric Outpatient Register and the Swedish National Patient Register. Participants were 223 842 individuals followed up to age 27 years by 2011, of whom 4073 had diagnosed ASD (mean [SD] age, 21.5 [2.7] years; 65.9% male; 2927 without intellectual disability and 1146 with intellectual disability) and 219 769 had no ASD (mean [SD] age, 22.1 [2.8] years; 50.9% male). By age 27 years, 19.8% (n = 808) of individuals diagnosed having ASD had a diagnosis of depression compared with 6.0% (n = 13 114) of the general population (adjusted relative risk [RR], 3.64; 95% CI, 3.41-3.88). The risk of a depression diagnosis was higher in ASD without intellectual disability (adjusted RR, 4.28; 95% CI, 4.00-4.58) than in ASD with intellectual disability (adjusted RR, 1.81; 95% CI, 1.51-2.17). Nonautistic full-siblings (adjusted RR, 1.37; 95% CI, 1.23-1.53) and half-siblings (adjusted RR, 1.42; 95% CI, 1.23-1.64) of individuals with ASD also had a higher risk of depression than the general population. Compared with their nonautistic full-siblings, individuals with ASD had more than a 2-fold risk of a depression diagnosis (adjusted odds ratio, 2.50; 95% CI, 1.91-3.27) in young adulthood. According to this study's results, ASD, particularly ASD without intellectual disability, is associated with depression by young adulthood compared with the general population. It appears that this association is unlikely to be explained by shared familial liability. Future research to identify modifiable pathways between ASD and depression may assist in the development of preventive interventions.

Depression in Children and Adolescents with Autism Spectrum Disorder.

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.

Bullying Linked to Depression in Youth With Autism

Back to table of contents Previous article Next article Clinical and Research NewsFull AccessBullying Linked to Depression in Youth With AutismRebecca GreenbergRebecca GreenbergSearch for more papers by this authorPublished Online:16 Aug 2018https://doi.org/10.1176/appi.pn.2018.8a8AbstractChildren with autism are often the target of bullying, which can contribute to the development of depression.By age 10, children with autism spectrum disorder (ASD) or autistic traits have more symptoms of depression than their peers, according to a study published June 13 in JAMA Psychiatry. Irrespective of genetic factors, the researchers found that depressive symptoms worsened up to the end of the study as the adolescents reached age 18 and were exacerbated by bullying. “[F]urther research into the role of traumatic experiences, such as bullying, and the utility of interventions to reduce bullying or address its adverse effects could have the potential to reduce the burden of depression in this population,” wrote lead author Dheeraj Rai, Ph.D., a senior lecturer in psychiatry at the University of Bristol, and colleagues. For the study, the authors relied on data from the Avon Longitudinal Study of Parents and Children. The Avon study collected data from 1990 to 1992 on more than 15,000 parents and children from pregnancy through childhood in the Bristol area from self-report questionnaires; clinical assessments; biological samples; and birth, medical, and educational records.The final dataset for the study included 8,087 children. Five groups were identified as either having ASD or symptoms of ASD. Of this group, 96 were diagnosed with ASD, 546 had social communication impairments, 526 had problems with speech coherence, 419 displayed repetitive behaviors, and 801 had poor social temperament with overlap between the groups. Participants with ASD and the four autistic traits had higher depression scores than the general population, as assessed by the Short Mood and Feelings Questionnaire (SMFQ) and the computerized version of the Clinical Interview-Revised, a psychiatric interview widely used in community samples. Their scores continued to rise over time. The SMFQ was administered at six points between ages 10 and 18 via mailed questionnaires or in clinics. Data analysis was conducted from January to November 2017.At age 10, the children with ASD or autistic traits who reported being bullied had the highest average SMFQ scores; likewise, youth with social communication impairments who reported being bullied in childhood or adolescence were more likely to have a diagnosis of depression at age 18.“It is possible that children with social communication problems, who may not have developed a good understanding of social rules and how to fit in, may be targets for bullies,” Rai told Psychiatric News. “Many of the autistic people I have worked with over the years have mentioned that the awareness of being excluded or targeted because of being perceived as different was particularly traumatic.” “These findings add to the evidence highlighting a higher burden of depression and also suggest a potentially modifiable pathway, through bullying,” the authors wrote. “However, gaps remain in our understanding of the measurement and phenomenology of depression in individuals with autism, which could be a priority for future research. Further work could also focus on improvements in psychological and pharmacological management of depression in ASD.”A systematic review of nearly 8,000 research articles in the March issue of the Journal of Abnormal Child Psychology reported that people with ASD are four times more likely to experience depression in their lifetime than people without ASD.Rai noted that depression can be more difficult to detect in these patients because they may not recognize or be able to describe their mood states. For clinicians, Rai said the study shows that many young people and adults with depression have also had a history of trauma. “[T]hese findings suggest that focusing on the role of traumatic experiences such as bullying and interventions targeting these could be important and may have the potential to make a real difference in the well-being of autistic people,” he said in a press release from the University of Bristol. The study was funded by the Baily Thomas Charitable Fund. ■“Association of Autistic Traits With Depression From Childhood to Age 18 Years” can be accessed here. “Prevalence of Depressive Disorders in Individuals With Autism Spectrum Disorder: a Meta-Analysis” is available here. ISSUES NewArchived

