Those diagnosed as autistic face a range of challenges as a result of their condition. But new, disturbing research appears to show that for individuals on the autism spectrum, premature death -- ranging from 12 to as much as 30 years -- might prove to be the most significant problem of all.
A new study, undertaken by Sweden's Karolinska Institute and published in The British Journal of Psychiatry, compared over 2.5 million average adults with roughly 27,000 autism spectrum disorder (ASD)-diagnosed adults between 1987 and 2009.
The study found that less than 1 percent of non-ASD adults died during this 22-year period, as compared to nearly 3 percent of those with ASD. On average, ASD subjects died 18 years younger than those without the condition. And rather than a result of a physical illness, these deaths were often brought on by suicide. This finding shook many in the field.
"The inequality in outcomes for autistic people shown in this data is shameful," said Jon Spiers, the chief exec of the British autism charity Autistica, speaking with the Washington Post. "We cannot accept a situation where many autistic people will never see their 40th birthday."
Many past studies seem to support these findings. One study published in The Lancet Psychiatry, for example, found that two-thirds of nearly 400 people with ASD reported suicidal thoughts, while over a third actually attempted suicide. A number of factors -- both biological and social -- may lurk behind these grave findings.
First, is the influence of other disabilities. The Centers for Disease Control and Prevention report that over 83 percent of ASD diagnoses go hand-in-hand with other non-ASD developmental diagnoses, such as learning disabilities.
Healthcare issues may also play a major role in ASD suicide risk. A study by the Academic Autistic Spectrum Partnership in Research and Education (AASPIRE) found that far more people with ASD reported unmet healthcare needs and dissatisfaction with providers than those without ASD.
"As a primary care provider, I know that our healthcare system is not always set up to offer high quality care to adults on the autism spectrum," stated Dr. Christina Nicolaidis, the study's principle investigator and AASPIRE co-director. "However, I was saddened to see how large the disparities were. We really need to find better ways to serve them."
Another factor in premature ASD deaths may be substance abuse. Most experts claim that autistic individuals generally don't drink or use drugs, partly due to a disdain for risk. But recent studies have shown that those with more pronounced ASD traits are more likely to drink or use. In 2014, researchers at the Washington University School of Medicine in St. Louis found that such ASD individuals who drank or smoked were more likely to develop an addiction than other drinkers or smokers. This may partly be due to the common ASD need to repeat behaviors and patterns.
"People with autistic traits can be socially withdrawn, so drinking with peers is less likely," says author Duneesha De Alwis, PhD. "But if they do start drinking, even alone, they tend to repeat that behavior, which puts them at increased risk for alcohol dependence."
Combined with their higher risk for mood disorders, such as depression, it's unsurprising that such substance abuse may play a significant role in the new BJP findings of premature deaths by suicide.