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Code  ›  孤独症患者过早死亡风险及死亡原因
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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10091241/
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Beijing Da Xue Xue Bao Yi Xue Ban. 2023 Apr 18; 55(2): 375–383.
Published online 2023 Feb 14. Chinese. doi: 10.19723/j.issn.1671-167X.2023.02.027
PMCID: PMC10091241
PMID: 37042154

Language: Chinese | English

孤独症患者过早死亡风险及死亡原因

Early death and causes of death of patients with autism spectrum disorders: A systematic review

赵 亚楠 , 1, 2, 3 范 慧芸 , 3, 4 王 翔宇 , 3, 4 罗 雅楠 , 3, 5 张 嵘 , corresponding author 6, 7, * and 郑 晓瑛 corresponding author 1, 3, 7, *

赵 亚楠

中国医学科学院, 北京协和医学院群医学与公共卫生学院, 北京 100730, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China 北京大学中国卫生发展研究中心, 北京 100191, China Center for Health Development Studies, Peking University, Beijing 100191, China 北京大学亚太经合组织健康科学研究院, 北京 100871, Peking University Asia Pacific Economic Cooperation Health Sciences Academy, Beijing 100871, China

Find articles by 赵 亚楠

范 慧芸

北京大学亚太经合组织健康科学研究院, 北京 100871, Peking University Asia Pacific Economic Cooperation Health Sciences Academy, Beijing 100871, China 北京大学人口研究所, 北京 100871, Institute of Population Research, Peking University, Beijing 100871, China

Find articles by 范 慧芸

王 翔宇

北京大学亚太经合组织健康科学研究院, 北京 100871, Peking University Asia Pacific Economic Cooperation Health Sciences Academy, Beijing 100871, China 北京大学人口研究所, 北京 100871, Institute of Population Research, Peking University, Beijing 100871, China

Find articles by 王 翔宇

罗 雅楠

北京大学亚太经合组织健康科学研究院, 北京 100871, Peking University Asia Pacific Economic Cooperation Health Sciences Academy, Beijing 100871, China 北京大学公共卫生学院全球卫生学系, 北京 100191, Department of Global Health, Peking University School of Public Health, Beijing 100191, China

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张 嵘

北京大学神经科学研究所, 北京大学基础医学院神经生物学系, 神经科学教育部重点实验室, 卫生部神经科学重点实验室, 北京 100191, Neuroscience Research Institute, Peking University; Department of Neurobiology, Peking University School of Basic Medical Sciences; Key Laboratory for Neuroscience of the Ministry of Education; Key Laboratory for Neuroscience of the Ministry of National Health Commission; Beijing 100191, China 北京大学医学部孤独症研究中心, 北京 100191, Autism Research Centre, Peking University Health Science Centre, Beijing 100191, China

Find articles by 张 嵘

郑 晓瑛

中国医学科学院, 北京协和医学院群医学与公共卫生学院, 北京 100730, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China 北京大学亚太经合组织健康科学研究院, 北京 100871, Peking University Asia Pacific Economic Cooperation Health Sciences Academy, Beijing 100871, China 北京大学医学部孤独症研究中心, 北京 100191, Autism Research Centre, Peking University Health Science Centre, Beijing 100191, China 中国医学科学院, 北京协和医学院群医学与公共卫生学院, 北京 100730, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China 北京大学中国卫生发展研究中心, 北京 100191, China Center for Health Development Studies, Peking University, Beijing 100191, China 北京大学亚太经合组织健康科学研究院, 北京 100871, Peking University Asia Pacific Economic Cooperation Health Sciences Academy, Beijing 100871, China 北京大学人口研究所, 北京 100871, Institute of Population Research, Peking University, Beijing 100871, China 北京大学公共卫生学院全球卫生学系, 北京 100191, Department of Global Health, Peking University School of Public Health, Beijing 100191, China 北京大学神经科学研究所, 北京大学基础医学院神经生物学系, 神经科学教育部重点实验室, 卫生部神经科学重点实验室, 北京 100191, Neuroscience Research Institute, Peking University; Department of Neurobiology, Peking University School of Basic Medical Sciences; Key Laboratory for Neuroscience of the Ministry of Education; Key Laboratory for Neuroscience of the Ministry of National Health Commission; Beijing 100191, China 北京大学医学部孤独症研究中心, 北京 100191, Autism Research Centre, Peking University Health Science Centre, Beijing 100191, China RR g (95% RR (by gender)a, the specific categories may vary as some articles study the pervasive developmental disorder population only; b, data available for 23-46 years old people; c, data available for 20-28 years old people; d, data available for 5-25 years old people; e, data available for 6-13 years old people; f, data available for 8-18 years old people; g, the articles may use hazard ratio ( HR ), odd ratio ( OR ) or other indicators to measure RR which connotations are similar. ASD, autism spectrum disorder; NA, not available; RR , risk ratio; CI , confidence interval; USA, United States of America; UK, United Kingdom; F, female; M, male. Shavelle et al [ 7 ] 2001USA13 1112022.40 (NA)F: 5.5; M: 1.7Pickett et al [ 36 ] 2006USA13 1112802.45 (2.18-2.76)F: 5.2; M: 2.3Bilder et al [ 8 ] 2013USA3052911.59 (6.24-21.53)F: 30.14; M: 9.91Akobirshoev et al [ 37 ] 2020USA34 2374621.51 (1.33-1.72)F: 2.75; M: 1.25Isager et al [ 38 ] 1999Denmark341121.90 (1.00-3.40)F: 3.61; M: 1.67Mouridsen et al [ 6 ] 2008Denmark341261.93 (1.26-2.82)F: 4.01; M: 1.57Schendel et al [ 11 ] 2016Denmark20 492682.00 (1.50-2.80)F: 3.5; M: 1.8Gillberg et al [ 39 ] 2010Sweden120 b 95.60 (2.50-10.50)F: 20.7; M: 2.3Hirvikoski et al [ 34 ] 2016Sweden27 1227062.56 (2.38-2.76)F: 2.24; M: 2.87Hwang et al [ 40 ] 2019Australia35 9292442.06 (1.64-2.58)NAJokiranta-Olkoniemi et al [ 41 ] 2021Finland4 695 c 531.70 (1.20-2.60)F: 5.3; M: 1.5Hosking et al [ 42 ] 2016UK1 532152.22 (1.01-4.86)NASmith et al [ 43 ] 2021UK9 754 d 61.10 (0.50-2.50)NAKim et al [ 44 ] 2021South Korea32 878 e 2372.50 (2.20-2.90)F: 4.8; M: 1.9Yoo et al [ 45 ] 2022South Korea35 529 f NA2.34 (2.06-2.65)F: 4.22; M: 1.77

