Systematic reviews and meta-analyses of evidence on comorbid health conditions in people with autism spectrum disorder: A systematic review Ewelina Rydzewska, Kirsty Dunn, Christopher Gillberg, Sally-Ann Cooper University of Glasgow, Institute of Health and Wellbeing ewelina.rydzewska@glasgow.ac.uk www.sldo.ac.uk Introduction People with autism spectrum disorder (ASD) experience a wide range of comorbid health problems, some of which may have different prevalence compared with the general population. Since health problems can significantly affect quality of life, it is important to know how common they are in people with ASD. Methods PsycINFO, Scopus, CINAHL, Medline and Cochrane were searched limited to sources published in English between January 2005 and July 2016 search terms: ‘autis*’ OR ‘pervasive developmental disorder’ OR ‘Asperger*’ OR ‘ASD’ animal, brain-imaging or genetic studies and reviews of intervention and treatment studies on the core symptoms of autism or comorbid health conditions were excluded quality of all included papers reviewed using a tool for Assessing the Methodological Quality of Systematic Reviews (AMSTAR) Aim The aim was to identify and systematically review existing systematic reviews and meta-analyses of evidence on co-occurring health conditions. Research questions How common are co-occurring health needs of people with ASD? Are specific co-occurring health needs in people with ASD more prevalent than in the general population? Are there gaps in the evidence base on co-occurring health needs in people with ASD? Results Flow chart of reviewed articles Physical health standardised mortality rate is reported as 2.8; higher SMR for females and learning disabilities or epilepsy related deaths, and accidental deaths from drowning, suffocation, cancer, respiratory, nervous, sensory, and circulatory diseases life expectancy at 65 is >3 years shorter than the general population epilepsy is much more common than for the general population, especially in groups with additional learning disabilities, and for women sleep disorders are reported in 45% of adults Type II diabetes risk is higher for antipsychotic-exposed youth, but lower in antipsychotic-exposed youth with ASD gastrointestinal problems, including general symptoms, diarrhoea, constipation and abdominal pain seem to be more common than for comparison groups of typically developing children and youth inconclusive findings on peripheral hearing loss, oral health and cancer atopy, such as dermatitis, allergic rhinitis, and asthma may be more common Mental health depression (4-34%), bipolar disorder (6-21%) and suicidal ideation (31-50%) appear to be more common than in the general population anxiety appears to occur more commonly than expected, and may be more common in girls than boys findings on schizophrenia are inconclusive findings regarding ASD prevalence in eating disorders are inconclusive PsycINFO 407 MEDLINE 2,485 Scopus 758 Records identified 3,964 Title and abstract reviewed 3,404 Full papers read 97 Included 24 Did not meet inclusion criteria 73 3,307 Duplicates removed 560 CINAHL 211 Cochrane 103 Limitations of literature Lack of information on: assessment and operationalisation of ASD and comorbidities samples recruitment Inconsistent results reported due to: varying study designs different source populations participant characteristics small or highly selective samples Conclusions prevalence of some mental (e.g. mood and anxiety disorders) and physical health conditions (e.g. epilepsy and gastrointestinal problems) seems to be higher in people with ASD heterogeneous methodological approaches and sample characteristic often preclude meaningful pooling of findings there is a need for more robust research to draw comparisons between specific health needs of people with and without ASD References (full list available on request): Amiet et al. 2008; Bartolomé-Villar et al. 2016; Beers et al. 2014; Billeci et al. 2015; Catala-Lopez et al. 2014; Elrod and Hood 2015; Galling et al. 2016; Hannon and Taylor 2013; Huke et al. 2013; McElhanon et al. 2014; Padgett et al. 2010; Perkins and Berkman 2012; Reilly et al. 2013; Rubenstein et al. 2015; Segers and Rawana 2014; Skokauska and Gallagher 2009; Spain et al. 2016; Stewart et al. 2006; Su et al. 2016; van de Wouw et al. 2012; Vannucchi et al. 2014; van Steensel et al. 2011; White et al. 2009; Woolfenden et al. 2012.