Neuropsychiatric Disease and Treatment (Feb 2024)

Excess Mortality in Individuals with Autism Spectrum Disorder: A Population-Based Cohort Study

  • Huang YH,
  • Wu SI,
  • Lee MJ,
  • Chen YL,
  • Yang YH,
  • Kuo TY,
  • Hung TH,
  • Dewey ME,
  • Stewart R,
  • Chen VCH

Journal volume & issue
Vol. Volume 20
pp. 247 – 255

Abstract

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Yu-Hsin Huang,1,2,* Shu-I Wu,1,2 Min-Jing Lee,3– 5,* Yi-Lung Chen,6,7,* Yao-Hsu Yang,8,9 Ting-Yu Kuo,8 Tai-Hsin Hung,3,4 Michael E Dewey,10 Robert Stewart,11,12 Vincent Chin-Hung Chen3,4 1Department of Medicine, MacKay Medical College, New Taipei City, Taiwan; 2Department of Psychiatry, MacKay Memorial Hospital, Taipei City, Taiwan; 3Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan; 4School of Medicine, Chang Gung University, Taoyuan, Taiwan; 5Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; 6Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan; 7Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan; 8Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan; 9Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan; 10Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK; 11Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK; 12South London and Maudsley National Health Services Foundation Trust, London, UK*These authors contributed equally to this workCorrespondence: Vincent Chin-Hung Chen, Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan, Tel +886-5-3621000 ext2303, Fax +886-5-3622188, Email [email protected]: Autism spectrum disorder (ASD) may be associated with increased mortality, but relevant findings have been inconsistent. The modifying effects of gender and intellectual disability on excess mortality in individuals with ASD are underexplored.Patients and Methods: Using Taiwan’s National Health Insurance Research Database and the National Death Registry, this population-based cohort study selected the data of 75,946 patients with ASD (ASD cohort) and 75,946 age group-, gender-, and income-matched (1:1) patients without ASD (non-ASD cohort). Cox proportional hazards models were used to compare mortality rates between the cohorts, and stratified analyses were used to evaluate the influence of gender and intellectual disability on mortality risk.Results: The ASD cohort had higher mortality rates for all causes of death than did the non-ASD cohort (adjusted hazard ratio 1.64, 95% confidence interval 1.54– 1.75). Comorbid intellectual disability was associated with an increased risk of mortality, and this association was stronger in female patients than in male patients. Moreover, when focusing on deaths from natural causes, we found a significantly higher odds ratio for mortality in the ASD population with ID compared to those without ID.Conclusion: ASD is associated with increased mortality, especially among female individuals and those with intellectual disability.Keywords: mortality, autism, population-based cohort study

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