Mental health problems are a significant concern in autistic individuals. To what extent do young autistic female and male individuals differ in their psychiatric diagnoses and hospitalizations compared with nonautistic individuals?
Although little research has proven that there are sex differences, the data now available suggests that autistic women are more vulnerable than autistic men.
A new study by the Karolinska Institutet examined sex differences in psychiatric diagnoses and hospitalizations in autistic compared with nonautistic young adults. The study involves more than 1.3 million people in Sweden who were followed from 16 to 24 between 2001 and 2013. Just over 20,000 of these individuals were diagnosed with autism.
Scientists discovered that by age 25, 77 out of 100 autistic women had received at least one psychiatric diagnosis, and more than 62 out of 100 autistic men.
Miriam Martini, a doctoral student in psychiatric epidemiology at the Department of Medical Epidemiology and Biostatistics at Karolinska Institutet and the first author of the study, said, “We saw an increased risk of eleven different psychiatric conditions, including depression, anxiety disorders, self-harm and difficulty sleeping.”
What’s worrisome is that 32 out of 100 autistic women had been hospitalized as a result of their mental illness, compared with 19 out of 100 autistic men. For nonautistic people, the corresponding figure was less than five out of 100.
Miriam Martini said, “The study focuses on young adults who are at a crucial time in their life when many mental health problems increase, while the transition to adulthood often means poorer access to care.”
“Healthcare for young adults needs to be expanded, especially for autistic women, so that mental illness can be detected in time to avoid worsening of symptoms resulting in hospitalization.”
However, it remains elusive why autistic women are more affected by mental illness than autistic men; still, scientists suggested several possible factors.
Previous research has shown that autistic women, to a greater extent, use compensatory behaviors to camouflage their autism, which may be due to the fact that women generally tend to adapt to the expectations of those around them. This delays diagnosis and the provision of assistance, which can negatively affect their mental health. Another possible explanation may be that it could be difficult to detect autism in women using diagnostic criteria.
Miriam Martini said, “It may be that autism manifests differently in women than in men, which means that women are not detected using today’s diagnostic criteria. This is something we need to do more research on.”
- Miriam I. Martini, Ralf Kuja-Halkola, et al. Sex Differences in Mental Health Problems and Psychiatric Hospitalization in Autistic Young Adults. JAMA Psychiatry. DOI: 10.1001/jamapsychiatry.2022.3475