Autistic people have higher rates of chronic physical health conditions and are more likely to have complex health needs, according to a study led by researchers at the University of Cambridge. Their findings, published in the journal Molecular Autism , have important implications for the clinical care of autistic people.
This study emphasizes the greater health vulnerability of autistic people in both the types and number of conditions they may have. (Dr. Elizabeth Weir)
Previous studies have shown that autistic people die much younger than others and are more likely to experience a variety of physical health conditions. Until now, it was believed that autistic people were more likely to suffer from specific conditions, such as gastrointestinal pain, sleep problems, and epilepsy/seizure disorders.
The new study is different because it investigated a much broader range of health risks than had been done before and shows that autistic people experience a wider spectrum of health vulnerabilities than previously thought.
Specifically, autistic people are more likely to have physical health problems in all organ systems, including the brain (such as migraine), the gastrointestinal system (such as celiac disease), and the endocrine system (such as endometriosis). ), compared to non-autistic people.
Dr Elizabeth Weir, research associate at the Cambridge Autism Research Centre, who led the team, said: “This study emphasizes the increased health vulnerability of autistic people in both the types and number of conditions they can have. have. “We now need to understand the causes of these increased risks, which are likely to be multifactorial in nature.”
This is the first study to show that autistic people are more likely than non-autistic people to experience "physical health multimorbidity ," meaning they have at least two or more somatic conditions. These include concurrent fibromyalgia and polycystic ovary syndrome (which causes irregular menstrual cycles, infertility, excessive hair growth and acne in women) in different organ systems.
Figure : Ising model network analysis of condition reports by organ system observed in the non-autistic (L) versus autistic (R) sample. Multiple comparison fix applied
The study was conducted by a team at the ARC and used an anonymous self-report survey to compare the experiences of 1,129 autistic people with 1,176 non-autistic people aged 16 to 90. Participants were international, although 67% of participants were from the UK.
The survey assessed the risk of 60 physical health conditions in nine different organ systems (gastrointestinal, endocrine, rheumatological, neurological, ocular, renal/hepatic, otolaryngological, hematological and dermatological). The analysis took into account other factors such as age, sex assigned at birth, country of residence, ethnicity, educational level, alcohol consumption, smoking, body mass index, and family medical history.
The team found that autistic people were more likely to be diagnosed with medical conditions in all nine organ systems analyzed, compared to non-autistic people. In terms of specific conditions, autistic people had higher rates of 33 specific conditions compared to their non-autistic peers. These included celiac disease, gallbladder disease, endometriosis, syncope (fainting or fainting), vertigo, urinary incontinence, eczema, and iron deficiency anemia.
Dr John Ward, visiting research scientist at the ARC in Cambridge, who carried out the analysis, said: “This research adds to the body of evidence that the healthcare needs of autistic people are greater than those of non-autistic people. autistic “More research is required, particularly around early identification and monitoring of chronic diseases.”
This is also the first epidemiological study to show that Ehlers-Danlos syndrome (EDS), a group of disorders that affects connective tissues and causes symptoms such as joint hypermobility, loose joints that dislocate easily, pain and clicking , easy bruising skin, extreme tiredness, digestive problems, dizziness, stretchy skin, wounds that are slow to heal, organ prolapse and hernias, may be more common among autistic women than non-autistic women.
The new research also replicates previous findings to show that autistic people have higher rates of all central sensitivity syndromes , which are a varied group of conditions related to central nervous system dysregulation, compared to non-autistic people. Central sensitivity syndromes include irritable bowel syndrome (IBS), temporomandibular joint syndrome (TMJ), migraine, tinnitus , myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), and fibromyalgia.
The new study also investigated the physical health risks of multimorbidity with a novel application of "network analysis ," a technique used to understand relationships between different parts of a system. This method of analysis is commonly used in neuroscience to understand how different regions of the brain interact with each other. In this study, the analysis assessed how often conditions from different organ systems occurred together in the same person. In addition to highlighting complex health needs, this analysis established for the first time that combinations of frequently co-occurring medical conditions may be different between autistic and non-autistic adults.
These results are preliminary evidence that healthcare providers, such as primary care physicians or family doctors, need to monitor the healthcare needs of autistic people much more closely.
Dr Carrie Allison, ARC Chief Strategy Officer and team member, added: “These findings highlight the urgent need to adapt the healthcare system to better meet the needs of autistic people. “These results need to be confirmed in larger population-based samples.”
Professor Sir Simon Baron-Cohen, director of the ARC and another member of the team, said: “We are aware of the risks of mental health conditions in autistic people, but this new research also identifies their risks of physical health conditions. “We urgently need to re-evaluate current healthcare systems to improve support for autistic people.”
Reference : Ward, J. & Weir, E., Allison, C., Baron-Cohen, S. Increased rates of chronic physical health conditions across all organ systems in autistic adolescents and adults. Molecular Autism (2023).
Funding for this project was provided by the Cambridge Autism Center of Excellence, Rosetrees Trust, Cambridge and Peterborough NHS Foundation Trust, Corbin Charitable Trust, Queen Anne’s Gate Foundation, MRC, Wellcome Trust and Innovative Medicines Initiative.
