Autism, Self-Harm, and Co-Occurring Psychiatric Diagnoses

In The Politics of Autism, I write about the many challenges facing people on the spectrum.  Among many other things, they are at high risk for suicide. (In July, the United States transitioned from 10-digit National Suicide Prevention Lifeline to 988 – an easy-to-remember three-digit number for 24/7 crisis care. "

Meng-Chuan Lai et al., "Self-Harm Events and Suicide Deaths Among Autistic Individuals in Ontario, Canada," JAMA Netw Open. 2023;6(8):e2327415. doi:10.1001/jamanetworkopen.2023.27415

Key Points

Question What are the sex-stratified rates of self-harm events and suicide death among autistic individuals vs nonautistic individuals and the associated sociodemographic and clinical risk factors?

Findings In this cohort study including 379 630 individuals regarding self-harm findings and 334 690 individuals regarding suicide death findings in Ontario, Canada, autistic females had an 83% increased risk and autistic males had a 47% increased risk of self-harm compared with nonautistic individuals, when accounting for neighborhood income and rurality, intellectual disabilities, and psychiatric diagnoses. The crude hazard ratio showed that autistic females had a 98% increased risk and autistic males had a 34% increased risk of suicide death, but these increases were associated with psychiatric diagnoses.

Meaning This study suggests that psychiatric diagnoses were significantly associated with risks of self-harm and especially suicide among autistic females and males.