如 图 1 所示，来自13篇文献 [ 6 , 8 , 11 , 34 , 36 - 37 , 39 - 45 ] 的证据表明(因重复队列问题，采用13篇文献中的队列数据做meta分析)，孤独症患者整体的死亡风险相对于一般人群更高( RR =2.32, 95% CI : 1.98~2.72, I 2 =87.1%, P < 0.001)；来自10篇文献 [ 6 , 8 , 11 , 34 , 36 - 37 , 39 , 41 , 44 - 45 ] 的证据表明，女性孤独症患者的死亡风险更高(男性患者： RR =2.00, 95% CI : 1.57~2.55, I 2 =93.2%, P < 0.001；女性患者： RR =4.66, 95% CI : 3.30~6.58, I 2 =92.0%, P < 0.001)；来自2篇文献 [ 40 - 41 ] 的证据表明，伴有认知障碍(intellectual disorder, ID)的孤独症患者死亡风险更高(伴有ID： RR =4.86, 95% CI : 0.94~25.01, I 2 =90.0%, P < 0.01；不伴有ID： RR =2.00, 95% CI : 1.30~2.90)。

An external file that holds a picture, illustration, etc. Object name is bjdxxbyxb-55-2-375-1.jpg

ASD患者的死亡风险(分组)

Risk of mortality in patients with ASD by group

Diamond, estimated effect size; Width of diamond, the precision of the estimate (95% CI ). ASD, autism spectrum disorder; RR , risk ratio; CI , confidence interval; ID, intellectual disorder.

尽管整体上孤独症患者的死亡风险更高，但是英国苏格兰地区的一项研究发现，孤独症患者的死亡风险为1.1，并未显著增高 [ 43 ] ，与其他研究的结果并不一致( 表 1 )。人口年龄构成的差异、调查时间的差异可能是造成这一区别的原因，且苏格兰的整体健康服务质量较高 [ 43 ] ，这也可能使得孤独症的死亡风险更低。

综上，孤独症患者的死亡风险是一般人群的1.5~9.9倍，综合死亡风险是一般人群的2.32倍，其中，女性患者的死亡风险是一般女性人群的4.66倍，男性患者的死亡风险是一般男性人群的2倍。除苏格兰的研究外，其他研究都认为孤独症患者的死亡风险显著更高。

3.2. 过早死亡的高风险因素

认知障碍影响死亡风险。认知障碍是指认知功能的损害，智商小于70，伴有适应性功能(个体独立及社会功能需要的日常支持)的缺陷 [ 46 ] 。据统计，70%左右的孤独症患者存在认知障碍 [ 47 - 48 ] ，而40%的孤独症患者患有严重的认知障碍 [ 46 ] 。研究证实，有认知障碍的孤独症患者的死亡风险更高 [ 8 , 34 , 41 ] 。

性别造成的死亡风险方面仍有争议。尽管大部分研究都发现女性孤独症患者的过早死亡风险相对更高 [ 6 - 7 , 11 , 36 - 39 , 41 , 44 - 45 ] ，但也有相反的研究结论，认为女性死亡风险并不显著更高，女性死亡风险更高主要体现在低功能孤独症患者中，在高功能孤独症患者中并未有此发现 [ 34 ] 。

伴有癫痫会造成更高的死亡风险。癫痫是一种慢性神经疾病，以反复发作的自发性癫痫发作为特征 [ 49 ] 。研究发现，合并癫痫的患者死亡风险偏高 [ 6 , 34 , 36 , 39 ] 。如果癫痫同时伴有认知障碍，则死亡风险会更高 [ 50 - 51 ] 。

孤独症严重程度及日常生活的活动能力也与死亡率相关，低功能孤独症人群的死亡风险更高 [ 4 , 34 ] ，日常生活活动能力低则死亡率更高 [ 52 ] 。大部分疾病都是年轻群体死亡率偏低，当患者进入中年以后死亡率高增长，而孤独症是低年龄群体的死亡率更高 [ 11 , 53 ] 。此外，地区健康资源分布不均衡 [ 45 ] 、健康服务缺乏 [ 29 ] 、护工的缺乏和技能不足 [ 54 ] 也造成死亡率更高。

4. 孤独症患者死亡原因的研究

4.1. 自然死亡与非自然死亡的研究

孤独症患者的死亡类型与一般人群的差异研究比较缺乏。孤独症患者的死亡类型可分为自然死亡和非自然死亡两类。自然死亡是指因为某种疾病发作或者年龄所导致的死亡，孤独症患者的过早死亡，主要是前者。非自然死亡是指外部作用所导致的死亡。

