Adults with autism spectrum disorders are less likely to receive individual talk therapy, but when they do, they make use of it more than adults without autism.
Using Medicaid data, Brenna B. Maddox, PhD, of the University of Pennsylvania, Philadelphia, and her colleagues presented the results of a study looking at treatment use by 268 adults with autism spectrum disorder (ASD) and 1,072 without, all of whom had depression or anxiety. They published their results in Research in Autism Spectrum Disorders.
Participants with ASD were less likely than those without ASD to receive either individual talk therapy (57.1% vs. 64.3%, P less than .05) or group talk therapy (0.7% vs. 2.9%, P less than .05). However, among those who did receive talk therapy, people with ASD had a significantly higher monthly mean number of visits than those without ASD (0.64 vs. 0.44, P less than .001).
“As predicted, adults with ASD and anxiety/depression were less likely to receive individual talk therapy, consistent with reports that they often experience difficulty accessing mental health services,” wrote Dr. Maddox and her colleagues.
The authors suggested the increased number of talk therapy visits by adults with ASD could reflect a need for more session time for those patients, compared with those without ASD. For example, cognitive-behavioral therapy programs are often adapted to ASD patients by increasing the number of sessions.
“An alternative explanation is that talk therapy in the community is less effective with adults with ASD, who therefore stay in therapy for a longer period in pursuit of greater symptom relief,” the authors wrote.
However, they also commented on the fact that both groups received less than one session a month and that it was unlikely that anxiety and depression symptoms would be well addressed with so few visits. “This finding highlights that the problem of limited access to mental health care is not exclusive to adults with ASD.”
Almost twice as many people with ASD used antipsychotics (39.6% vs. 21.5%, P less than .001) and stimulants (11.9% vs. 6.1%, P less than .001), compared with people without ASD. There were similar numbers of benzodiazepine and antidepressant users in both groups, but people with ASD were prescribed all medication types for a significantly higher number of days per month.
Those with ASD also were more likely to be prescribed different classes of medications at the same time. However, they also were less likely to show substance use.
Dr. Maddox and her colleagues cited several limitations. For example, the diagnosis of psychiatric and medical conditions was made using ICD-9 codes, and those conditions were not validated using clinical evaluation.
The study was supported by the National Institute of Mental Health. No conflicts of interest were declared.
SOURCE: Maddox BB et al. Res Autism Spectr Disord. 2018 Apr 11. doi: 10.1016/j.rasd.2018.03.009.