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    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.
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Premature mortality in autism spectrum disorder

  • Tatja Hirvikoski (a1), Ellenor Mittendorfer-Rutz (a2), Marcus Boman (a3), Henrik Larsson (a3), Paul Lichtenstein (a3) and Sven Bölte (a4)...
Abstract
Background

Mortality has been suggested to be increased in autism spectrum disorder (ASD).

Aims

To examine both all-cause and cause-specific mortality in ASD, as well as investigate moderating role of gender and intellectual ability.

Method

Odds ratios (ORs) were calculated for a population-based cohort of ASD probands (n = 27 122, diagnosed between 1987 and 2009) compared with gender-, age- and county of residence-matched controls (n = 2 672 185).

Results

During the observed period, 24 358 (0.91%) individuals in the general population died, whereas the corresponding figure for individuals with ASD was 706 (2.60%; OR = 2.56; 95% CI 2.38–2.76). Cause-specific analyses showed elevated mortality in ASD for almost all analysed diagnostic categories. Mortality and patterns for cause-specific mortality were partly moderated by gender and general intellectual ability.

Conclusions

Premature mortality was markedly increased in ASD owing to a multitude of medical conditions.

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Copyright
COPYRIGHT: © Royal College of Psychiatrists, 2016 
Corresponding author
Tatja Hirvikoski, PhD/Neuropsychologist, Center for Neurodevelopmental Disorders at Karolinska Institutet (KIND), CAP Research Center, Gävlegatan 22B, SE-11330 Stockholm, Sweden. Email: Tatja.Hirvikoski@ki.se
Footnotes
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Declaration of interest

None.