目前，有研究对孤独症患者的死亡原因进行了较为详细的对照分析，如 图 1 所示，纳入文章需同时包含自然死亡和非自然死亡两类。来自2篇文献 [ 11 , 41 ] 的证据表明，孤独症患者自然死亡的风险相对于一般人群更高( RR =3.44, 95% CI : 1.27~9.26, I 2 =80.2%, P =0.025)，尽管这两篇文献 [ 11 , 41 ] 也表明，孤独症患者非自然死亡的风险也更高( RR =1.95)，但是相对于一般人群并不显著。

4.2. 病例死亡类型对照

在自然死亡中有一类“神经性原因”，主要指因癫痫等神经性原因导致的死亡，这一类原因占死亡总数相当大的一部分。对于非自然死亡的类型，可以进一步分成意外伤害致死和自杀两类。大部分针对死亡的研究没有对意外和自杀进行区分，统称为意外致死(非自然死亡)。 表 2 对于孤独症内部的死亡原因分布进行了对比分析。

表 2

ASD患者死亡原因的研究

Studies on causes of mortality in patients with ASD

Authors Year Country Participant with ASD a Deaths Natural cause Unnatural cause Undetermined
Sum Neurologic Sum Accidents Intentional self-harm
a, the specific categories may vary as some articles study the pervasive developmental disorder population only; b, data available for above 10 years old people; c, data available for 23-46 years old people; d, data available for 20-28 years old people. Abbreviations as in Table 1 .
Mouridsen et al [ 6 ] 2008 Denmark 341 26 73.12% 19.23% 23.08% NA NA 3.80%
Schendel et al [ 11 ] 2016 Denmark 20 492 68 49.12% 12.28% 50.88% 26.32% 22.81% 0.00%
Shavelle et al [ 7 ] 2001 USA 13 111 202 54.45% 12.38% 24.26% NA NA 21.29%
Bilder et al [ 8 ] 2013 USA 305 29 89.66% 51.72% 10.34% NA NA 0.00%
Smith DaWalt et al [ 52 ] 2019 USA 406 b 26 61.54% 11.54% 19.23% NA NA 19.23%
Gillberg et al [ 39 ] 2010 Sweden 120 c 9 77.78% 44.44% 11.11% NA NA 11.11%
Hwang et al [ 40 ] 2019 Australia 35 929 255 45.00% 20.00% 23.00% NA NA 32.00%
Jokiranta-Olkoniemi et al [ 41 ] 2021 Finland 4 695 d 53 50.90% NA 47.10% 24.50% 22.60% 2.00%

由 表 2 可以发现，整体上，孤独症患者中的自然死亡更多，占比一半及以上，非自然死亡占比为11.11%~50.88%，大部分研究发现，非自然死亡在整体死亡中只占10%~25%。自然死亡的原因中，因癫痫或癫痫相关状态的死亡都占据一定的比例，但是不同研究的样本量、样本平均年龄和调查时间差异较大，需要进一步的分析。

4.3. 自然死亡风险的研究

丹麦2016年一项大样本调查显示，因癫痫等神经性原因而死亡的孤独症患者比例尽管只有12.28%，但是死亡风险显著更高，是一般人群的4.1倍 [ 11 ] ；芬兰2020年的一项研究发现，孤独症患者死亡原因分布与丹麦的研究类似，但是死亡风险更高只体现在自然死亡上，自然死亡风险是一般人群的6倍 [ 41 ] 。女性和有认知障碍的孤独症患者是自然死亡的高危人群 [ 4 , 41 ] 。

最显著的自然死亡诱因是由癫痫持续状态引发的相关病症等 [ 6 - 7 ] 。如 表 2 所示，癫痫等神经性原因占总体死亡的10%~52%。之前有综述研究甚至发现，仅癫痫疾病本身就占据了所有死亡原因的7%~30% [ 4 ] 。在非癫痫相关的自然死亡原因中，血液循环系统疾病、呼吸系统疾病(肺炎)和恶性肿瘤等也占有一定比例。

4.4. 非自然死亡风险存在内部差异

造成孤独症患者非自然死亡的原因有车祸、溺水、窒息、自杀等 [ 4 , 55 - 57 ] 。相对于一般人群，这些因素是否显著偏高并没有确切的结论。尽管有研究发现，有精神障碍意味着更高的死亡率，并且主要体现是更高的非自然死亡率 [ 57 ] ，但是芬兰2020年的研究 [ 41 ] 及本研究的综述结果都发现，孤独症患者的非自然死亡并没有显著更高。

非自然死亡内部分为意外伤害致死和自杀两类，有研究发现意外伤害是导致孤独症患者非自然死亡的重要原因 [ 36 , 39 ] ，尤其是对于15岁以下的青少年及儿童。有研究对意外伤害的类别进行了具体划分，在意外伤害中，自缢窒息最多，其次为中毒窒息，第三为溺水 [ 58 ] 。自杀是孤独症人群过早死亡的最重要原因，但是自杀的概率近些年是否提高仍然存在争议，有研究认为自杀的孤独症患者逐年递增 [ 11 , 34 ] ，甚至自杀的风险是一般人群的4.6倍 [ 11 ] ；也有研究认为最近几年孤独症患者的死因中自杀的概率并未显著增加 [ 41 ] 。

