Occurrence and overlap of physical and mental health conditions in autistic adults

Mental and physical health conditions are a major topic of concern in autistic adults, but studies rarely consider their overlap. Therefore, this study assessed physical health conditions and mental health conditions in autistic adults in the Netherlands and potential associations between them. Using questionnaires, we compared autistic (n = 327) and non-autistic (n = 274) adults (30-90 years) on mental health conditions, physical health conditions, and health-related quality of life. Autistic adults reported lower health-related quality of life than non-autistic adults. Logistic regressions indicated significantly higher rates of all mental health conditions reported by autistic adults, most common being mood (45%), anxiety (22%), and personality disorders (21%), with odds ratios ranging from six to 34. Regarding physical health conditions, autistic adults reported significantly higher rates of bowel conditions (27%), allergies (48%), and hypothyroid conditions (6%), with odds ratios ranging from two to four. Psychometric network analysis of autism and the most frequently occurring mental health conditions and physical health conditions highlighted autism as a central node, followed by mood and personality disorders, bowel and respiratory conditions, and allergies. Mental health conditions were tightly clustered, indicating high comorbidity. While no single condition connected physical and mental health in particular, we found several links between the two. These findings emphasize the need for improved healthcare and broader societal changes to enhance the well-being of autistic individuals.Lay AbstractAutistic adults often face a range of physical and mental health conditions, but the relationship between these two types of health issues is not well understood. Our study looked at how often physical and mental health conditions in autistic adults occurred. We also studied the connections between these conditions, using a method called psychometric network analysis. We surveyed 327 autistic and 274 non-autistic adults, aged 30-90 years, about potential health conditions they faced and the perception of the quality of their health, also known as health-related quality of life. We found that autistic adults had a lower health-related quality of life and reported higher rates of all mental health conditions. Mood (45%), anxiety (22%), and personality disorders (21%) were most common. Autistic adults were between six and 34 times more likely to have these mental health conditions compared to non-autistic adults. In terms of physical health, autistic adults reported higher rates of bowel conditions (27%), allergies (48%), hypothyroid conditions (6%), and less robustly of strokes (CVA/TIAs; 3%), and rheumatic conditions (31%)- and a two- to four-times higher risk than non-autistic adults. Using psychometric network analysis, we found that mental health conditions in autistic adults are closely linked, showing how complex their health challenges are. While there was no single condition that connected physical and mental health in particular, we found several links between the two. These findings emphasize the need for improved healthcare and broader societal changes to enhance the well-being of autistic individuals.