1. Psychiatric and Medical Challenges in Adults with Autism Spectrum Disorder (ASD)
Lawrence Fung, M.D., Ph.D.
Autism & Developmental Disabilities Clinic
Pediatric Neuropsychopharmacology Clinic
Stanford University School of Medicine

2. Outline Psychiatric co-morbidities in ASD
ASD with vs. without intellectual disability
Young Adults vs. Middle-aged vs. Elderly with ASD
Gender effects
Medical co-morbidities
Summary

3. Psychiatric Co-Morbidities in Adults with ASD
Author, Year
Location
# of ASD subjects
# of Control subjects
Intellectual disability?
Age (years)
Croen, 2015
Kaisar, USA
1507
15070 (non-ASD)
N/A
29±12
Buck, 2014
UT, USA
129
76% with ID
26 to 54
Cervantes, 2015
LS, USA
149
158 (with ID)
Yes
51±12
Hofvander, 2009
Sweden
122 No
16 to 60
(median 29)
Lugnegard, 2011 54
19±8
Joshi, 2013
MA, USA 63
29±11
Strunz, 2015
Germany 59
106 (TD), 62 (NPD), 80 (BPD)
33±11
Lever, 2016
Netherlands
172
19 to 79
Helles, 2016 50
23±5

4. Prevalence of Psychiatric Conditions in Adults with ASD and Non-ASD Controls
Croen et al. Autism. 2015, Vol. 19(7) 814–823

5. Anxiety and OCD are Most Common Psychiatric Diagnoses in Adults with ASD+ID.
Current Age: 51±12 years
Buck et al. J Autism Dev Disord (2014) 44:3063–3071

6. Depression and Anxiety are Most Common Psychiatric Disorders in High-functioning Adults with ASD

7. Adults with ASD but without Intellectual Disability have more Psychiatric Diagnoses than other Adults with any Psychiatric Diagnoses.
Joshi et al. J Autism Dev Disord (2013) 43:1314–1325

8. Compared to Young and Middle-aged Adults with HF-ASD, Older Adults with HF-ASD tend to have Fewer Active Co-morbid Psychiatric Problems.
Lever et al. J Autism Dev Disord (2016) 46:1916–1930

9. Variation in prevalence of psychiatric conditions among adults with ASD by gender
Croen et al. Autism. 2015, Vol. 19(7) 814–823

10. MEDICAL CO-MORBIDITIES IN ADULTS WITH ASD

11. Medical Co-morbidities in Adults with ASD
Author, Year
Location
# of ASD subjects
# of Control subjects
Intellectual disability?
Age (years)
Kohane, 2012
MA, USA
14000
N/A
18 to 34
Croen, 2015
Kaisar, USA
1507
15070 (non-ASD)
29±12
Tyler, 2011
OH, USA
108
206
25% ID
29±10
Jones, 2016
UT, USA 92
62% ID
24 to 51 (Median 36)

13. Epilepsy is a Common Co-morbid Neurologic Disorder in Adults with ASD
Croen et al. Autism. 2015, Vol. 19(7) 814–823

14. GERD is a Common Co-morbid Gastrointestinal Disorder in Adults with ASD
Croen et al. Autism. 2015, Vol. 19(7) 814–823

15. Immune and Sleep Disorders are More Common in Adults with ASD than Controls.
Croen et al. Autism. 2015, Vol. 19(7) 814–823

16. Cardiovascular and Metabolic Disorders are More Common in Adults with ASD than Controls.
Croen et al. Autism. 2015, Vol. 19(7) 814–823

17. Comparison of chronic diseases between adults with ASD and controls in a health care system in Cleveland, OH.
Tyler et al. AJIDD. 2011, Vol. 116(5) 371–380

18. Conclusions Psychiatric Co-morbidities
Adults with ASD and intellectual disability
Anxiety and OCD are Most Common Psychiatric Diagnoses
Adults with high-functioning ASD or Asperger’s disorder
Depression and anxiety are most common psychiatric co-morbidities in adults with ASD.
Psychiatric problems are less prevalent in older adults with ASD.
Medical Co-morbidities
Epilepsy is a common co-morbid neurologic disorder in adults with ASD
Gastrointestinal (e.g., constipation), immune, sleep, cardiovascular (e.g., hyperlipidemia) and metabolic disorders are more common in adults with ASD

19. ON-GOING RESEARCH STUDIES

20. ON-GOING RESEARCH STUDIES (1)

21. ON-GOING RESEARCH STUDIES (2)