4.5. 死亡原因相关的热点问题

4.5.1. 认知状态与死亡类型

近些年，认知障碍与死亡的关系得到较多关注，尤其是非自然死亡。有研究发现，非自然死亡与认知障碍密切相关 [ 6 , 41 ] ，对于伴有认知障碍的孤独症患者来说，溺水和窒息等意外死亡的风险更高 [ 7 ] ，同时癫痫等神经系统障碍死亡的风险也更高 [ 40 ] 。对于不伴有认知障碍的孤独症患者来说，自杀的死亡风险更高 [ 34 , 59 ] 。

4.5.2. 自杀

自杀是一个全球性的健康危机 [ 60 ] ，对于自杀的关注能够为应对一个极端负面情况提供更加理性而科学的干预思路。目前的研究发现，孤独症患者更容易出现自杀的想法和行动 [ 59 , 61 - 64 ] 。瑞典的一项研究发现，孤独症患者死于自杀的风险接近一般人群的8倍 [ 34 ] ，其中，不伴随认知障碍的群体 [ 34 ] 、女性 [ 34 , 65 ] 、年轻群体 [ 65 ] 的自杀风险更高。可能的原因在于，青少年、认知正常以及女性孤独症群体会经历更多的身份认同障碍和社交困难，使得他们面临更大的压力。不同国家的背景(如自然环境 [ 66 ] 、社会环境 [ 67 ] 、健康服务 [ 67 ] )可能导致自杀的国别差异。

4.5.3. 家庭虐待

孤独症患者，尤其是儿童患者，相对于一般人群更容易被忽视、虐待 [ 68 ] 。孤独症越严重，照料者的压力越大，患者越容易受到身体虐待 [ 68 ] 。美国的一项采用媒体报道信息的研究发现，受害者的平均年龄是10.4岁，85%的施暴者是父母或其他照料者，主要原因是照料压力，主要伤害方式是枪杀以及溺亡 [ 69 ] 。也有研究发现大部分家庭暴力的受害者是男性 [ 69 ] 。事实上，孤独症患者的父母更容易伴有精神问题，如人格障碍、精神分裂症等，使得照料工作对于他们来说更加艰难 [ 70 - 71 ] 。

4.5.4. 健康风险与死亡

有关孤独症的住院研究发现，相对一般人群，孤独症人群因心脏病、瘫痪、糖尿病、甲状腺功能减退、风湿性血管疾病、肥胖等导致的死亡风险也都较高，其中，甲状腺功能减退的致死风险是一般人群的4倍以上 [ 37 ] 。这些疾病与孤独症患者的不良生活习惯等因素有关，如对于年轻的孤独症患者，主要的健康风险因素是不良饮食习惯 [ 72 ] 、肥胖 [ 5 , 72 ] 、活动不足 [ 73 ] ，以及很多孤独症患者都服用一些精神类药物 [ 60 ] 。虽然从整体看，孤独症人群的健康状况更差 [ 5 ] ，但是目前缺乏大规模人群样本研究以探讨孤独症患者生命周期中的健康问题 [ 35 ] 。

5. 讨论

在过去的几十年中，对于孤独症过早死亡的研究在不断拓展，整体上的研究发现，孤独症患者的死亡风险仍然较高，死亡原因中自然原因和非自然原因都占有一定的比例。

首先，孤独症患者的死亡风险为一般人群的2.32倍。女性孤独症患者，伴有认知障碍、癫痫等共病的孤独症患者，低功能孤独症患者的死亡风险更高。孤独症患者的生存状况需要被更多关注。

其次，孤独症患者自然死亡的风险为一般人群的3.44倍。近些年，孤独症死亡率的上升更多体现在自然死亡上，尤其是女性孤独症患者 [ 4 , 41 , 74 ] 。孤独症容易伴随很多其他疾病，任何一种疾病都带来了更多的健康风险，产生更多的自然死亡。从共病入手进行研究，可以从医疗角度降低直接的死亡风险。

第三，孤独症患者非自然死亡的风险是一般人群的1.95倍，但与一般人群的差异并不显著。非自然死亡类型中，意外伤害致死和自杀是两类原因。对于意外伤害致死，其背后的原因在于孤独症的核心特征——社交障碍会严重削弱患者遇到伤害之后进行求救的能力，从而使患者在遭遇意外时丧失自救的机会 [ 34 ] ，同时，伴有认知障碍的个体也无法精准识别风险因素，这提示我们应该关注社会环境，提供给残疾人口更安全的环境。女性、不伴有认知障碍、青少年孤独症患者自杀的风险较高，社会应通过为其提供更多支持性社交网络、心理疏导和提升其生活满意度来防止自杀行为发生 [ 34 , 75 ] 。

第四，家庭与社会方面在孤独症患者生命早期的不平等随着时间而加剧，影响后续的疾病进程 [ 76 ] 。孤独症人群内部的不平等也会导致同一群人最终的结果有差异。国家内部需要平衡各地区的康复资源，并提供更多高质量的终身康复监测照护服务。同时，家庭照料者可能在承受着巨大的压力，对于照料者的心理健康服务和社会支持应该被纳入干预项目，提升家庭的复原力。

总之，为了更好地应对孤独症患者的死亡风险，从源头来讲是监测、预防与干预，不错过孤独症儿童社会功能恢复的关键期；对可能表现出身体或心理健康问题的新迹象或症状保持警惕，并支持孤独症患者及其护理者参加定期的健康检查；提高对伤害预防的警惕，鼓励促进健康的活动，如戒烟和积极的生活方式。

