Format

Send to

Choose Destination
Psychol Med. 2019 Jun 26:1-12. doi: 10.1017/S0033291719001405. [Epub ahead of print]

Individual risk and familial liability for suicide attempt and suicide in autism: a population-based study.

Author information

1
Department of Women's and Children's Health, Pediatric Neuropsychiatry Unit,Center for Neurodevelopmental Disorders at Karolinska Institutet (KIND), Karolinska Institutet,Stockholm,Sweden.
2
Department of Medical Epidemiology and Biostatistics,Karolinska Institutet,Stockholm,Sweden.
3
Department of Clinical Neuroscience, Division of Insurance Medicine,Karolinska Institutet,Stockholm,Sweden.

Abstract

BACKGROUND:

Studies on the individual gender-specific risk and familial co-aggregation of suicidal behaviour in autism spectrum disorder (ASD) are lacking.

METHODS:

We conducted a matched case-cohort study applying conditional logistic regression models on 54 168 individuals recorded in 1987-2013 with ASD in Swedish national registers: ASD without ID n = 43 570 (out of which n = 19035, 43.69% with ADHD); ASD + ID n = 10 598 (out of which n = 2894 individuals, 27.31% with ADHD), and 270 840 controls, as well as 347 155 relatives of individuals with ASD and 1 735 775 control relatives.

RESULTS:

The risk for suicidal behaviours [reported as odds ratio OR (95% confidence interval CI)] was most increased in the ASD without ID group with comorbid ADHD [suicide attempt 7.25 (6.79-7.73); most severe attempts i.e. requiring inpatient stay 12.37 (11.33-13.52); suicide 13.09 (8.54-20.08)]. The risk was also increased in ASD + ID group [all suicide attempts 2.60 (2.31-2.92); inpatient only 3.45 (2.96-4.02); suicide 2.31 (1.16-4.57)]. Females with ASD without ID had generally higher risk for suicidal behaviours than males, while both genders had highest risk in the case of comorbid ADHD [females, suicide attempts 10.27 (9.27-11.37); inpatient only 13.42 (11.87-15.18); suicide 14.26 (6.03-33.72); males, suicide attempts 5.55 (5.10-6.05); inpatient only 11.33 (9.98-12.86); suicide 12.72 (7.77-20.82)]. Adjustment for psychiatric comorbidity attenuated the risk estimates. In comparison to controls, relatives of individuals with ASD also had an increased risk of suicidal behaviour.

CONCLUSIONS:

Clinicians treating patients with ASD should be vigilant for suicidal behaviour and consider treatment of psychiatric comorbidity.

KEYWORDS:

Autism; family studies; gender differences; self-harm; suicide

PMID:
31238998
DOI:
10.1017/S0033291719001405

Supplemental Content

Full text links

Icon for Cambridge University Press
Loading ...
Support Center