Disproportionate mental health risks in autistic females: A rapid review with quantitative and narrative syntheses

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Lacroix, A., Tzang, C. C., Yu, J., Jacob, B. K., Alexandrovsky, M., Winge-Breen, A., Rodak, T., & Lai, M. C. (2025). Disproportionate mental health risks in autistic females: A rapid review with quantitative and narrative syntheses. Frontiers in Neuroendocrinology, 80, 101229. https://doi.org/10.1016/j.yfrne.2025.101229

Publication date: 14 Dec 2025 Added to AutiHub: 4 Jul 2026 Type: Article Article language: English
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Authors

Publication authors
8
Publication authors identified as autistic
2 / 8 (25.0%)
  1. Adeline Lacroix *
  2. Chih-Chen Tzang
  3. Jiakun Yu
  4. Benjamin Koshy Jacob
  1. Mishel Alexandrovsky *
  2. Anna Winge-Breen
  3. Terri Rodak
  4. Meng-Chuan Lai

Abstract

Mental health conditions are highly prevalent among autistic people, but an updated synthesis of sex-stratified prevalence data, contributing factors, and support strategies is lacking.To address this knowledge gap, we conducted a rapid review utilizing PRISMA-ScR guidelines. MEDLINE, CINAHL, and PsycINFO databases were searched for studies (2004-2024) including female participants with a clinical autism diagnosis, and with a focus on mental health. Of 8,420 records screened, 218 met inclusion criteria. An exploratory quantitative synthesis of population-based and registry-based studies revealed higher rates of mental health conditions in autistic females than males for anxiety, mood, eating, obsessive-compulsive, psychotic, and personality disorders. Narrative synthesis identified moderating factors, including sex-related physiology, gendered experiences, age, age at autism diagnosis, autism characteristics, and co-occurring conditions. Biological and social mechanisms likely interact as contributing factors. Severe consequences of poor mental health underscore the need for tailored approaches accounting for the specific profiles of autistic females.

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Bibliography inclusion overview

These indicators describe the cited bibliography imported for this publication. Cited-reference metrics use the cited-reference total as denominator. Cited-author metrics state whether they use all cited-author occurrences or only occurrences linked to authors already integrated in the AutiHub database. They use cached links between cited authors and authors integrated in the AutiHub database. Last computed: 16 Aug 2026 11:30.

Cited references
270
Total cited references integrated for this publication.
Cited references with an identified autistic author
14 / 270 (5.2%)
Cited author occurrences identified as autistic
24 / 1441 (1.7%)
Among occurrences linked to AutiHub author records: 24 / 421 (5.7%). Distinct cited authors identified as autistic: 19 / 1157 (1.6%).
Cited author occurrences linked to AutiHub author records
421 / 1441 (29.2%)
Distinct linked cited authors: 235 / 1157 (20.3%)
Linked cited-author occurrences not identified as autistic
397 / 421 (94.3%)
Among linked cited-author occurrences only. Across all cited-author occurrences: 397 / 1441 (27.6%). Distinct linked cited authors not identified as autistic: 216 / 235 (91.9%).
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