然而，迄今为止发表的研究中存在着偏倚风险，缺乏终身视角下孤独症患者死亡及健康风险的高质量信息。基于人群的死亡研究主要集中在欧美国家，尽管这些研究使社会对于孤独症患者面临的健康风险有了进一步的认知，但是其结果需要谨慎外推，不同的国家其健康照护服务类型以及医疗卫生服务体系有差异 [ 77 ] ，可能会导致不同国家的孤独症患者面临不同的死亡风险及死亡类型分布。同时，作为一种功能障碍，孤独症被大规模诊断出来的时间较晚，这部分确诊的孤独症人口年龄更低，甚至还未到中年，因此，对于死亡的研究可能还存在着较高的样本年龄局限性。

未来，需要照料者、精神科医生、神经科医生、康复机构、政府共同合作以减少孤独症患者的死亡风险，也应该加强我国孤独症患者负面疾病结局的研究。

Funding Statement

北京市科技计划项目(Z181100001518005)

Funding Statement

Supported by the Beijing Municipal Science & Technology Commission (Z181100001518005)

References

1. American Psychiatric Association . Diagnostic and statistical manual of mental disorders (DSM) Arlington: American Psychiatric Publishing; 2013. [ Google Scholar ]
2. Maenner MJ, Shaw KA, Bakian AV, et al. Prevalence and characteristics of autism spectrum disorder among children aged 8 years: Autism and Developmental Disabilities Monitoring Network, 11 sites, United States, 2018. MMWR Surveill Sum. 2021; 70 (11):1–20. doi: 10.15585/mmwr.ss7011a1. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
3. 郭 超, 赵 艺皓, 郑 晓瑛. 从罕见到高发: 对孤独症的重新审视 残疾人研究 2020; 38 (2):60–65. doi: 10.3969/j.issn.2095-0810.2020.02.007. [ CrossRef ] [ Google Scholar ]
4. Woolfenden S, Sarkozy V, Ridley G, et al. A systematic review of two outcomes in autism spectrum disorder: Epilepsy and mortality. Dev Med Child Neurol. 2012; 54 (4):306–312. doi: 10.1111/j.1469-8749.2012.04223.x. [ PubMed ] [ CrossRef ] [ Google Scholar ]
5. Croen LA, Zerbo O, Qian Y, et al. The health status of adults on the autism spectrum. Autism. 2015; 19 (7):814–823. doi: 10.1177/1362361315577517. [ PubMed ] [ CrossRef ] [ Google Scholar ]
6. Mouridsen SE, Bronnum-Hansen H, Rich B, et al. Mortality and causes of death in autism spectrum disorders: An update. Autism. 2008; 12 (4):403–414. doi: 10.1177/1362361308091653. [ PubMed ] [ CrossRef ] [ Google Scholar ]
7. Shavelle RM, Strauss DJ, Pickett J. Causes of death in autism. J Autism Dev Disord. 2001; 31 (6):569–576. doi: 10.1023/A:1013247011483. [ PubMed ] [ CrossRef ] [ Google Scholar ]
8. Bilder D, Botts EL, Smith KR, et al. Excess mortality and causes of death in autism spectrum disorders: A follow up of the 1980s Utah/UCLA autism epidemiologic study. J Autism Dev Disord. 2013; 43 (5):1196–1204. doi: 10.1007/s10803-012-1664-z. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
9. Kanner L. Autistic disturbances of affective contact. Acta Paedopsychiatr. 1968; 35 (4):100–136. [ PubMed ] [ Google Scholar ]
10. Gerhardt PF, Lainer I. Addressing the needs of adolescents and adults with autism: A crisis on the horizon. J Contemp Psychother. 2011; 41 (1):37–45. doi: 10.1007/s10879-010-9160-2. [ CrossRef ] [ Google Scholar ]
11. Schendel DE, Overgaard M, Christensen J, et al. Association of psychiatric and neurologic comorbidity with mortality among persons with autism spectrum disorder in a Danish population. JAMA Pediatr. 2016; 120 (3):243–250. [ PubMed ] [ Google Scholar ]
12. Howlin P, Goode S, Hutton J, et al. Adult outcome for children with autism. J Child Psychol Psychiatry. 2004; 45 (2):212–219. doi: 10.1111/j.1469-7610.2004.00215.x. [ PubMed ] [ CrossRef ] [ Google Scholar ]
13. Centers for Disease Control and Prevention. Autism spectrum disorder (ASD): Data & statistics[EB/OL]. (2016-07-11) [2016-12-02]. https://www.cdc.gov/ncbddd/autism/data.html .
14. Perou R, Bitsko RH, Blumberg SJ, et al. Mental health surveillance among children: United States, 2005-2011. MMWR Suppl. 2013; 62 (2):1–35. [ PubMed ] [ Google Scholar ]
15. Baxter AJ, Brugha TS, Erskine HE, et al. The epidemiology and global burden of autism spectrum disorders. Psychol Med. 2015; 45 (3):601–613. doi: 10.1017/S003329171400172X. [ PubMed ] [ CrossRef ] [ Google Scholar ]
16. Carroll D, Hallett V, McDougle CJ, et al. Examination of aggression and self-injury in children with autism spectrum disorders and serious behavioral problems. Child Adolesc Psychiatr Clin N Am. 2014; 23 (1):57–72. doi: 10.1016/j.chc.2013.08.002. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
17. Soke GN, Rosenberg SA, Hamman RF, et al. Factors associated with self-injurious behaviors in children with autism spectrum disorder: findings from two large national samples. J Autism Dev Disord. 2017; 47 (2):285–296. doi: 10.1007/s10803-016-2951-x. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
18. Mannion A, Leader G. Comorbidity in autism spectrum disorder: A literature review. Res Autism Spectr Disord. 2013; 7 (12):1595–1616. doi: 10.1016/j.rasd.2013.09.006. [ CrossRef ] [ Google Scholar ]
19. Doshi-Velez F, Ge Y, Kohane I. Comorbidity clusters in autism spectrum disorders: An electronic health record time-series analysis. Pediatrics. 2014; 133 (1):54–63. doi: 10.1542/peds.2013-0819. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
