Aug 2026· Healthcare· Vol 14· 0 citations· 57 references
Medicine
TL;DR
A narrative review of papers published between 1 January 2015 and 16 February 2026 that were pertinent to comorbidity and autism finds how the variable risk of comorbidity mimics the heterogeneity present in autism, thus inviting further investigations.
Abstract
Highlights What are the main findings? A diagnosis of autism spectrum disorder (ASD) carries elevated risk(s) for multiple comorbidities across behavioural, psychiatric, and somatic domains. Data on the frequency of various comorbidities are presented alongside their profiles according to sex and age. What is the implication of the main findings? Such data forms the starting point for investigations into screening programmes for the early detection and intervention for various comorbidities which can impact quality of life. Abstract Background/Objectives: Autism spectrum disorder (ASD) is currently singularly described as a behaviourally defined neurodevelopmental diagnosis with symptoms affecting social communication and social understanding alongside the presence of restricted patterns of behaviour. Wide, and often very personal, variations in symptom intensities and differing developmental trajectories, reflective of large heterogeneity, are an important feature of the label. ASD carries enhanced risks for multiple over-represented, sometimes overlapping, comorbidities spanning behavioural, psychiatric and somatic domains. Said comorbidities often have numerous and far-reaching effects on quality of life by way of their impacts and, in extreme cases, their potential effects on life expectancy. It is of paramount importance that data on the risks of such comorbidities are available and, where possible, screening, preventive and/or treatment options implemented. Methods: In this narrative review, the authors searched databases (PubMed/Medline, ScienceDirect, Google Scholar) for papers published between 1 January 2015 and 16 February 2026 that were pertinent to comorbidity and autism. Results: We present data on the frequency of various somatic (gastrointestinal, immunological, metabolic, neurological, motor-sensory disorders), psychiatric (anxiety, mood, schizophrenia spectrum, personality, substance abuse, trauma, feeding and eating, sleeping, self-harm, neurocognitive disorders) and neurodevelopmental comorbidities (intellectual, attentional, speech and language, motor disorders) that can present alongside a diagnosis of ASD. We provide accompanying data on the magnitude of potential risk and, where available, information on comorbidity risks according to sex and age. Conclusions: This review paper deals with an extremely broad field. Limitations of the narrative review strategy are discussed alongside how the variable risk of comorbidity mimics the heterogeneity present in autism, thus inviting further investigations.
There is an urgent need for prospective longitudinal studies to adequately map the aging trajectories of this population of older adults with ASD, which constitute a vulnerable population.
J. P. S. Gontijo, Marcelo H S S Martins, L. M. Alves· Trends in Psychiatry and Psy...· 0 citations
This review systematically summarizes the conceptual definition and clinical phenotypes of profound autism and emphasizes the need to shift the intervention focus toward managing serious comorbidities and establishing augmentative and alternative communication systems.
Yang Xue, Fei-yong Jia· Zhongguo dang dai er ke za z...· 0 citations
The Australian and New Zealand Journal of Psychiatry GRADE Evidence Guidelines for Schizophrenia highlight the importance of considering psychiatric comorbidities, including autism spectrum disorder. These guidelines acknowledge that there is limited empirical research to guide the management of individuals with schizophrenia who also have these comorbid conditions. This lack of evidence poses challenges for clinicians, especially those working in early psychosis services, where the possibility of a missed diagnosis of autism spectrum disorder is increasingly being examined, and pre-existing diagnoses of autism spectrum disorder are not uncommon. This commentary explores the complex overlaps among shared histories, risk factors and symptomatology, as well as the difficulties stemming from the absence of validated assessment tools to aid in diagnostic clarification. Psychotic symptoms may complicate the recognition and differentiation of underlying neurodevelopmental characteristics of autism spectrum disorder. Considering the limited available evidence, practical guidance is offered to assist clinicians in their decision-making when a strong evidence base is lacking. In the context of early psychosis, diagnostic formulation should be considered provisional, with assessment of a possible a missed ASD diagnosis occurring after the stabilisation of psychotic symptoms wherever possible.
