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Prevalence of Depressive Disorders in Individuals with Autism Spectrum Disorder: a Meta-Analysis

Hudson, Chloe C., Hall, Layla, Harkness, Kate L.·2019·Journal of Abnormal Child Psychology

DOI 10.1007/s10802-018-0402-1

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Abstract

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.

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Gong, X.-R., You, X.-R., Guo, M.-R., Ding, X., & Ma, B. (2023) · Medicine · doi:10.1097/md.0000000000036794 · Cited by 8
“[46,47] The microbiota-gut-brain axis is involved in the pathophysiology of ASD and major depressive disorder, based on neuroinflam-matory processes leading to neuronal cell death.”
Background
The Presentation of Depression in Depressed Autistic Individuals: A Systematic Review
Hinze, E., Paynter, J. M., Dargue, N., & Adams, D. (2024) · Review Journal of Autism and Developmental Disorders · doi:10.1007/s40489-024-00480-z · Cited by 7
Understanding depression in autism: the role of subjective perception and anterior cingulate cortex volume
Hao, Y., Banker, S. M., Trayvick, J., Barkley, S., Peters, A. W., Thinakaran, A. A., McLaughlin, C., Gu, X., Schiller, D., & Foss‐Feig, J. H. (2025) · Molecular Autism · doi:10.1186/s13229-025-00638-4 · Cited by 8
“Given rates of depression are much higher when participants with ASD report their own depressive symptoms [3], our current study focused on self-report of depression.”
Higher prevalence of mood disorders in admitted patients with autism
Etyemez, S., Saleh, A., Hamilton, J. E., Koshy, A. J., Abraham, J. E., & Selek, S. (2020) · Neurology Psychiatry and Brain Research · doi:10.1016/j.npbr.2020.06.007 · Cited by 7
Is a Negative Attentional Bias in Individuals with Autism Spectrum Disorder Explained by Comorbid Depression? An Eye-Tracking Study
Bergman, M. A., Vrijsen, J. N., Rinck, M., van Oostrom, I., Kan, C. C., Collard, R. M., van Eijndhoven, P., Vissers, C., & Schene, A. H. (2021) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-021-04880-6 · Cited by 9
Pilot randomized controlled trial of MINDful TIME, a novel telehealth mindfulness-based intervention for autistic adolescents and their caregivers.
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“These findings are especially promising in the context of the high prevalence of autistic individuals with co-occurring depression (Hudson et al., 2018) and limited empirically supported psychosocial interventions for depression in this population (White et al., 2018).”
Early Life Experiences Moderate the Relationship Between Genetic Risk of Autism and Current and Lifetime Mental Health
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Effects of Neurodevelopmental Disorders on the Clinical Presentations and Therapeutic Outcomes of Children and Adolescents with Severe Mood Disorders: A Multicenter Observational Study
Benarous, X., Lefebvre, C., Guilé, J.-M., Consoli, A., Cravero, C., Cohen, D., & Lahaye, H. (2024) · Child Psychiatry & Human Development · doi:10.1007/s10578-024-01770-7 · Cited by 6
Common and unique menopause experiences among autistic and non-autistic people: A qualitative study
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“One study suggests that autistic people are four-times more likely to experience depression compared to non-autistic people (Hudson et al., 2018).”
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Psychometric properties of the 10-item Autism Quotient in an acute psychiatric sample
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“A recent meta-analysis of the prevalence of depressive disorders in autistic people indicated that autistic individuals are 4 times more likely to experience depression in their lifetime as compared to non-autistic individuals (Hudson et al., 2018).”
Early Reflections on the Therapeutic Effects of Mindfulness-Based Therapies in Adults with Autism and Suggestions for Future Research
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“According to metanalyses, 40% of young individuals with ASD have clinical anxiety [6] and adults are estimated to experience depression at quadruple the rate of the general population [7].”
Background
Correlates of self-reported life satisfaction among autistic youth with and without intellectual disability
Moser, C., DaWalt, L. S., Burke, M. M., & Taylor, J. L. (2025) · Autism · doi:10.1177/13623613251327347 · Cited by 8
“…our findings align with other studies suggesting a potential disadvantage in subjective outcomes for autistic individuals without ID relative to those with ID, with perhaps the most evidence for higher rates of depressive symptoms in this group (Hollocks et al., 2019; Hudson et al., 2019).”
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“In terms of depression, a meta-analysis conducted by Hudson et al. (2019) found that autistic individuals are four times more likely to experience depression in their lifetime compared to non-autistic peers.”
Adverse Childhood Experiences and Health Outcomes Among Transition-Age Autistic Youth
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Social prescribing for autistic people: A framework for service provision
Charlton, R. A., Crompton, C. J., Roestorf, A., Torry, C., & The Autistica Physical Health and Ageing Study Group (2020) · AMRC Open Research · doi:10.12688/amrcopenres.12901.1 · Cited by 10
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“Since DMX has previously been regarded as a mixture of both manic and depressive components in its psychopathology (Fornaro et al., 2012), various reports have suggested close association between bipolarity and DMX (Benazzi, 2008b; Inoue et al., 2015; Takeshima and Oka, 2015, 2013).”
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“Other studies have observed that autistic individuals are four times more likely to experience depression than non-autistic individuals (Hudson et al., 2019) whilst 42 – 79 % of people with autism experience anxiety disorders (Kent and Simonoff, 2017).”
Background
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“2020), and children with ASD show disproportionately higher levels of depression compared to NT children (Hudson et al. 2019).”
Background
Editorial: Internalizing disorders in individuals with autism spectrum disorder
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“Autistic children face a high risk for mental health problems compared to neurotypical children (Boss et al., 2018; Hudson et al., 2019; Vasa & Mazurek, 2015).”
Modelling cell type-specific lncRNA regulatory network in autism with Cycle
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“The results of a recent meta-analysis suggest that autistic people are 4 times more likely to experience depression in their lifetime than nonautistic people (Hudson et al., 2019).”
Incorporating autism symptoms into a transdiagnostic model of anxiety and depression symptoms results in an improved model and distinct factor structure for autistic youth
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“Autistic individuals are over two and a half times more likely than the neurotypical population to have a diagnosis of an anxiety disorder and four times more likely to have a diagnosis of a depressive disorder (Nimmo-Smith, et al., 2019, Hudson, et al., 2018).”
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“In high-functioning ASDs, self-report may be more reliable than parent report in detecting depressive symptoms, so assessment methods should be selected according to the individual [50].”
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“Moreover, individuals with Autism Spectrum Disorder (ASD) have a four-times-higher chance of developing depression when compared to typically developed peers [3], and the reported point prevalence of MDD among youths with ASDsvaries between 0 and 88% [4].”
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“This ﬁ nding is consistent with previous research on autistic populations, which has consistently reported high rates of co-occurrence between these two mental health conditions (Hollocks et al., 2019; Hudson et al., 2019).”
An exploratory study on predicting depressive symptoms in autistic individuals using wearable devices and machine learning
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“The risk of developing major depressive disorder (MDD) is nearly four times greater in individuals with ASD than in their neurotypical peers (Hudson et al., 2018).”

