Department of Clinical and Experimental Medicine, University of Pisa, Italy.
Department of Clinical and Experimental Medicine, University of Pisa, Italy.
Compr Psychiatry. 2019 May;91:34-38. doi: 10.1016/j.comppsych.2019.03.004. Epub 2019 Apr 3.
Autism spectrum is a psychopathological dimension which encompasses a wide range of clinical presentations: from subthreshold forms and autistic traits (AT), that can be found in the general population, to full-blown autism spectrum disorder (ASD). Many studies reported high rates of comorbidity between both ASD and AT and mood disorders, as well as a high prevalence of suicidal ideation among patients with ASD/AT. The aim of this study was to investigate the presence of mood symptoms and suicidal ideation and behaviors in patients with full-blown ASD and in subjects with AT, as well in a healthy control (HC) group, with a specific focus on which of the autistic features may be predictive of suicidal ideation and behaviors.
We recruited 262 adult subjects: 34 with ASD without intellectual impairment or language disability (ASD group), 68 fulfilling only one symptom criterion for ASD according to DSM-5 but who do not meet criteria for a full-blown diagnosis of ASD (AT group), and 160 HC. All subjects were assessed with the Structured Clinical Interview for DSM-5 (SCID-5); in addition, they were asked to fill two questionnaires: The Mood Spectrum, Self-report (MOODS-SR) and the Adult Autism Subthreshold Spectrum (AdAS Spectrum).
ASD subjects reported significantly higher AdAS Spectrum and MOODS-SR total scores, as well as higher MOODS-SR depressive component total scores, when compared with AT and HC subjects. AT subjects scored significantly higher than the HC group. No significant differences were reported between ASD and AT subjects for the suicidality score according to MOODS-SR, despite both groups scored significantly higher than the HC group. The strongest predictor of suicidality score were MOODS-SR depressive component score and AdAS Spectrum Restricted interests and rumination domain score.
Our results highlight a correlation between autism and mood spectrum, as well as between suicidality and both ASD and AT. Subthreshold forms of ASD should be accurately investigated due to their relationship with suicidal thoughts and behaviors.
自闭症谱系是一种心理病理学维度，包括广泛的临床表现：从亚阈值形式和自闭症特质（AT），可以在普通人群中发现，到全面的自闭症谱系障碍（ASD）。许多研究报告了 ASD 和 AT 与心境障碍之间的高共病率，以及 ASD/AT 患者中自杀意念的高发率。本研究旨在调查全面性 ASD 患者和 AT 患者以及健康对照组（HC）中情绪症状和自杀意念和行为的存在情况，并特别关注哪些自闭症特征可能预测自杀意念和行为。
我们招募了 262 名成年受试者：34 名无智力障碍或语言障碍的 ASD 患者（ASD 组），68 名仅根据 DSM-5 符合 ASD 一个症状标准但不符合全面性 ASD 诊断标准的受试者（AT 组），和 160 名 HC。所有受试者均接受 DSM-5 结构临床访谈（SCID-5）评估；此外，他们被要求填写两份问卷：情绪谱，自我报告（MOODS-SR）和成人自闭症亚阈值谱（AdAS Spectrum）。
与 AT 和 HC 受试者相比，ASD 受试者报告的 AdAS Spectrum 和 MOODS-SR 总分以及 MOODS-SR 抑郁成分总分显著更高。AT 受试者的得分显著高于 HC 组。尽管两组的 MOODS-SR 自杀得分均显著高于 HC 组，但 ASD 和 AT 组之间的自杀得分无显著差异。MOODS-SR 抑郁成分评分和 AdAS Spectrum 受限兴趣和沉思域评分是自杀得分的最强预测因素。
我们的结果强调了自闭症与情绪谱之间的相关性，以及 ASD 和 AT 与自杀之间的相关性。由于与自杀意念和行为有关，应准确调查亚阈值形式的 ASD。
