Diagnostic criteria for attention deficit hyperactivity disorder (ADHD) and autism have broadened and are common at estimated adult prevalences of 3%. This paper explores the incidence of autism and overlap of features in ADHD young adults transitioning from Child and Adolescents Mental Health Services (CAMHS) into a specialist adult ADHD service, and the utility of the Ritvo Autism Asperger Diagnostic Scale 14 (RAADS-14) assisting assessment and support planning.

This comparative cohort study included all young adult ADHD patients referred from CAMHS. A comprehensive assessment and diagnostic formulation, including RAADS-14 was completed. Those without a current autism diagnosis but clinical assessment suggested autism, underwent further assessment. Percentage of autistic and ADHD young adults was calculated. RAADS-14 total and subscale scores were compared between groups. Gender differences were assessed.

Co-occurrence of autism in a group of young adults diagnosed with ADHD was high (53%). High levels of autism features were evident in the ADHD only group. Significant differences in the RAADS-14 sub-scores (social anxiety, mentalizing and sensory sensitivities) were found between the autistic ADHD and non autistic ADHD groups. Autistic females scored higher on all domains of the RAADS-14 compared to males. Sensory sensitivities were significantly higher in females in both groups.

The level of co-occurrence of autism, and overlap of features, suggests employment of neurodevelopmental rather than single condition approaches to avoid mis-diagnosis/missed diagnoses. Sensory sensitivities are suggestive of neurodevelopmental differences particularly in females regardless of diagnostic category. The RAADS-14 may be helpful as part of screening and support planning.

1. (1) The intention of this paper is to support staff and service users within therapy in understanding the intersection of neurodivergence and gender diversity when working with adults.

2. (2) The first aim is to provide a provisional framework of understanding the overlap between being autistic and being transgender and gender diverse, where these two constructs intersect and where they are disparate.

3. (3) The second aim is to provide suggestions on how cognitive behavioural therapists, psychological therapists and psychologists may use this framework within psychological therapy to support neurodivergent transgender or gender diverse individuals.

Autistic traits have been associated with greater risk of childhood trauma and adulthood psychopathology. However, the role that childhood trauma plays in the association among autism, autistic traits, and depression in adulthood is poorly understood.

We used a UK-based birth cohort with genotype and phenotype data on autism, autistic traits, childhood trauma, and depression in up to 9,659 individuals prospectively followed up until age 28 years. Using mixed-effects growth-curve models, we assessed trajectories of depression symptoms over time according to autism diagnosis, autism polygenic score and trait measures, and explored whether these differed by trauma exposure. We further investigated the association between autism/autistic traits and depression in adulthood using confounder-adjusted logistic regression models and undertook mediation analyses to investigate the relationship with childhood trauma.

All autism variables demonstrated increased depressive symptom trajectories between ages 10 and 28 years. Social communication difficulties (SCDs) were most strongly associated with a depression diagnosis in adulthood (age 24 OR = 1.86; 95% CIs: 1.15–3.01). Trauma and autistic traits combined to further increase depression symptom scores. Mediation analyses provided evidence for direct pathways between autistic traits and increased risk of depression alongside indirect pathways through increased risk of trauma.

Autism/autistic traits increase the odds of experiencing childhood trauma and of being diagnosed with depression at ages 18 and 24. Depressive symptom trajectories emergent in childhood persist into adulthood. The combined effect of SCDs and childhood trauma is greater than the individual exposures, suggesting worse depression symptomatology following trauma in individuals with SCDs.

Emotion dysregulation is a transdiagnostic construct associated with multiple mental health conditions and shown to be an amenable target for treatment. The original Emotion Dysregulation Inventory (EDI) was created as a proxy-report measure validated in autistic and nonautistic youth. The goal of the current study was to develop a self-report version, the EDI-Self-Report (EDI-SR), that captures a first-person perspective and creates the option of multi-reporter measurement from adolescence through adulthood.

Using methods developed by the Patient-Reported Outcomes Measurement Information System (PROMIS), potential items and response options were written and tested in cognitive interviews. Two samples (996 participants who are autistic or have other intellectual and developmental disabilities and 1,000 participants selected to be representative of the US census as a nonclinical comparison group) completed the initial item pool. Items were assessed using exploratory and confirmatory factor analyses, item response theory analyses, concurrent calibrations, convergent correlations with comparable legacy measures, internal consistency reliability, and test–retest reliability.

Exploratory factor analyses suggested splitting Reactivity and Dysphoria items for confirmatory factor analyses and subsequent analyses. Following analyses, a 25-item Reactivity scale, a 7-item Dysphoria scale, and a 6-item Reactivity short-form scale were finalized. EDI-SR subscales showed convergent validity and superior total information when compared with similar measures, strong internal consistency reliability, and good test–retest reliability.

The EDI-SR provides an efficient, precise measure of ED in autistic individuals, individuals with other intellectual and developmental disabilities, and a US census-matched representative sample, and allows for multi-reporter assessment in clinical and research contexts.

This study investigated mental health diagnoses in autistic adults to determine whether there were any sex differences in presentation. Autistic adults attending the neurodevelopmental service at Surrey and Borders Partnership NHS Foundation Trust were included.