Authors: Hudson, C. C., Hall, L., & Harkness, K. L.
Affiliations: Queen's University (CA)
Corresponding author: Hudson, Chloe C.
ORCID: Hudson, Chloe C.
Harkness, Kate L.
Venue: Journal of Abnormal Child Psychology
Publisher: Springer Science and Business Media LLC
Published: 2018-03-01
Volume: 47
Issue: 1
Pages: 165-175
ISSN: 0091-0627 (ISSN-L)
1573-2835
DOI: 10.1007/s10802-018-0402-1
OpenAlex: W2792899115
Cited by: 411
References: 40
Citations by year: 2026: 50 · 2025: 65 · 2024: 80 · 2023: 58 · 2022: 51 · 2021: 56 · 2020: 30 · 2019: 19 · 2018: 2
FWCI: 3.58
Type: journal article
Language: en
Open access: closed
Licence: www.springer.com/tdm (tdm)
Locations: Research on Child and Adolescent Psychopathology (publishedVersion)
PubMed (publishedVersion)
Topics: Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
Keywords: autism spectrum disorder, depressive disorders, depression prevalence, lifetime prevalence, current prevalence, major depressive disorder, children and adolescents, adults, intelligence, age differences, racial differences, depression screening
MeSH terms: Autism Spectrum Disorder, Adolescent, Adult, Child, Child, Preschool, Depressive Disorder, Humans, Comorbidity, Prevalence, Young Adult

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Prevalence of Depressive Disorders in Individuals with Autism Spectrum Disorder: a Meta-Analysis

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