Major changes discovered in medical profiles of adults diagnosed with autism since 2010
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The medical profiles of adults diagnosed with autism have changed since 2010, finds a study of medical records in the U.K. and Sweden, published in the online journal BMJ Mental Health.
There's been a pronounced shift from a prior diagnosis of epilepsy, psychosis and intellectual disability to ADHD (attention deficit hyperactivity disorder), anxiety and depression since 2010, the data analysis indicates.
And the steepest rise in diagnoses has been among 16–20-year-olds, females and those of white ethnic background.
The number of people being diagnosed with autism has increased worldwide in recent decades, although it's not entirely clear if this has been driven by greater public awareness, reduced stigma or changes in diagnostic practice, say the researchers.
To explore this further, the researchers studied U.K. primary care records up to 2023 (CPRD Aurum; 47,413,279 patients from 1,784 general practices) and Swedish population-wide registry data (13,345,950 people) up to 2021 to look at trends over time.
They particularly wanted to find out if the social and demographic patterns of incident and prevalent autism diagnoses in adults, and the prevalence of other concurrent neuropsychiatric conditions, have changed over time. They also wanted to know if these trends are consistent in direction and magnitude across both the U.K. and Sweden.
Eligibility criteria included study entry on Jan. 1, 2010, age 16 and, in the U.K., at least one year registered at a general practice. Monitoring ended at death, ceasing to be registered at a general practice (U.K.), emigration (Sweden) or study end date (Dec. 31, 2023, in the U.K. and Dec. 31, 2021, in Sweden), whichever came first.
The data were analyzed for each person's first recorded diagnosis of autism; intellectual disability; ADHD; epilepsy; migraines/headaches; anxiety; depression; psychosis; bipolar disorders; obsessive-compulsive disorder and related conditions; stress-related conditions (including post-traumatic stress disorder); eating disorders; personality disorders; suicidality/self-harm; sleep disorders; and chronic fatigue.
First recorded prescriptions (U.K.) or dispensations (Sweden) of antipsychotics; antidepressants; antiseizure medications; opioids; gabapentinoids; melatonin; and benzodiazepines/z-drugs (sedatives) were also noted.
In the U.K., 24,537,039 adults contributed to the study, 141,119 of whom had been diagnosed with autism. In Sweden, 9,096,874 adults contributed, 100,817 of whom had been diagnosed with autism.
Incident (first recorded) autism diagnoses in adults were consistently higher in Sweden than in the U.K., but the number of new cases rose sharply in the U.K. after 2020.
In the U.K., rates of new diagnoses increased from 6/100,000 people in 2010 to 64 in 2023. In Sweden, they rose from 43/100,000 people in 2010 to 65 in 2021.
New diagnoses increased fastest for 16–20-year-olds in both nations, rising from 31/100,000 people in 2010 in the U.K. to 364 in 2023, and from 165/100,000 people in 2010 in Sweden to 361 in 2021.
New diagnoses also rose fastest in females in both nations, as well as in people of white ethnicity in the U.K. and those with Swedish-born parents in Sweden.
In both countries, age-standardized prevalence was consistently higher for males than females, increasing in both sexes over the study period to 1.4% for males and 0.7% for females in the U.K. in 2023, and to 1.8% for males and 1.2% for females in Sweden in 2021.
Prevalence also increased over time in all age groups and was consistently higher in younger age groups. The prevalence of autism among 16–20-year-olds was 4.1% in 2023 in the U.K. and in Sweden in 2021.
Over time, the proportion of adults with autism who had a prior diagnosis of epilepsy, psychosis and/or intellectual disability fell while the proportion of those with a prior diagnosis of ADHD, anxiety, depression and other mental illnesses increased.
For example, in the U.K. between 2010 and 2023, a history of epilepsy among adults newly diagnosed with autism fell from 10% to 4%, while a history of anxiety rose from 29% to just over 58%. Trends were broadly consistent between both sexes.
This is an observational study, and as such, can't establish the reasons for the observed changes in the profiles of those diagnosed with autism.
But the researchers point out: "The characteristics of individuals diagnosed as autistic have changed dramatically since 2010 in both the U.K. and Sweden."
And they conclude: "While these data are unable to shed light on whether these changes indicate greater appreciation of nuanced forms of autism, or misdiagnoses of other psychiatric presentations as autism, efforts will need to be made to recognize and address the needs with appropriate support."
Publication details
Changes in the profile of adults diagnosed as autistic since 2010: population-based studies in the UK and Sweden, BMJ Mental Health (2026). DOI: 10.1136/bmjment-2026-302983
Journal information: BMJ Mental Health
Key medical concepts
Autism Spectrum DisorderAnxietyEpilepsyAttention Deficit Hyperactivity Disorder
Clinical categories
PsychiatryPsychology & Mental healthPediatricsChildren's health Provided by British Medical Journal Who's behind this story?
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