Clinical Characterizations of Women and Men with ASD, Diagnosed As Adults.

Background: Although based on but a few studies, it has been suggested through both clinical trials, in population-based studies, as well as expert testimonials that ASD is associated with long-term impairments in major life activities, also regarding intellectually able individuals with ASD. These include areas such as mental well-being, education, occupation, living situation, and coping with everyday hassles. Many of these studies have primarily focused on the situations of male individuals with ASD (diagnosed as children), leaving a gap in the knowledge regarding females with ASD and possible extant gender differences.

Objectives: The focus of the study is to explore the clinical characteristics of a clinical cohort of young women and men with ASD, diagnosed as adults. The characteristics involve psychiatric comorbidity, cognition, and adult life outcomes (relationships, education, employment, and living situation). Potential gender differences will be analysed.

Methods: Between 2001 and 2013, 830 adult patients were enrolled in the study at a tertiary outpatient clinic in Stockholm, Sweden. Out of these, n=348 patients were diagnosed with ASD. Patient’s case files and life situation questionnaire were used as data sources regarding life outcomes. Comprehensive neuropsychological testing was conducted to assess general intellectual ability, and cognitive profile and clinical interviews were conducted to assess psychiatric co-morbidity.

Results: Of the n=348 adults diagnosed with ASD, out of these a sizeable proportion were female (ASD-ID, n=104; ASD+ID, n=19). At least one additional lifetime DSM-IV diagnosis was established in 84% of the individuals with ASD. Most common were additional neurodevelopmental disorders and mood disorders followed by anxiety disorders. Mood disorders were more prevalent among women with ASD, as compared to men with ASD. Otherwise, no significant gender differences were seen with regard to psychiatric comorbidity. The analyses regarding cognitive profile and current life situation are in progress.

Conclusions: It is very common among individuals with ASD diagnosed as adults to also have psychiatric comorbidity from a broad spectrum of disorders, especially additional neurodevelopmental disorders and mood disorders.