Department of Psychology, Queen's University, 62 Arch Street, Kingston, ON, K7L 3N6, Canada.
J Abnorm Child Psychol. 2019 Jan;47(1):165-175. doi: 10.1007/s10802-018-0402-1.
Substantial uncertainty exists about the prevalence of depressive disorders in individuals with autism spectrum disorder (ASD). This meta-analysis quantitatively summarized studies that assessed the lifetime and current prevalence of unipolar depressive disorders in children, adolescents, and adults with ASD. We also examined demographic, methodological, and study moderators. This meta-analysis adhered to PRISMA guidelines. A total of 7857 articles were identified through 5 databases (PubMed, Web of Science, PYSCInfo, CINAHL, ProQuest Dissertations and Theses), forward searches, and backward searches. Two reviewers independently screened articles and extracted data. Sixty-six articles met inclusion criteria. Results indicated that the pooled lifetime and current prevalence was 14.4% (95% CI 10.3-19.8) and 12.3% (95% CI 9.7-15.5), respectively. Rates of depressive disorders were highest among studies that used a standardized interview to assess depressive disorders (lifetime = 28.5%, 95% CI 20.1-38.8; current = 15.3%, 95% CI 11.0-20.9) and required participants to report on their own depressive symptoms (lifetime = 48.6%, 95% CI 33.3-64.2; current = 25.9%, 95% CI 17.0-37.3). Rates were also higher in studies that included participants with higher intelligence. Lifetime, but not current, prevalence was positively associated with age and the proportion of the sample that was White. In conclusion, we found that the rates of depressive disorders are high among individuals with ASD. Compared to typically developing individuals, individuals with ASD are 4-times more likely to experience depression in their lifetime. These results suggest that individuals with ASD should be regularly screened and offered treatment for depression.
自闭症谱系障碍(ASD)个体中抑郁障碍的患病率存在很大的不确定性。本荟萃分析定量总结了评估 ASD 儿童、青少年和成人终身和当前单相抑郁障碍患病率的研究。我们还检查了人口统计学、方法学和研究调节因素。本荟萃分析遵循 PRISMA 指南。通过 5 个数据库(PubMed、Web of Science、PYSCInfo、CINAHL、ProQuest Dissertations and Theses)、正向搜索和反向搜索共确定了 7857 篇文章。两位审查员独立筛选文章并提取数据。符合纳入标准的文章共有 66 篇。结果表明,终身和当前的患病率分别为 14.4%(95%CI 10.3-19.8)和 12.3%(95%CI 9.7-15.5)。使用标准化访谈评估抑郁障碍的研究中(终身患病率=28.5%,95%CI 20.1-38.8;当前患病率=15.3%,95%CI 11.0-20.9)和要求参与者报告自己的抑郁症状(终身患病率=48.6%,95%CI 33.3-64.2;当前患病率=25.9%,95%CI 17.0-37.3),抑郁障碍的发生率最高。在纳入智力较高的参与者的研究中,终身患病率,但不是当前患病率,与年龄和样本中白种人比例呈正相关。总之,我们发现 ASD 个体中抑郁障碍的发生率较高。与发育正常的个体相比,ASD 个体一生中患抑郁症的可能性高出 4 倍。这些结果表明,ASD 个体应定期进行抑郁筛查并提供治疗。