20. Davignon MN, Qian Y, Massolo M, et al. Psychiatric and medical conditions in transition-aged individuals with ASD. Pediatrics. 2018; 141 (Suppl 4):S335–S345. [ PubMed ] [ Google Scholar ]
21. Cochran DM, Dvir Y, Frazier JA. "Autism-plus" spectrum disorders: Intersection with psychosis and the schizophrenia spectrum. Child Adolesc Psychiatr Clin N Am. 2013; 22 (4):609–627. doi: 10.1016/j.chc.2013.04.005. [ PubMed ] [ CrossRef ] [ Google Scholar ]
22. Tsakanikos E, Sturmey P, Costello H, et al. Referral trends in mental health services for adults with intellectual disability and autism spectrum disorders. Autism. 2007; 11 (1):9–17. doi: 10.1177/1362361307070987. [ PubMed ] [ CrossRef ] [ Google Scholar ]
23. Stewart ME, Barnard L, Pearson J, et al. Presentation of depression in autism and Asperger syndrome: A review. Autism. 2006; 10 (1):103–116. doi: 10.1177/1362361306062013. [ PubMed ] [ CrossRef ] [ Google Scholar ]
24. Bolton PF, Carcani-Rathwell I, Hutton J, et al. Epilepsy in autism: Features and correlates. Br J Psychiatry. 2011; 198 (4):289–294. doi: 10.1192/bjp.bp.109.076877. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
25. Tuchman R, Cuccaro M, Alessandri M. Autism and epilepsy: Historical perspective. Brain Dev. 2010; 32 (9):709–718. doi: 10.1016/j.braindev.2010.04.008. [ PubMed ] [ CrossRef ] [ Google Scholar ]
26. Guinchat V, Cravero C, Diaz L, et al. Acute behavioral crises in psychiatric inpatients with autism spectrum disorder (ASD): Recognition of concomitant medical or non-ASD psychiatric conditions predicts enhanced improvement. Res Dev Disabil. 2015; 38 (3):242–255. [ PubMed ] [ Google Scholar ]
27. Leyfer OT, Folstein SE, Bacalman S, et al. Comorbid psychiatric disorders in children with autism: Interview development and rates of disorders. J Autism Dev Disord. 2006; 36 (7):849–861. doi: 10.1007/s10803-006-0123-0. [ PubMed ] [ CrossRef ] [ Google Scholar ]
28. Lundström S, Reichenberg A, Melke J, et al. Autism spectrum disorders and coexisting disorders in a nationwide Swedish twin study. J Child Psychol Psychiatry. 2015; 56 (6):702–710. doi: 10.1111/jcpp.12329. [ PubMed ] [ CrossRef ] [ Google Scholar ]
29. Nicolaidis C, Raymaker DM, Ashkenazy E, et al. "Respect the way I need to communicate with you": Healthcare experiences of adults on the autism spectrum. Autism. 2015; 19 (7):824–831. doi: 10.1177/1362361315576221. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
30. Raymaker DM, McDonald KE, Ashkenazy E, et al. Barriers to healthcare: Instrument development and comparison between autistic adults and adults with and without other disabilities. Autism. 2017; 21 (8):972–984. doi: 10.1177/1362361316661261. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
31. Buck TR, Viskochil J, Farley M, et al. Psychiatric comorbidity and medication use in adults with autism spectrum disorder. J Autism Dev Disord. 2014; 44 (12):3063–3071. doi: 10.1007/s10803-014-2170-2. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
32. Fortuna RJ, Robinson L, Smith TH, et al. Health conditions and functional status in adults with autism: a cross-sectional evaluation. J Gen Intern Med. 2015; 31 (1):77–84. [ PMC free article ] [ PubMed ] [ Google Scholar ]
33. van Heijst BF, Geurts HM. Quality of life in autism across the lifespan: A meta-analysis. Autism. 2015; 19 (2):158–167. doi: 10.1177/1362361313517053. [ PubMed ] [ CrossRef ] [ Google Scholar ]
34. Hirvikoski T, Mittendorfer-Rutz E, Boman M, et al. Premature mortality in autism spectrum disorder. Br J Psychiatry. 2016; 208 (3):232–238. doi: 10.1192/bjp.bp.114.160192. [ PubMed ] [ CrossRef ] [ Google Scholar ]
35. Bishop-Fitzpatrick L, Kind A. A scoping review of health disparities in autism spectrum disorder. J Autism Dev Disord. 2017; 47 (11):3380–3391. doi: 10.1007/s10803-017-3251-9. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
36. Pickett JA, Paculdo DR, Shavelle RM, et al. 1998-2002 update on "causes of death in autism". J Autism Dev Disord. 2006; 36 (2):287–288. doi: 10.1007/s10803-005-0066-x. [ PubMed ] [ CrossRef ] [ Google Scholar ]
37. Akobirshoev L, Mitra M, Dembo R, et al. In-hospital mortality among adults with autism spectrum disorder in the United States: A retrospective analysis of US hospital discharge data. Autism. 2020; 24 (1):1–13. [ PubMed ] [ Google Scholar ]
38. Isager T, Mouridsen SE, Rich B. Mortality and causes of death in pervasive developmental disorders. Autism. 1999; 3 (1):7–16. doi: 10.1177/1362361399003001002. [ CrossRef ] [ Google Scholar ]
39. Gillberg C, Billstedt E, Sundh V, et al. Mortality in autism: A prospective longitudinal community-based study. J Autism Dev Disord. 2010; 40 (3):352–357. doi: 10.1007/s10803-009-0883-4. [ PubMed ] [ CrossRef ] [ Google Scholar ]