Footnotes
References
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1 Billstedt, E, Gillberg, IC, 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: 351–60.
2 Howlin, P, Moss, P, Savage, S, Rutter, M. Social outcomes in mid- to later adulthood among individuals diagnosed with autism and average nonverbal IQ as children. J Am Acad Child Adolesc Psychiatry 2013; 52: 572–81.
3 Pinborough-Zimmerman, J, Bakian, AV, Fombonne, E, Bilder, D, Taylor, J, McMahon, WM. Changes in the administrative prevalence of autism spectrum disorders: contribution of special education and health from 2002–2008. J Autism Dev Disord 2012; 42: 521–30.
4 Wazana, A, Bresnahan, M, Kline, J. The autism epidemic: fact or artifact? J Am Acad Child Adolesc Psychiatry 2007; 46: 721–30.
5 Cederlund, M, Hagberg, B, Billstedt, E, Gillberg, IC, Gillberg, C. Asperger syndrome and autism: a comparative longitudinal follow-up study more than 5 years after original diagnosis. J Autism Dev Disord 2008; 38: 72–85.
6 Howlin, P, Goode, S, Hutton, J, Rutter, M. Adult outcome for children with autism. J Child Psychol Psychiatry 2004; 45: 212–29.
7 Gillberg, C, Steffenburg, S. Outcome and prognostic factors in infantile autism and similar conditions: a population-based study of 46 cases followed through puberty. J Autism Dev Disord 1987; 17: 273–87.
8 Bölte, S, de Schipper, E, Robison, JE, Wong, VC, Selb, M, Singhal, N, et al. Classification of functioning and impairment: the development of ICF core sets for autism spectrum disorder. Autism Res 2014; 7: 167–72.
9 Caamano, M, Boada, L, Merchan-Naranjo, J, Moreno, C, Llorente, C, Moreno, D, et al. Psychopathology in children and adolescents with ASD without mental retardation. J Autism Dev Disord 2013; 43: 2442–9.
10 Hofvander, B, Delorme, R, Chaste, P, Nyden, A, Wentz, E, Stahlberg, O, et al. Psychiatric and psychosocial problems in adults with normal-intelligence autism spectrum disorders. BMC Psychiatry 2009; 9: 35.
11 Lichtenstein, P, Carlstrom, E, Rastam, M, Gillberg, C, Anckarsater, H. The genetics of autism spectrum disorders and related neuropsychiatric disorders in childhood. Am J Psychiatry 2010; 167: 1357–63.
12 Lugnegard, T, Hallerback, MU, Gillberg, C. Psychiatric comorbidity in young adults with a clinical diagnosis of Asperger syndrome. Res Dev Disabil 2011; 32: 1910–7.
13 Skokauskas, N, Gallagher, L. Psychosis, affective disorders and anxiety in autistic spectrum disorder: prevalence and nosological considerations. Psychopathology 2010; 43: 8–16.
14 Persico, AM, Napolioni, V. Autism genetics. Behav Brain Res 2013; 251: 95–112.
15 Gillberg, C, Billstedt, E, Sundh, V, Gillberg, IC. Mortality in autism: a prospective longitudinal community-based study. J Autism Dev Disord 2010; 40: 352–7.
16 Isager, T, Mouridsen, SE, Rich, B. Mortality and causes of death in pervasive developmental disorders. Autism 1999; 3: 7–16.
17 Mouridsen, SE, Bronnum-Hansen, H, Rich, B, Isager, T. Mortality and causes of death in autism spectrum disorders: an update. Autism 2008; 12: 403–14.
18 Pickett, JA, Paculdo, DR, Shavelle, RM, Strauss, DJ. 1998–2002 update on Causes of death in autism. J Autism Dev Disord 2006; 36: 287–8.
19 Shavelle, RM, Strauss, DJ, Pickett, J. Causes of death in autism. J Autism Dev Disord 2001; 31: 569–76.
20 Bilder, D, Botts, EL, Smith, KR, Pimentel, R, Farley, M, Viskochil, J, 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: 1196–204.
21 Woolfenden, S, Sarkozy, V, Ridley, G, Coory, M, Williams, K. A systematic review of two outcomes in autism spectrum disorder – epilepsy and mortality. Dev Med Child Neurol 2012; 54: 306–12.
22 Idring, S, Rai, D, Dal, H, Dalman, C, Sturm, H, Zander, E, et al. Autism spectrum disorders in the Stockholm Youth Cohort: design, prevalence and validity. PLoS ONE 2012; 7: e41280.
23 World Health Organization. ICD-9: International Statistical Classification of Diseases and Related Health Problems. WHO, 1978.
24 World Health Organization. ICD-10: The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. WHO, 1992.
25 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th edn (DSM-5). APA, 2013.
26 Idring, S, Magnusson, C, Lundberg, M, Ek, M, Rai, D, Svensson, AC, et al. Parental age and the risk of autism spectrum disorders: findings from a Swedish population-based cohort. Int J Epidemiol 2014; 43: 107–15.
27 Magnusson, C, Rai, D, Goodman, A, Lundberg, M, Idring, S, Svensson, A, et al. Migration and autism spectrum disorder: population-based study. Br J Psychiatry 2012; 201: 109–15.
28 Lager, A, Berlin, M, Heimerson, I, Danielsson, M. Young people's health: Health in Sweden: The National Public Health Report 2012. Chapter 3. Scand J Public Health 2012; 40: 42–71.
29 Mittendorfer-Rutz, E, Rasmussen, F, Wasserman, D. Restricted fetal growth and adverse maternal psychosocial and socioeconomic conditions as risk factors for suicidal behaviour of offspring: a cohort study. Lancet 2004; 364: 1135–40.
30 Baxter, AJ, Brugha, TS, Erskine, HE, Scheurer, RW, Vos, T, Scott, JG. The epidemiology and global burden of autism spectrum disorders. In Psychol Med 2014: 11: 1–13.
31 Cassidy, S, Bradley, P, Robinson, J, Allison, C, McHugh, M, Baron-Cohen, S. 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: 142–7.
32 Fowler, JC. Suicide risk assessment in clinical practice: pragmatic guidelines for imperfect assessments. Psychotherapy 2012; 49: 81–90.
33 Oquendo, MA, Dragatsi, D, Harkavy-Friedman, J, Dervic, K, Currier, D, Burke, AK, et al. Protective factors against suicidal behavior in Latinos. J Nerv Ment Dis 2005; 193: 438–43.
34 Chioqueta, AP, Stiles, TC. The relationship between psychological buffers, hopelessness, and suicidal ideation: identification of protective factors. Crisis 2007; 28: 67–73.
35 Bjorkenstam, E, Ljung, R, Burstrom, B, Mittendorfer-Rutz, E, Hallqvist, J, Weitoft, GR. Quality of medical care and excess mortality in psychiatric patients – a nationwide register-based study in Sweden. BMJ Open 2012; 2: e000778.
