Santé mentale chez les adultes autistes : revue rapide de la prévalence des troubles psychiatriques et revue parapluie de l’efficacité des interventions dans une perspective tenant compte de la neurodiversité

Titre original en anglais : Mental health in autistic adults: A rapid review of prevalence of psychiatric disorders and umbrella review of the effectiveness of interventions within a neurodiversity informed perspective

Cette publication est incluse dans le projet « Contributions académiques de personnes autistes sur l’autisme ». un auteur·ice de cette publication est identifié·e comme autiste dans le projet.

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Curnow, E., Rutherford, M., Maciver, D., Johnston, L., Prior, S., Boilson, M., Shah, P., Jenkins, N., & Meff, T. (2023). Mental health in autistic adults: A rapid review of prevalence of psychiatric disorders and umbrella review of the effectiveness of interventions within a neurodiversity informed perspective. PLOS ONE, 18(7), e0288275. https://doi.org/10.1371/journal.pone.0288275

Date de publication: 13/07/2023 Ajout dans AutiHub: 04/10/2026 Type: Article Langue de l’article: Anglais
Source éditeur (DOI) Texte intégral Source OpenAlex

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Auteurs

Auteur·ices des publications
9
Auteur·ices de la publication identifié·es comme autistes
1 / 9 (11,1 %)
  1. Eleanor Curnow
  2. Marion Rutherford
  3. Donald Maciver
  4. Lorna Johnston
  5. Susan Prior
  1. Marie Boilson
  2. Premal Shah
  3. Natalie Jenkins *
  4. Tamsin Meff

Résumé

Contexte Les adultes autistes présentent un risque élevé de mauvaise santé mentale et certaines interventions disponibles ont été associées à une augmentation des diagnostics psychiatriques. Comprendre la prévalence des diagnostics psychiatriques est important pour orienter l’élaboration de traitements et de soutiens individualisés pour les adultes autistes, qui ont été identifiés comme une priorité de recherche par la communauté autiste. Les interventions doivent être évaluées à la fois en termes d’efficacité et de leur acceptabilité pour la communauté autiste. Objectif Cette revue rapide a identifié la prévalence des troubles psychiatriques chez les adultes autistes, puis des revues systématiques d’interventions visant à soutenir les adultes autistes ont été examinées. Une revue rapide des études de prévalence a été menée parallèlement à une revue parapluie des interventions. Les lignes directrices Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) ont été suivies, y compris l’enregistrement du protocole (PROSPERO#CRD42021283570). Sources de données MEDLINE, CINAHL, PsycINFO et Cochrane Database of Systematic Reviews. Critères d’éligibilité des études Langue anglaise ; publiées entre 2011 et 2022 ; études primaires décrivant la prévalence d’affections psychiatriques chez les adultes autistes ; ou revues systématiques évaluant des interventions destinées aux adultes autistes. Évaluation et synthèse Le biais a été évalué à l’aide du Prevalence Critical Appraisal Instrument et d’AMSTAR2. La prévalence a été regroupée selon le diagnostic psychiatrique. Les interventions ont été regroupées en thérapies pharmacologiques, liées à l’emploi, psychologiques ou mixtes. Le niveau de preuve des interventions a été évalué à l’aide de GRADE (Grading of Recommendations, Assessment, Development and Evaluation). Des chercheurs autistes de l’équipe ont soutenu l’interprétation. Résultats Vingt études de prévalence ont été identifiées. Bon nombre incluaient de petits effectifs ou ne comparaient pas leur groupe d’échantillon à la population générale, réduisant la validité. La prévalence des diagnostics psychiatriques était variable, la prévalence de tout diagnostic psychiatrique allant de 15,4 % à 79 %. L’hétérogénéité était associée à l’âge, à la méthode diagnostique, aux méthodes d’échantillonnage et au pays. Trente-deux revues systématiques d’interventions ont été identifiées. Quatre revues étaient de haute qualité, quatre étaient modérées, cinq étaient faibles et dix-neuf étaient d’un niveau critique faible, ce qui indiquait un biais. Après synthèse, aucune intervention n’a été jugée « fondée sur des preuves ». L’acceptabilité des interventions pour les adultes autistes et les priorités des adultes autistes n’étaient souvent pas prises en compte. Conclusions Il existe une certaine compréhension de l’ampleur de la mauvaise santé mentale dans l’autisme, mais les interventions ne sont pas adaptées aux besoins des adultes autistes, ne sont pas fondées sur des preuves et peuvent se concentrer sur la promotion de comportements neurotypiques plutôt que sur les priorités des personnes autistes.

