Suicidal ideation and behavior among autistic, self-reported autistic, and non-autistic adults in Latin America

Suicidal ideation and behavior are recognized as major public-health concerns among autistic adults, yet almost all existing evidence comes from high-income, English-speaking countries. This study is the first multi-country investigation of lifetime suicidal ideation and behavior in confirmed autistic, adults who suspect they are autistic, and non-autistic adults across seven Latin American countries.

Using the culturally adapted Suicide Behaviors Questionnaire-Autism Spectrum Conditions (SBQ-ASC), a cross-sectional online survey was conducted through the Red Espectro Autista Latinoamérica(REAL) network. The final analytic sample comprised 1,083 adults classified as confirmed autistic (n = 387), adults who suspect they are autistic (n = 188), or non-autistic (n = 508).

Lifetime suicidality differed markedly across groups (all χ² p < 0.001): lifetime suicide attempt was reported by 22.5%, 14.0%, and 5.7% respectively. Confirmed autistic adults had 3.96- to 5.32-fold higher odds and adults who suspect they are autistic adults 3.44- to 4.93-fold higher odds of every lifetime outcome compared to non-autistic adults (all p < 0.001) in models adjusted for country of residence only. Past-12-month intense suicidal ideation was reported by 70.0%, 65.4%, and 33.1% respectively; adjusted odds ratios ranged from 2.72 to 5.08 (all p ≤ 0.01).

In this non-probability online sample recruited across several Latin American countries, both diagnosed autistic adults and adults who suspect they are autistic reported elevated, graded levels of suicidal ideation and behavior relative to non-autistic adults after adjusting for country of residence. These preliminary findings highlight the potential value of autism-informed suicide prevention and of expanding diagnostic and mental-health services in the region, and underscore the need for confirmatory research using representative samples and multivariable adjustment.