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

Population-based studies following trajectories of depression in autism spectrum disorders (ASD) from childhood into early adulthood are rare. The role of genetic confounding and of potential environmental intermediaries, such as bullying, in any associations is unclear. To compare trajectories of depressive symptoms from ages 10 to 18 years for children with or without ASD and autistic traits, to assess associations between ASD and autistic traits and an International Statistical Classification of Diseases, 10th Revision (ICD-10) depression diagnosis at age 18 years, and to explore the importance of genetic confounding and bullying. Longitudinal study of participants in the Avon Longitudinal Study of Parents and Children birth cohort in Bristol, United Kingdom, followed up through age 18 years. Data analysis was conducted from January to November 2017. Depressive symptoms were assessed using the Short Mood and Feelings Questionnaire (SMFQ) at 6 time points between ages 10 and 18 years. An ICD-10 depression diagnosis at age 18 years was established using the Clinical Interview Schedule-Revised. Exposures were ASD diagnosis and 4 dichotomized autistic traits (social communication, coherence, repetitive behavior, and sociability). An autism polygenic risk score was derived using the Psychiatric Genomics Consortium autism discovery genome-wide association study summary data. Bullying was assessed at ages 8, 10, and 13 years. The maximum sample with complete data was 6091 for the trajectory analysis (48.8% male) and 3168 for analysis of depression diagnosis at age 18 years (44.4% male). Children with ASD and autistic traits had higher average SMFQ depressive symptom scores than the general population at age 10 years (eg, for social communication 5.55 [95% CI, 5.16-5.95] vs 3.73 [95% CI, 3.61-3.85], for ASD 7.31 [95% CI, 6.22-8.40] vs 3.94 [95% CI, 3.83-4.05], remaining elevated in an upward trajectory until age 18 years (eg, for social communication 7.65 [95% CI, 6.92-8.37] vs 6.50 [95% CI, 6.29-6.71], for ASD 7.66 [95% CI, 5.96-9.35] vs 6.62 [95% CI, 6.43-6.81]). Social communication impairments were associated with depression at age 18 years (adjusted relative risk, 1.68; 95% CI, 1.05-2.70), and bullying explained a substantial proportion of this risk. There was no evidence of confounding by the autism polygenic risk score. Analysis in larger samples using multiple imputation led to similar but more precise results. Children with ASD and ASD traits have higher depressive symptom scores than the general population by age 10 years, which persist to age 18 years, particularly in the context of bullying. Social communication impairments are an important autistic trait in relation to depression. Bullying, as an environmental intermediary, could be a target for interventions.

The Hospital Anxiety and Depression scale: Factor structure and psychometric properties in older adolescents and young adults with autism spectrum disorder.

Research on the validity of measurement of anxiety and depression in ASD is currently lacking. The aim of this study was to explore the properties of the Hospital Anxiety and Depression Scale (HADS) in a sample of 151 young people with ASD. Participants completed HADS and a range of mental health and well-being measures. Encouragingly, our findings suggest that HADS provides a reliable and valid assessment of anxiety and depression in ASD.

