Occurrence of psychosis and bipolar disorder in adults with autism: A systematic review and meta-analysis. (March 2022)

• Record Type: Journal Article
• Authors: Varcin, Kandice J.; Herniman, Sarah E.; Lin, Ashleigh; Chen, Yanyu; Perry, Yael; Pugh, Charlotte; Chisholm, Katharine; Whitehouse, Andrew J.O.; Wood, Stephen J.
• Is Part Of: Neuroscience and biobehavioral reviews. Volume 134(2022)
• Publication Date: 2022-03
• Subjects: Autism -- Schizophrenia spectrum disorders -- Bipolar disorder -- Psychosis -- Risk factors; Psychophysiology -- Periodicals; Human behavior -- Periodicals; Animal behavior -- Periodicals; Neurology -- Periodicals; Behavior -- Periodicals; Ethology -- Periodicals; Neurology -- Periodicals; Psychophysiologie -- Périodiques; Comportement humain -- Périodiques; Animaux -- Mœurs et comportement -- Périodiques; Neurologie -- Périodiques; Animal behavior; Human behavior; Neurology; Psychophysiology; Periodicals; Electronic journals; 573.8
• DOI: 10.1016/j.neubiorev.2022.104543
• Languages: English
• ISSNs: 0149-7634

Abstract

Highlights: Adults with autism are at increased risk for co-occurring psychosis and/or bipolar disorder. Males with autism were at increased likelihood of co-occurring psychosis, and females of co-occurring bipolar disorder. Older age was also associated with increased prevalence of psychosis in autism. Clinical and research efforts must focus on assessment, monitoring, diagnosis, and intervention of co-occurring conditions in adults with autism. Abstract: Objective: Evidence suggests that individuals with autism spectrum disorder have increased rates of co-occurring psychosis and/or bipolar disorder. Considering the peak age of onset for psychosis and bipolar disorder occurs in adulthood, we investigated the co-occurrence of these disorders in adults with autism. Methods: We conducted a systematic review and meta-analysis (PROSPERO Registration Number: CRD42018104600) to (1) examine the prevalence of psychosis and bipolar disorder in adults with autism, and (2) review potential risk factors associated with their co-occurrence. Results: Fifty-three studies were included. The pooled prevalence for the co-occurrence of psychosis in adults with autism was 9.4 % ( N = 63, 657, 95 %CI = 7.52, 11.72). The pooled prevalence for the co-occurrence of bipolar disorders in adults with autism was 7.5 % ( N = 31, 739, 95 %CI = 5.79, 9.53). Conclusions: Psychosis and bipolar disorder occur at a substantially higher prevalence in adults with autism compared to general population estimates. While there is an overall dearth of research examining risk factors for these disorders in autism, males had increased likelihood of co-occurring psychosis, and females of co-occurring bipolar disorder. These results highlight the need for ongoing assessment and monitoring of these disorders in adults with autism.