40. Hwang YIJ, Srasuebkul P, Foley KR, et al. Mortality and cause of death of australians on the autism spectrum. Autism Res. 2019; 12 (5):806–815. doi: 10.1002/aur.2086. [ PubMed ] [ CrossRef ] [ Google Scholar ]
41. Jokiranta-Olkoniemi E, Gyllenberg D, Sucksdorff D, et al. Risk for premature mortality and intentional self-harm in autism spectrum disorders. J Autism Dev Disord. 2021; 51 (9):3098–3108. doi: 10.1007/s10803-020-04768-x. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
42. Hosking FJ, Carey IM, Shah SM, et al. Mortality among adults with intellectual disability in England: Comparisons with the general population. Am J Public Health. 2016; 106 (8):1483–1490. doi: 10.2105/AJPH.2016.303240. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
43. Smith GS, Fleming M, Kinnear D, et al. Mortality in 787 666 school pupils with and without autism: A cohort study. Autism. 2021; 25 (1):300–304. doi: 10.1177/1362361320944037. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
44. Kim KN, Yoo SM, Kang SC, et al. Mortality of children with autism spectrum disorder using data from a large-scale Korean national cohort. Yonsei Med J. 2021; 62 (10):943–947. doi: 10.3349/ymj.2021.62.10.943. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
45. Yoo SM, Kim KN, Kang SC, et al. Prevalence and premature mortality statistics of autism spectrum disorder among children in Korea: A nationwide population-based birth cohort study. J Korean Med Sci. 2022; 37 (1):e1. doi: 10.3346/jkms.2022.37.e1. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
46. World Health Organization . The ICD-10 classification of mental and behavioural disorders: Clinical descriptions and diagnostic guidelines. Geneva: World Health Organization; 1992. pp. 174–203. [ Google Scholar ]
47. Fombonne E. The epidemiology of autism: A review. Psychol Med. 1999; 29 (4):769–786. doi: 10.1017/S0033291799008508. [ PubMed ] [ CrossRef ] [ Google Scholar ]
48. Yeargin-Allsopp M, Rice C, Karapurkar T, et al. Prevalence of autism in a US metropolitan area. JAMA. 2003; 289 (1):49–55. doi: 10.1001/jama.289.1.49. [ PubMed ] [ CrossRef ] [ Google Scholar ]
49. Engel J. ILAE classification of epilepsy syndromes. Epilepsy Res. 2006; 70 (Suppl 1):S5–S10. [ PubMed ] [ Google Scholar ]
50. Forsgren L, Edvinsson S, Nystrom L, et al. Influence of epilepsy on mortality in mental retardation: An epidemiologic study. Epilepsia. 1996; 37 (10):956–963. doi: 10.1111/j.1528-1157.1996.tb00533.x. [ PubMed ] [ CrossRef ] [ Google Scholar ]
51. Neligan A, Bell G, Johnson A, et al. The long-term risk of premature mortality in people with epilepsy. Brain. 2011; 137 (Pt 2):388–389. [ PubMed ] [ Google Scholar ]
52. Smith DaWalt L, Hong J, Greenberg JS, et al. Mortality in individuals with autism spectrum disorder: Predictors over a 20-year period. Autism. 2019; 23 (7):1732–1739. doi: 10.1177/1362361319827412. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
53. Rosenberg RE, Law JK, Yenokyan G, et al. Characteristics and concordance of autism spectrum disorders among 277 twin pairs. Arch Pediatr Adolesc Med. 2009; 163 (10):907–914. doi: 10.1001/archpediatrics.2009.98. [ PubMed ] [ CrossRef ] [ Google Scholar ]
54. Zerbo O, Massolo ML, Qian Y, et al. A study of physician know-ledge and experience with autism in adults in a large integrated healthcare system. J Autism Dev Disord. 2015; 45 (12):4002–4014. doi: 10.1007/s10803-015-2579-2. [ PubMed ] [ CrossRef ] [ Google Scholar ]
55. Billstedt E, Gillberg C, Gillberg C. Autism after adolescence: Population-based 13- to 22-year follow-up study of 120 individuals with autism diagnosed in childhood. J Autism Dev Disord. 2005; 35 (3):351–360. doi: 10.1007/s10803-005-3302-5. [ PubMed ] [ CrossRef ] [ Google Scholar ]
56. Kobayashi R, Mutara T, Yoshinaga K. A follow-up study of 201 children with autism in Kyushu and Yamaguchi areas, Japan. J Autism Dev Disord. 1992; 22 (3):395–411. doi: 10.1007/BF01048242. [ PubMed ] [ CrossRef ] [ Google Scholar ]
57. Larsen FW, Mourdisen SE. The outcome in children with childhood autism and Asperger syndrome originally diagnosed as psychotic. Eur Child Adolesc Psychiatry. 1997; 6 (4):181–190. doi: 10.1007/BF00539924. [ PubMed ] [ CrossRef ] [ Google Scholar ]
58. Guan J, Li G. Injury mortality in individuals with autism. Am J Public Health. 2017; 107 (5):791–793. doi: 10.2105/AJPH.2017.303696. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
59. Cassidy S, Bradley P, Robinson J, et al. Suicidal ideation and suicide plans or attempts in adults with Asperger' s syndrome attending a specialist diagnostic clinic: A clinical cohort study. Lancet Psychiatry. 2014; 1 (2):142–147. doi: 10.1016/S2215-0366(14)70248-2. [ PubMed ] [ CrossRef ] [ Google Scholar ]