Hooked on a feeling: Repetitive cognition and internalizing symptomatology in relation to autism spectrum symptomatology.

Repetitive cognition, including rumination such as that seen in depression, has been shown to correlate with depression symptoms in both typically developing individuals and individuals with autism spectrum disorder. Repetitive cognition is more common in autism spectrum disorder than in typically developing peers, as is depression; thus, this study evaluated the role of repetitive cognition in relation between autism spectrum symptomatology and depressive symptomatology. In all, 200 typically developing adults completed self-report questionnaires measuring autism spectrum symptomatology, different forms of repetitive cognition (general perseveration and depressive rumination), depression, and rejection sensitivity. Perseveration was found to mediate the relation between autism spectrum symptoms and depression, and to partially mediate the relation between autism spectrum symptoms and rejection sensitivity. We conclude that it is of vital importance to consider cognition when considering depression in autism spectrum disorder.

Further evidence of HPA-axis dysregulation and its correlation with depression in Autism Spectrum Disorders: Data from girls

To further describe Hypothalamus-Pituitary-Adrenal (HPA) axis activity in children with Autism Spectrum Disorder (ASD), the Diurnal Fluctuation (DF) and Cortisol Awakening Response (CAR) were investigated in a sample of 39 high functioning girls with ASD. Although group mean data conformed to the DF and CAR models, over half of the participants showed inverse CAR and over 14% had inverted DF cortisol concentrations. Examination of three potential sets of predictor factors (physiological, ASD-related, and mood) revealed that only self-reported Major Depressive Disorder was significantly associated with CAR status, and that the girls' concern about dying or suicide was the most powerful contributor to the variance in CAR status. These findings add to the literature regarding the HPA axis dysfunction in children with ASD.

Challenges in the diagnosis and treatment of depression in autism spectrum disorders across the lifespan

Diagnosis and treatment of comorbid neuropsychiatric illness is often a secondary focus of treatment in individuals with autism spectrum disorder (ASD), given that substantial impairment may be caused by core symptoms of ASD itself. However, psychiatric comorbidities, including depressive disorders, are common and frequently result in additional functional impairment, treatment costs, and burden on caregivers. Clinicians may struggle to appropriately diagnose depression in ASD due to communication deficits, atypical presentation of depression in ASD, and lack of standardized diagnostic tools. Specific risk and resilience factors for depression in ASD across the lifespan, including level of functioning, age, family history, and coping style, have been suggested, but require further study. Treatment with medications or psychotherapy may be beneficial, though more research is required to establish guidelines for management of symptoms. This review will describe typical presentations of depression in individuals with ASD, review current information on the prevalence, assessment, and treatment of comorbid depression in individuals with ASD, and identify important research gaps.

Challenges in the diagnosis and treatment of depression in autism spectrum disorders across the lifespan

Challenges in the diagnosis and treatment of depression in autism spectrum disorders across the lifespan

Characterization of Depression in Children With Autism Spectrum Disorders

Depressive syndromes represent a disabling comorbidity for many children with autism spectrum disorders (ASD); however, the ascertainment of depression can be complicated by phenotypic overlap between the 2 conditions, by ways in which autistic symptomatology can mask cardinal features of depression and by atypical manifestations of depression in children with ASD. These issues have contributed to wide variation in the estimation of prevalence rates of depression in individuals with ASD and invoke the need for new approaches to the specific detection of depression and other neuropsychiatric comorbidities that aggregate in children affected by ASD. The authors review the scientific literature relevant to the occurrence of depression in ASD and consider important parameters of risk, including psychosocial factors such as insight into affectation status, as well as biological factors such as the aggregation of depressive syndromes in certain families affected by autism, which has suggested possible overlap in genetic influences underlying the 2 conditions. Variability in the manifestations of depression across environmental contexts provides important clues to intervention and underscores the potential importance of involving multiple informants in ascertaining depression in children and adolescents with ASD. A practical strategy for evaluating the presence of depression in youth with ASD is synthesized from the available data and discussed.