The following is a summary of “Sex Differences in Mental Health Problems and Psychiatric Hospitalization in Autistic Young Adults” published in the October 2022 issue of Psychiatry by Martini et al.

Both children and adults with autism frequently have psychiatric illnesses. There was little information on gender differences in early adult hospitalization and mental diseases. For a study, researchers sought to investigate sex disparities in hospitalizations and psychiatric diagnoses among young individuals with autism vs. those without autism.

In the population-based cohort research, the people born between 1985 and 1997 were evaluated. Between 2001 and 2013, a total of 1,335,753 people, including 20,841 autistic people (7,129 [34.2%] female people), were monitored from the age of 16 to 24. Between June 2021 and August 2022, an analysis was done. According to the International Classification of Diseases, autism is classified as having at least one clinical diagnosis of the condition. A birth year-standardized risk difference was utilized to compare autistic female and male persons directly. The cumulative incidence of 11 psychiatric disorders up to age 25 was calculated. Using Cox regression, hazard ratios (HRs) with 95% CI for each sex were obtained. To evaluate mental hospitalization, analyses for inpatient diagnosis were conducted once again.

About 650,314 (46.7%) of the 1,335,753 participants in the research had a female birth gender assigned to them. With a mean (SD) age of 16.1 (5.1) years (17.0 [4.8] years for females and 15.7 [5.2] years for males) for the first documented autism diagnosis, 20,841 persons (1.6%; 7,129 [34.2%] female) were clinically diagnosed with autism. Autistic women were more likely to have psychiatric diagnoses and be hospitalized for the majority of diseases. A minimum of 1 psychiatric diagnosis had been made in 77 out of 100 autistic females and 62 out of 100 autistic males by age 25. For any mental condition (−0.18; 95% CI, −0.26 to −0.10) and more particularly for anxiety, depressive, and sleep disorders, statistically significant standardized risk differences between autistic male and female people were found. Comparing autistic and non-autistic people, risk differences were more pronounced. Autistic male and female persons had higher odds of developing all psychiatric disorders compared to nonautistic same-sex individuals. When compared to autistic male persons (HR range [95% CI], 2.98 [2.75-3.23]-18.52 [17.07-20.08]), autistic female individuals (HR range [95% CI], 3.17 [2.50-4.04.]-20.78 [18.48-23.37]) had statistically substantially higher rates of any mental hospitalization (32 of 100) compared with autistic male individuals (19 of 100). However, compared to non-autistic female and male individuals, autistic female and male individuals had a higher relative risk for psychiatric hospitalization across all disorders (female individuals: HR range [95% CI], 5.55 [4.63-6.66]-26.30 [21.50-32.16]; male individuals: HR range [95% CI], 3.79 [3.22-4.45]-29.36 [24.04-35.87]).

The results underlined the need for comprehensive mental health treatment for young people with autism. Female autistic patients needed more clinical monitoring and assistance since they had greater mental issues at all levels of care.

Reference: jamanetwork.com/journals/jamapsychiatry/fullarticle/2797528