60. World Health Organization. Suicide[EB/OL]. (2021-06-17)[2021-12-11]. http://www.who.int/news-room/fact-sheets/detail/suicide .
61. Folch A, Cortés MJ, Salvador-Carulla L, et al. Risk factors and topographies for self-injurious behaviour in a sample of adults with intellectual developmental disorders. J Intellect Disabil Res. 2018; 62 (12):1018–1029. doi: 10.1111/jir.12487. [ PubMed ] [ CrossRef ] [ Google Scholar ]
62. Kõlves K, Fitzgerald C, Nordentoft M, et al. Assessment of suicidal behaviors among individuals with autism spectrum disorder in Denmark. JAMA Netw Open. 2021; 4 (1):e2033565. doi: 10.1001/jamanetworkopen.2020.33565. [ PubMed ] [ CrossRef ] [ Google Scholar ]
63. Veenstra-VanderWeele J. Recognizing the problem of suicidality in autism spectrum disorder. J Am Acad Child Adolesc Psychiatry. 2018; 57 (5):302–303. doi: 10.1016/j.jaac.2018.03.003. [ PubMed ] [ CrossRef ] [ Google Scholar ]
64. Chen MH, Pan TL, Lan WH, et al. Risk of suicide attempts among adolescents and young adults with autism spectrum disorder: A nationwide longitudinal follow-up study. J Clin Psychiatry. 2017; 78 (9):e1174–e1179. doi: 10.4088/JCP.16m11100. [ PubMed ] [ CrossRef ] [ Google Scholar ]
65. Kirby AV, Bakian AV, Zhang Y, et al. A 20-year study of suicide death in a statewide autism population. Autism Res. 2019; 12 (4):658–666. doi: 10.1002/aur.2076. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
66. Holopainen J, Helama S, Björkenstam C, et al. Variation and seasonal patterns of suicide mortality in Finland and Sweden since the 1750s. Environ Health Prev Med. 2013; 18 (6):494–501. doi: 10.1007/s12199-013-0348-4. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
67. Amitai M, Apter A. Social aspects of suicidal behavior and prevention in early life: A review. Int J Environ Res Public Health. 2012; 9 (3):985–994. doi: 10.3390/ijerph9030985. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
68. Chan KKS, Lam CB. Parental maltreatment of children with autism spectrum disorder: A developmental-ecological analysis. Res Autism Spect Dis. 2016; 32 (10):106–114. [ Google Scholar ]
69. Guan J, Blanchard A, Blanchard C, et al. Homicide incidents involving children with autism spectrum disorder as victims reported in US news media, 2000-2019. J Autism Dev Disord. 2022; 52 (4):1673–1677. doi: 10.1007/s10803-021-05065-x. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
70. Piven J, Palmer P. Psychiatric disorder and the broad autism phenotype: Evidence from a family study of multiple-incidence autism families. Am J Psychiatry. 1999; 156 (4):557–563. doi: 10.1176/ajp.156.4.557. [ PubMed ] [ CrossRef ] [ Google Scholar ]
71. Daniels JL, Forssen U, Hultman CM, et al. Parental psychiatric disorders associated with autism spectrum disorders in the off spring. Pediatrics. 2008; 121 (5):e1357–e1362. doi: 10.1542/peds.2007-2296. [ PubMed ] [ CrossRef ] [ Google Scholar ]
72. Hyman SL, Stewart PA, Schmidt B, et al. Nutrient intake from food in children with autism. Pediatrics. 2012; 130 (Suppl 2):S145–S153. [ PMC free article ] [ PubMed ] [ Google Scholar ]
73. Esbensen AJ, Greenberg JS, Seltzer MM, et al. A longitudinal investigation of psychotropic and non-psychotropic medication use among adolescents and adults with autism spectrum disorders. J Autism Dev Disord. 2009; 39 (9):1339–1349. doi: 10.1007/s10803-009-0750-3. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
74. Amiet C, Gourfinkel-An I, Laurent C, et al. Does epilepsy in multiplex autism pedigrees define a different subgroup in terms of clinical characteristics and genetic risk? Mol Autism. 2013; 4 (1):47. doi: 10.1186/2040-2392-4-47. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
75. Oquendo MA, Dragatsi D, Harkavy-Friedman J, et al. Protective factors against suicidal behavior in Latinos. J Nerv Ment Dis. 2005; 193 (7):438–443. doi: 10.1097/01.nmd.0000168262.06163.31. [ PubMed ] [ CrossRef ] [ Google Scholar ]
76. Hill CV, Pérez-Stable EJ, Anderson NA, et al. The national institute on aging health disparities research framework. Ethn Dis. 2015; 25 (3):245–254. doi: 10.18865/ed.25.3.245. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
77. Nadash P, Doty P, Mahoney KJ, et al. European long-term care programs: Lessons for community living assistance services and supports? Health Serv Res. 2011; 47 (1 Pt 1):309–328. [ PMC free article ] [ PubMed ] [ Google Scholar ]
Articles from Journal of Peking University (Health Sciences) are provided here courtesy of Editorial Office of Beijing Da Xue Xue Bao Yi Xue Ban, Peking University Health Science Center
 
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