Mental health disorders and suicide risk among autistic children, adolescents and adults: a population-based study using linked administrative data

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Singal, D., Enns, J. E., Friesen, K., Piroddi, N., Cameranesi, M., Lai, J., Nickel, N. C., Shooshtari, S., Zwaigenbaum, L., Brownell, M., & Hanlon-Dearman, A. (2026). Mental health disorders and suicide risk among autistic children, adolescents and adults: a population-based study using linked administrative data. The Lancet Regional Health - Americas, 60, 101505. https://doi.org/10.1016/j.lana.2026.101505

Publication date: 15 Jun 2026 Added to AutiHub: 22 Sep 2026 Type: Article Article language: English
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Authors

Publication authors
11
Publication authors identified as autistic
1 / 11 (9.1%)
  1. Deepa Singal
  2. Jennifer E. Enns
  3. Kevin Friesen
  4. Nicholas Piroddi *
  1. Margherita Cameranesi
  2. Jonathan Lai
  3. Nathan C. Nickel
  4. Shahin Shooshtari
  1. Lonnie Zwaigenbaum
  2. Marni Brownell
  3. Ana Hanlon-Dearman

Abstract

BACKGROUND: Autistic people face elevated mental health risks, yet few population-based studies have quantified these risks across developmental stages. We examined the prevalence and relative risk of physician-diagnosed mental health disorders and suicide attempts among autistic individuals in the province of Manitoba, Canada, using linked administrative health data. METHODS: We conducted a whole-population cohort study using provincial health records from 2018 to 2022. Autistic individuals were identified using a validated case definition and compared to all other Manitobans without autism. We assessed five-year prevalence and sex- and age-adjusted relative risks of attention-deficit hyperactivity disorder (ADHD), conduct disorder, mood/anxiety disorders, schizophrenia, substance use disorders, and suicide attempts across three age groups (6-12, 13-17, and 18-45 years) using regression models. FINDINGS: Autistic people had substantially higher prevalence of all examined mental health disorders (except substance use disorder) and significantly elevated relative risks across every age group we examined. Compared to non-autistic individuals, autistic people had higher risks of ADHD (age- and sex-adjusted relative risk [aRR] 5.24, 95% confidence interval [CI] 4.82-5.70), conduct disorder (aRR 5.96, 95% CI 4.61-7.70), mood/anxiety disorders (aRR 2.00, 95% CI 1.89-2.12), schizophrenia (aRR 9.82, 95% CI 8.94-10.78), and attempted suicide (aRR 3.14, 95% CI 2.31-4.27). The study cohort included n = 317,073 males and n = 314,261 females. Autistic males (n = 4523) had higher risk of being diagnosed with ADHD (aRR 1.39, 95% CI 1.35-1.43), conduct disorder (aRR 1.54, 95% CI 1.34-1.78), and schizophrenia (aRR 1.83, 95% CI 1.71-1.96), whereas autistic females (n = 1377) had higher risk of mood/anxiety disorders (aRR 1.96, 95% CI 1.87-2.00) and attempted suicide (aRR 2.22, 95% CI 2.00-2.44). INTERPRETATION: Autistic individuals experience disproportionate mental health challenges, including suicide risk, across their life course. These findings demonstrate the urgent need for sex-specific, autism-informed mental health strategies, early routine screening, and specialized clinical training to improve diagnostic assessment and care delivery in universal health systems. FUNDING: We gratefully acknowledge the support of the Azrieli Foundation, the National Centre for Autism Collaboration, the Autism Alliance of Canada, and the Canadian Institutes of Health Research.

Bibliography cited by this reference

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Cited bibliography overview

These indicators describe the bibliography cited by this publication. An author name is counted each time it appears in one cited reference, so the same person can be counted more than once. Names not yet linked to an author already present in AutiHub are treated as unknown, not as non-autistic. Last computed: 2 Oct 2026 01:40.

Cited references
36
With a DOI
25
Without a DOI, from raw bibliography text
11
3 / 36 (8.3%) cited references include at least one author identified as autistic.
References with data to complete
5 / 36 (13.9%)
References with detected author names
31 / 36 (86.1%)
Without detected author names
5
Without a structured title
0
Without a stable identifier
11
References with raw author names still to review
0
References with external metadata lookup issues
0
These indicators apply to cited references displayed on this page, after technical duplicates have been merged. A reference without a DOI can still support author statistics when a title and author names are available.
Author names detected in the cited bibliography
208
From DOI or external metadata
208
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
0
111 / 208 (53.4%) names are linked to an author already present in AutiHub. 97 / 208 (46.6%) names are not yet linked.
Names linked to a person identified as autistic
10 / 208 (4.8%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 10 / 111 (9.0%). Distinct people identified as autistic: 10 / 199 (5.0%).
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