36 Rutstein, DD, Berenberg, W, Chalmers, TC, Child, CG III, Fishman, AP, Perrin, EB. Measuring the quality of medical care. A clinical method. N Engl J Med 1976; 294: 582–8.
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  • Cited by 56
  • Cited by
    Crossref Citations
    Crossref logo
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.
    Isaksson, Johan Tammimies, Kristiina Neufeld, Janina Cauvet, Élodie Lundin, Karl Buitelaar, Jan K. Loth, Eva Murphy, Declan G. M. Spooren, Will and Bölte, Sven 2018. EU-AIMS Longitudinal European Autism Project (LEAP): the autism twin cohort. Molecular Autism, Vol. 9, Issue. 1,
    Jokinen, J. Talbäck, M. Feychting, M. Ahlbom, A. and Ljung, R. 2018. Life expectancy after the first suicide attempt. Acta Psychiatrica Scandinavica, Vol. 137, Issue. 4, p. 287.
    Culpin, Iryna Mars, Becky Pearson, Rebecca M. Golding, Jean Heron, Jon Bubak, Isidora Carpenter, Peter Magnusson, Cecilia Gunnell, David and Rai, Dheeraj 2018. Autistic Traits and Suicidal Thoughts, Plans, and Self-Harm in Late Adolescence: Population-Based Cohort Study. Journal of the American Academy of Child & Adolescent Psychiatry, Vol. 57, Issue. 5, p. 313.
    Nicolaidis, Christina 2018. The New Home for Our Emerging Field. Autism in Adulthood: Knowledge, Practice, and Policy,
    Crane, Laura Adams, Fern Harper, Georgia Welch, Jack and Pellicano, Elizabeth 2018. ‘Something needs to change’: Mental health experiences of young autistic adults in England. Autism, p. 136236131875704.
    Sancar, Nuriye and Inan, Deniz 2018. A novel method as a diagnostic tool for the detection of influential observations in the Cox proportional hazards model. Quality & Quantity,
    Kourti, Marianthi and MacLeod, Andrea 2018. “I Don't Feel Like a Gender, I Feel Like Myself”: Autistic Individuals Raised as Girls Exploring Gender Identity. Autism in Adulthood: Knowledge, Practice, and Policy,
    Hwang, Ye In Foley, Kitty-Rose and Trollor, Julian N. 2018. Aging Well on the Autism Spectrum: An Examination of the Dominant Model of Successful Aging. Journal of Autism and Developmental Disorders,
    Hedley, Darren Uljarević, Mirko Wilmot, Mathilda Richdale, Amanda and Dissanayake, Cheryl 2018. Understanding depression and thoughts of self-harm in autism: A potential mechanism involving loneliness. Research in Autism Spectrum Disorders, Vol. 46, Issue. , p. 1.
    Bachmann, Christian J Gerste, Bettina and Hoffmann, Falk 2018. Diagnoses of autism spectrum disorders in Germany: Time trends in administrative prevalence and diagnostic stability. Autism, Vol. 22, Issue. 3, p. 283.
    Koffer Miller, Kaitlin H Mathew, Mary Nonnemacher, Stacy L and Shea, Lindsay L 2018. Program experiences of adults with autism, their families, and providers: Findings from a focus group study. Autism, Vol. 22, Issue. 3, p. 345.
    Cassidy, S.A. Bradley, L. Bowen, E. Wigham, S. and Rodgers, J. 2018. Measurement properties of tools used to assess suicidality in autistic and general population adults: A systematic review. Clinical Psychology Review, Vol. 62, Issue. , p. 56.
    Eklund, Hanna Findon, James Cadman, Tim Hayward, Hannah Murphy, Declan Asherson, Philip Glaser, Karen and Xenitidis, Kiriakos 2018. Needs of Adolescents and Young Adults with Neurodevelopmental Disorders: Comparisons of Young People and Parent Perspectives. Journal of Autism and Developmental Disorders, Vol. 48, Issue. 1, p. 83.
    Cassidy, S. A. Bradley, L. Bowen, E. Wigham, S. and Rodgers, J. 2018. Measurement properties of tools used to assess depression in adults with and without autism spectrum conditions: A systematic review. Autism Research, Vol. 11, Issue. 5, p. 738.
    Bölte, Sven Mahdi, Soheil de Vries, Petrus J Granlund, Mats Robison, John E. Shulman, Cory Swedo, Susan Tonge, Bruce Wong, Virginia Zwaigenbaum, Lonnie Segerer, Wolfgang and Selb, Melissa 2018. The Gestalt of functioning in autism spectrum disorder: Results of the international conference to develop final consensus International Classification of Functioning, Disability and Health core sets. Autism, p. 136236131875552.
    Baker-Ericzén, Mary J Brookman-Frazee, Lauren and Brodkin, Edward S 2018. Accelerating research on treatment and services for transition age youth and adults on the autism spectrum. Autism, Vol. 22, Issue. 1, p. 2.
    Hedley, Darren and Uljarević, Mirko 2018. Systematic Review of Suicide in Autism Spectrum Disorder: Current Trends and Implications. Current Developmental Disorders Reports, Vol. 5, Issue. 1, p. 65.
    Flygare Wallén, E. Ljunggren, G. Carlsson, A. C. Pettersson, D. and Wändell, P. 2018. High prevalence of diabetes mellitus, hypertension and obesity among persons with a recorded diagnosis of intellectual disability or autism spectrum disorder. Journal of Intellectual Disability Research, Vol. 62, Issue. 4, p. 269.
    Mahdi, Soheil Albertowski, Katja Almodayfer, Omar Arsenopoulou, Vaia Carucci, Sara Dias, José Carlos Khalil, Mohammad Knüppel, Ane Langmann, Anika Lauritsen, Marlene Briciet da Cunha, Graccielle Rodrigues Uchiyama, Tokio Wolff, Nicole Selb, Melissa Granlund, Mats de Vries, Petrus J. Zwaigenbaum, Lonnie and Bölte, Sven 2018. An International Clinical Study of Ability and Disability in Autism Spectrum Disorder Using the WHO-ICF Framework. Journal of Autism and Developmental Disorders, Vol. 48, Issue. 6, p. 2148.
    Hedley, Darren Uljarević, Mirko Foley, Kitty-Rose Richdale, Amanda and Trollor, Julian 2018. Risk and protective factors underlying depression and suicidal ideation in Autism Spectrum Disorder. Depression and Anxiety,
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Premature mortality in autism spectrum disorder

  • Tatja Hirvikoski (a1), Ellenor Mittendorfer-Rutz (a2), Marcus Boman (a3), Henrik Larsson (a3), Paul Lichtenstein (a3) and Sven Bölte (a4)...
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