Kirk Chalmers, Kirstyn Laurie, S. Suetani et al.· Australian and New Zealand j...· 1 citation
Background Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition frequently associated with internalizing disorders, particularly depression, which significantly impacts functioning and quality of life (QoL) in children and adolescents. Objective This paper represents the first part of a two-part structured narrative overview examining internalizing psychopathology in children and adolescents with ASD. Given the high co-occurrence and shared neurobiological, psychological, and environmental mechanisms linking depression and anxiety, the multidisciplinary research team elected to develop two complementary overviews to allow a more comprehensive and clinically meaningful synthesis of the evidence. The present review specifically aims to identify and synthesize current evidence on modifiable risk and protective factors influencing depression in children and adolescents with ASD. Methods A structured narrative overview was conducted, integrating evidence from systematic reviews, meta-analyses, and robust clinical studies. Studies were selected based on relevance and methodological quality, and findings were synthesized across biological, psychosocial, and lifestyle domains. Results Growing body of evidence indicates that depression in ASD is influenced by a complex interplay of genetic vulnerability, sensory and emotional dysregulation, social stressors, and environmental factors. At the same time, modifiable protective factors—including physical activity, psychosocial interventions, digital health approaches, and family-centered care—show potential in enhancing resilience and emotional well-being. However, the evidence base remains heterogeneous and often limited by methodological constraints. Conclusions A multidisciplinary and prevention-oriented approach that simultaneously addresses risk and strengthens protective pathways may optimize mental health outcomes and improve QoL in children and adolescents with ASD.
E. Mihai, Ileana Ciobanu, Matei Teodorescu et al.· Frontiers in Psychiatry· 0 citations
This work will analyze some frequently observed autistic phenotypes not described in the DSM-5 and delve into four specific ones, recently defined in the literature, that show a genotype-phenotype correlation.
Autism is a neurodevelopmental condition characterized by differences in social interaction, communication and behaviour. Despite a global prevalence of one in 127 individuals, autism remains underdiagnosed in low-resource settings. We examined the epidemiology of autism among children aged 2 to 9 years in Northern Uganda. Using multistage sampling, 1,139 children were screened for neurodevelopmental conditions using the validated 23Q screening tool. Children who screened positive underwent clinical assessment, and suspected cases received specialist assessments according to DSM-5-TR criteria. Descriptive statistics and Firth logistic regression were employed for analysis. The mean age was 5.38 years (SD = 2.07), and 51.0% were male. The prevalence of autism was 10.5 per 1,000 children (95% confidence interval [CI] [6.0, 18.5]), of whom 75.0% had co-occurring neurodevelopmental conditions. Autistic children were more likely to have intellectual disability, epilepsy, learning disabilities, global developmental delay, attention-deficit/hyperactivity disorder, dyslexia, cerebral palsy, hearing impairment and speech delay (p < .0045). After adjusting for gender, family history of autism (adjusted odds ratio [aOR] = 6.95, 95% CI [1.60, 30.23]), teenage motherhood (aOR = 8.30, 95% CI [1.30, 53.12]), breech presentation (aOR = 12.23, 95% CI [1.83, 81.64]), and oxygen resuscitation at birth (aOR = 4.56, 95% CI [1.08, 19.33]) were independent predictors of autism. These findings highlight the need to strengthen early identification and targeted services for autistic children in low-resource settings. Lay Abstract Autism affects how people communicate, interact, and process information, and about one in 127 people worldwide are autistic. In low-resource settings, autism is often under-researched and underdiagnosed. We carried out a study in Northern Uganda to estimate how common autism is among children aged 2 to 9 years, to identify co-occurring neurodevelopmental conditions, and to explore factors that may increase likelihood of autism. We enrolled 1,139 children from diverse communities using a multi-step sampling process. After parental consent, one child per household was screened with the 23Q neurodevelopmental screener. Children with possible conditions received further assessment by trained health care workers, and likely cases were confirmed by specialist clinicians using DSM-5-TR diagnostic criteria. Approximately 1 in 95 children were autistic, and none had previously received a diagnosis of autism. The average age of the children diagnosed with autism was about 5 years, and slightly more than half were boys, and most lived in rural areas. Most autistic children (82%) had at least one additional neurodevelopmental condition, such as intellectual disability, learning delays, or epilepsy. Autism was linked to family history, teenage motherhood, and certain birth complications. Improving maternal care, community awareness, and early diagnosis could better support autistic children in Northern Uganda.
Ouma Simple, E. Estlin, Kennedy Kosko Okello et al.· Autism· 1 citation
