Suicidality in Autistic Spectrum Disorders: A Systematic Review
Background: It is suggested that people with autistic spectrum disorders (ASD) may be at increased risk of suicide; however, research on this topic has been minimal and there are conflicting reports in existing studies. Aim: To bring together research investigating the prevalence, risk factors, and comorbid factors of suicidality in ASD. Method: A systematic search was performed of Medline, Psych Info, Embase, and the Web of Science following PRISMA guidelines. After exclusion criteria were applied, 70 full-text articles were screened. The final review contained 12 papers with a total sample size of 2,651. Results: Prevalence of suicide attempts varied between 7% and 47%, while suicidal ideation was reported in up to 72% of cases. Being male and having a history of self-harm and depression were cited as significant risk factors. Limitations: Papers were cross sectional and contained a number of limitations. Only one paper used the gold standard for diagnosis of ASD and one a standardized measure of suicidal behavior. Conclusion: Suicidal attempts and ideation are increased in ASD; however, the extent of the increase and the risk factors identified within this group remain under-investigated. There is a lack of research on protective factors. The correlation between ASD and suicidality needs further examination with longitudinal research.