As part of a service audit, 150 random adults (75 males and females) were selected and their case notes were reviewed. Mental health diagnoses were common: 36% had current suicidal ideation, 20% had attempted suicide, 40% had a past or current diagnosis of anxiety and 62% had a past or current diagnosis of depression. There were more women diagnosed with an eating disorder (9% female, 0% male) and with a historical suicide attempt (21% female, 9% male). However, using a Holm–Bonferroni correction, there were no statistically significant sex differences between mental health diagnoses. Among both sexes, a significant number had been exposed to prenatal and early childhood trauma, nearly 10% had experienced physical trauma, abuse, neglect or assault, and nearly a third had been through parental separation.

This demonstrates that autistic people presenting to a National Health Service diagnostic clinic are more at risk of experiencing trauma, which subsequently increases their risk of mental illness, alongside any neurological predisposition.

Stigma towards individuals with mental, neurodevelopmental, and neurological conditions is associated with problems accessing healthcare (e.g. schizophrenia) and gaining employment (e.g. epilepsy). In Ireland, stigma differs towards different conditions, with previous research showing that schizophrenia is viewed more negatively than bipolar disorder or autism. More detailed understanding of stigma in Ireland requires replication of these findings in a larger, population-representative sample.

1,232 participants around Ireland completed a survey examining knowledge, attitudes, and behaviours towards schizophrenia, bipolar disorder, autism, and epilepsy as a comparator. Knowledge, attitudes, and behaviours towards these groups were compared using cumulative link mixed models.

Perception of others’ stigma and participants’ own self-reported behaviour were more negative towards schizophrenia compared to any of the other groups. Familiarity with mental health issues was associated with more positive self-reported behaviour towards those with schizophrenia. This improvement in behaviour was mediated by reduced perception of danger of this group. In contrast, greater mental health knowledge had no such impact on behaviour. Bipolar disorder was the second-most negatively perceived condition, followed by autism and epilepsy.

These findings support our recent pilot study and provide further evidence that stigma differs towards different conditions in Ireland, with Irish people perceiving more negative societal attitudes, and self-reporting more negative behaviour, towards schizophrenia. The finding that familiarity with schizophrenia predicted more positive behaviour and that this was mediated by reduced perception of danger suggests targets for future anti-stigma interventions.

Parental prenatal mood and anxiety disorders (PMADs) are linked to child neurodevelopmental disorders (NDDs), but evaluations of the magnitude and mechanisms of this association are limited. This study estimates the strength of the association and whether it is impacted by genetic and environmental factors.

A systematic search of PubMed, CENTRAL, PsycINFO, OVID, and Google Scholar was performed for articles published from January 1988 to September 2025. Of 2,420 articles screened, 74 met the inclusion criteria. Meta-analyses were conducted on 21 studies, and 53 were included in the narrative synthesis. We conducted random-effects meta-analyses, along with tests for heterogeneity (I2) and publication bias (Egger’s test). The review followed PRISMA and MOOSE guidelines.

Maternal PMADs were associated with a significantly increased risk of attention-deficit/hyperactivity disorder (ADHD; odds ratio [OR] 1.91, 95% confidence interval [CI] 1.45–2.52) and autism spectrum disorder (ASD; OR 1.75, 95% CI 1.43–2.14) in children. Paternal PMADs were also associated with the risk of NDDs, with combined odds for ASD and ADHD (OR = 1.23, 95% CI 1.14–1.33). Several studies suggested that the link between parental PMADs and offspring NDDs might be impacted by both genetic and environmental factors, including the impact of ongoing parental depression on child behavior.

Parental PMADs are associated with increased risk of NDDs in children. These findings likely reflect a combination of inherited liability and environmental processes; clarifying mechanisms will require genetically informed designs. Regardless of mechanism, offering optional, family-centered developmental support may help promote child well-being in families where a parent is experiencing PMADs.

Neurodivergence encompasses neurodevelopmental conditions including autism, attention-deficit hyperactivity disorder (ADHD) and Tourette syndrome. Particular physical traits, notably those linked to joint hypermobility, have an established association with both neurodivergence and bipolar affective disorder.

This case-control study tested, first, whether the presence of joint hypermobility predicted bipolar affective disorder and, secondly, whether neurodivergent characteristics were important in understanding this relationship.

Data were collected from 52 participants with self-reported clinical diagnoses of bipolar affective disorder and from a comparison group of 54 participants without diagnosis of bipolar affective disorder. All participants were assessed on screening instruments for autism (Ritvo Autism Asperger Diagnostic Scale; RAADS-R), ADHD (Wender Utah Rating Scale; WURS) and joint hypermobility. Group differences were explored, and odds ratios calculated for the presence of bipolar and neurodivergence given the presence of hypermobility. A mediation analysis was performed to determine the contribution of neurodivergent characteristics to the relationship between joint hypermobility and bipolar affective disorder.

The presence of joint hypermobility significantly predicted the presence of bipolar disorder (odds ratio 5.1; 95% CI = 2.1, 12.4). In the bipolar affective disorder group, the prevalence of likely autism and ADHD was greater (84.6 and 65.4% respectively) than in the comparison group (22.2 and 3.7% respectively). The odds ratio for a diagnosis of bipolar affective disorder was 18.2 (95% CI = (6.70, 49.41)) in those meeting the threshold for likely autism; and 46.89 (95% CI = 9.96, 220.74) in participants meeting the threshold for likely ADHD. Mediation analysis showed that autistic, ADHD and pooled neurodivergent characteristics mediated the link between joint hypermobility and bipolar affective disorder.

This suggests a potential mechanism for affective pathophysiology, through developmental characteristics associated with joint hypermobility. The appreciation of interacting physical and neurodivergent traits to the expression of psychiatric illness has implications for diagnostic formulation, personalised medicine and service design.