Co-occurring problems with mood and anxiety among adolescents and adults on the autism spectrum are highly prevalent and contribute to poor outcomes and diminished quality of life. The current study’s principal aim was to evaluate variation in the presentation of depression symptomatology among adolescents and adults with autism spectrum disorder, specifically to determine if social motivation may be implicated in an autism spectrum disorder–specific subtype of depression. A systematic review was conducted, with an initial search conducted in February 2018 and a search update conducted in November 2019, yielding 48 articles which met inclusion criteria. Results support other recent work indicating that symptoms of depression are highly prevalent among adolescents and adults with autism spectrum disorder. Coding of study variables related to core autism spectrum disorder symptoms provided initial evidence for the proposition of a conceptual model implicating social motivation in the etiology of depression among a subset of individuals with autism spectrum disorder. Lay abstract Many adolescents and adults with autism spectrum disorder experience difficulty with symptoms of depression. These symptoms can contribute to poor quality of life and lack of independence for adolescents and adults. To better understand these symptoms, we conducted a review of articles that examined the presentation of depression specific to autism spectrum disorder. Our goals in conducting this study were (1) to examine whether depression may be associated with symptoms that are common among people with autism spectrum disorder, such as loneliness or poor social motivation; (2) to determine whether people with autism spectrum disorder experience depression in a different way than the general population; and (3) to add to other recent studies that have examined how common depression is in autism spectrum disorder and how it is typically measured. Our study reviewed 48 papers on this topic. Results showed that a substantial proportion of people with autism spectrum disorder experience significant symptoms of depression. We related our results to social factors commonly studied in this field (i.e. social motivation) and proposed a new model for the development of depression in this population.
Quality of life in adolescents and adults with autism spectrum disorder: Results from a nationwide Danish survey using self-reports and parental proxy-reports
