Flawed strategies undermine research on undiagnosed autism and suicide | Spectrum

A research revealed final month within the British Journal of Psychiatry claimed that individuals who die by suicide have an elevated probability of being autistic or having undiagnosed autism, based mostly on an evaluation of coroner data and household interviews. Spectrum requested statistics knowledgeable Kristin Sainani for her ideas on the strategies and outcomes.

A brand new research purports to indicate proof that individuals with elevated autism traits and undiagnosed autism are at an elevated danger of suicide. It’s not shocking that autism could improve the danger of suicide, as a result of it’s recognized to co-occur with different psychiatric situations, akin to despair, that additionally improve this danger. However this research’s claims are unconvincing due to the shortage of an applicable management group. 

The researchers, led by Simon Baron-Cohen at Cambridge College in the UK, reviewed coroner data from 372 deaths in England that concerned suicide or self-harm. They used information from these data, which embrace the coroner’s interviews with members of the family, to determine at the least some proof of autism in 40 of those people, or 10.8 p.c. They in contrast this with the 1.1 p.c autism prevalence within the U.Ok. common inhabitants.  

However this comparability is deceptive, as the 2 research measured various things. The sooner research counted people as autistic provided that they met the total standards for a medical prognosis of autism, even when they had been beforehand undiagnosed. Against this, the brand new research flagged anybody who had even “attainable” indicators of autism.  

In reality, of the 40 people flagged, solely 2 had a documented prognosis of autism. The remaining 38 had what the researchers referred to as “attainable” or “robust proof” of autism. The researchers didn’t disclose what number of had been in every of those classes, however it’s truthful to guess that almost all had been within the “attainable” class.  

The researchers recommend that the “attainable” class could signify undiagnosed autism. However their very own information contradict this concept. They interviewed 29 households of the deceased, together with the households of 12 people categorised as having “attainable” autism. However, based on the authors, “not one of the 12 met the brink for autism” utilizing a validated diagnostic instrument.  

Additional undermining the research’s predominant argument, the authors discovered little correlation between the designation of “attainable” autism and scores on a validated questionnaire that measures autism traits. This means that what researchers flagged as proof of autism within the coroner experiences is just not a superb proxy for undiagnosed autism or elevated autism traits.  

And not using a related management group, it’s unclear whether or not 10.8 p.c is a excessive or low quantity. It’s attainable that 10.8 p.c of individuals on the whole would meet the authors’ standards for “attainable” autism. A great management right here would have been to make use of the identical strategies to overview the demise data of individuals of comparable age and gender who died from causes aside from suicide. With out such a management, the research doesn’t add a lot to our understanding of the position of autism in suicide. 

Kristin Sainani is affiliate instructing professor of epidemiology and inhabitants well being at Stanford College in California.  

For those who or somebody you understand is having suicidal ideas, assist is accessible. Here’s a worldwide listing of assets and hotlines you could name for help. 

Cite this text: https://doi.org/10.53053/VBNE9684