Autistic adults are not being effectively diagnosed with depression due to a lack of assessment tools, a new study has found.

Researchers from the University of Nottingham’s School of Psychologyundertook a systematic review of data on assessment tools for diagnosing adults with autistic spectrum conditions (ASC) with depression. The research published in Autism Research shows that there are no validated tools to specifically assess depression in autistic adults.

Unique and subtle signs

Dr Sarah Cassidy who led the research is now developing a new depression assessment tool for autistic adults. She says: “It is crucial that we are able to effectively identify depression in autistic adults. However, current tools have been developed for non-autistic populations and may miss the unique and subtle signs of depression in autistic people.”

79% of autistic people experience a mental health problem at some point in their lives, and depression is the most common.

The consequences of not detecting depression in autistic people can be devastating. Depression has been shown to increase risk of autistic adults experiencing thoughts of ending their own lives, and dying by suicide.

Overlapping symptoms

Dr Cassidy continues: “The challenge clinicians have diagnosing an autistic person with depression is that many of the characteristics of it overlap with the symptoms and behaviours of autism such as; social withdrawal, difficulties with sleep and reduced eye contact. This overlap of symptoms becomes especially problematic when using tools developed for the general non-autistic population.”

The research showed that the main tools used to diagnose depression are based on either interviews with a clinician or self reporting questionnaires, all of which were developed for use with the general non-autistic population. The answers to these are then used to score the patient on a scale which allows a diagnosis to be made. None of the tools have been designed specifically for autistic people.

“The current tools available for diagnosing depression rely on people self-reporting, relying on the ability to reflect and report on personal emotional experience, something autistic will find extremely difficult to do, with many finding it impossible” continues Dr Cassidy, “We would suggest that autism specific questions are needed to capture the unique presentation of depression in autistic people, such as changes in social withdrawal, sleep patterns, sensitivity to the environment, repetitive behaviors, or loss of interest in a usually very strong interest”.

As part of the ongoing research an online survey will be out soon to ask for feedback for the new draft tool. Follow @mhautism for updates.