Autism, Intellectual Disability and Suicide Risk in Adolescent Psychiatric Emergencies: A Two-Year Retrospective...

Area of Science:

• Neuroscience
• Psychiatry
• Developmental Psychology

Background:

• Adolescents with neurodevelopmental disorders (NDDs), including autism spectrum disorder (ASD) and borderline intellectual functioning/intellectual disability (BIF/ID), present complex challenges in psychiatric emergency settings.
• The specific contributions of ASD and BIF/ID to acute psychopathology and suicide risk in this population remain unclear.

Purpose of the Study:

• To investigate how ASD and BIF/ID differentially affect clinical severity, psychopathological profiles, and suicidality in adolescents admitted to psychiatric emergencies.
• To compare high-functioning ASD, ASD with cognitive impairment, and adolescents without NDDs.

Main Methods:

• A retrospective, single-center cohort study of 206 adolescents (aged 11-17) admitted to a psychiatric emergency unit.
• Patients were stratified into: high-functioning ASD (ASD-HF), ASD with BIF/ID (ASD-BIF/ID), BIF/ID without ASD, and controls (N-ASD/N-BIF/ID).
• Standardized measures assessed clinical severity, functioning, diagnoses, adverse childhood experiences, emotional dysregulation, and suicidality.

Main Results:

• Adolescents with ASD-BIF/ID displayed the lowest global functioning.
• High-functioning ASD adolescents showed functioning comparable to controls.
• Suicidal ideation and behaviors were significantly more frequent in the ASD-HF group.
• BIF/ID was associated with greater behavioral impairment but lower suicidality.

Conclusions:

• ASD and BIF/ID appear to differentially influence psychiatric emergency presentations in adolescents.
• Adolescents with high-functioning ASD demonstrated an elevated prevalence of suicidality within this clinical context.
• Risk assessment for suicidality in adolescents requires adaptation to specific cognitive and diagnostic profiles, particularly for those with high-functioning ASD.