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Depression affects 20 percent of young adults with autism

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Depression affects almost 20 percent of young adults with autism, a new research has revealed, a rate that’s more than triple that seen in the general population.

And young adults with autism who were relatively high-functioning — meaning they did not have intellectual disabilities– were actually at higher risk of depression than people with more severe forms of autism, British researchers found.

In the study published online on Aug 31 in JAMA Network Open, this higher-functioning subgroup was more than four times as likely to suffer from depression, compared to people without autism. The study was led by Dheeraj Rai, of the University of Bristol.

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In the study, Dheeraj’s group looked at data that tracked almost 224,000 Swedes living in a particular county between 2001 and 2011. A total of 4,073 had been diagnosed with an autism spectrum disorder.

People with autism without intellectual disabilities “may be particularly prone to depression because of greater awareness of their difficulties,” the researchers theorized.

Tracking the participants’ mental health, the study found that by their mid-to-late 20s, 19.8 percent of people with autism had a history of depression, compared to just 6 percent of those in the general population.

“Given the considerable social struggles that individuals with an autism spectrum disorder experience, it is not surprising that they are at significantly increased risk for depression,” said Dr Andrew Adesman. He directs developmental and behavioral pediatrics at Cohen Children’s Medical Center in New Hyde Park, NY.

Not all of the increase in risk for depression was caused by genetics, Dheeraj’s group added, because people with autism still had double the odds for depression compared to a full sibling who did not have the disorder.

That suggests that something other than DNA — perhaps the stress of living with autism — may play a role in depression risk.

The finding that autism without intellectual disability carried higher odds for depression highlights the need for earlier diagnosis, the researchers said.

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“Many individuals with autism spectrum disorder, especially those without cognitive impairments, receive a delayed diagnosis, often after experiencing other psychiatric problems,” the study authors wrote.

That can take a big psychological toll, perhaps contributing to depression risk, Rai’s team suggested.

“Individuals receiving a diagnosis of autism spectrum disorder later in life often report long-standing stress in relation to social isolation, bullying, exclusion, and the knowledge they are different without the explanatory framework of a diagnosis of autism spectrum disorder,” the team pointed out.

Agencies

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Suicide can’t be predicted by asking about suicidal thoughts : Study

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Most people who died of suicide deny they experience suicidal thoughts when asked by doctors in the weeks and months leading up to their death, a major Australian study has found.

The findings, co-authored by clinical psychiatrist and Professor Matthew Large from UNSW’s School of Psychiatry, Sydney that published in the journal BJPsych Open The meta-analysis challenge the widely-held assumption that psychiatrists can predict who will suicide by asking if they are preoccupied with thoughts of killing themselves.

The study showed that 80% of patients who were not undergoing psychiatric treatment and who died of suicide reported not to have suicidal thoughts when asked by their psychiatrist or GP.

“If you meet someone who has suicidal ideation there is a 98 per cent chance that they are not going to suicide,” said Professor Large, an international expert on suicide risk assessment who also works in the emergency department of a major Sydney hospital.

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“But what we didn’t know was how frequently people who go on to suicide have denied having suicidal thoughts when asked directly,” he added.

“This study proves we can no longer ration psychiatric care based on the presence of suicidal thoughts alone. We need to provide high-quality, patient-centred care for everyone experiencing mental illness, whether or not they reveal they are experiencing suicidal thoughts,” Professor Large said.

About one in 10 people will have suicidal ideation in their lifetime. But the study showed suicidal ideation alone was not rational grounds for deciding who gets treatment and who does not, Professor Large said.

“We know that suicide feeling is pretty common and that suicide is actually a rare event, even among people with severe mental illness,” Professor Large added.

Suicidal ideation tells us an awful lot about how a person is feeling, their psychological distress, sometimes their diagnosis and their need for treatment but it’s not a meaningful test of future behaviour.

Suicidal feelings can fluctuate rapidly and people may suicide very impulsively after only a short period of suicidal thoughts.

But, people had good reasons not to disclose thoughts of suicide, fearing stigma, triggering over-reactions or upsetting family and friends, and being involuntarily admitted for psychiatric treatment, Professor Large said.

Professor Large emphasized that clinicians should not assume that patients experiencing mental distress without reporting suicidal ideas were not at elevated risk of suicide.

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