Background Autistic adults have high risk of mental ill-health and some available interventions have been associated with increased psychiatric diagnoses. Understanding prevalence of psychiatric diagnoses is important to inform the development of individualised treatment and support for autistic adults which have been identified as a research priority by the autistic community. Interventions require to be evaluated both in terms of effectiveness and regarding their acceptability to the autistic community. Objective This rapid review identified the prevalence of psychiatric disorders in autistic adults, then systematic reviews of interventions aimed at supporting autistic adults were examined. A rapid review of prevalence studies was completed concurrently with an umbrella review of interventions. Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were followed, including protocol registration (PROSPERO#CRD42021283570). Data sources MEDLINE, CINAHL, PsycINFO, and Cochrane Database of Systematic Reviews. Study eligibility criteria English language; published 2011–2022; primary studies describing prevalence of psychiatric conditions in autistic adults; or systematic reviews evaluating interventions for autistic adults. Appraisal and synthesis Bias was assessed using the Prevalence Critical Appraisal Instrument and AMSTAR2. Prevalence was grouped according to psychiatric diagnosis. Interventions were grouped into pharmacological, employment, psychological or mixed therapies. Strength of evidence for interventions was assessed using GRADE (Grading of Recommendations, Assessment, Development and Evaluation). Autistic researchers within the team supported interpretation. Results Twenty prevalence studies were identified. Many included small sample sizes or failed to compare their sample group with the general population reducing validity. Prevalence of psychiatric diagnoses was variable with prevalence of any psychiatric diagnosis ranging from 15.4% to 79%. Heterogeneity was associated with age, diagnosis method, sampling methods, and country. Thirty-two systematic reviews of interventions were identified. Four reviews were high quality, four were moderate, five were low and nineteen critically low, indicating bias. Following synthesis, no intervention was rated as ‘evidence based.’ Acceptability of interventions to autistic adults and priorities of autistic adults were often not considered. Conclusions There is some understanding of the scope of mental ill-health in autism, but interventions are not tailored to the needs of autistic adults, not evidence based, and may focus on promoting neurotypical behaviours rather than the priorities of autistic people.

Bibliographie citée par cette référence

Les références citées sont importées depuis des sources externes de métadonnées lorsqu’elles sont disponibles. La liste peut être partielle.

Vue d’ensemble de la bibliographie citée

Ces indicateurs décrivent la bibliographie citée par cette publication. Un nom d’auteurice est compté chaque fois qu’il apparaît dans une référence citée : une même personne peut donc être comptée plusieurs fois. Les noms qui ne sont pas encore associés à un·e auteurice déjà présent·e dans AutiHub sont traités comme inconnus, pas comme non autistes. Dernier calcul : 28/10/2026 01:01.

Références citées
115
Avec un DOI
98
Sans DOI, à partir du texte brut de la bibliographie
17
7 / 115 (6,1 %) références citées comprennent au moins une personne identifiée comme autiste.
Références avec données à compléter
10 / 115 (8,7 %)
Références avec noms d’auteurices détectés
106 / 115 (92,2 %)
Sans nom d’auteurice détecté
9
Sans titre structuré
10
Sans identifiant stable
16
Références avec noms bruts d’auteurices restant à vérifier
9
Références avec problème de récupération des métadonnées externes
0
Ces indicateurs portent sur les références citées affichées sur cette page, après fusion des doublons techniques. Une référence sans DOI peut quand même soutenir les statistiques d’auteurices lorsqu’un titre et des noms d’auteurices sont disponibles.
Noms d’auteurices détectés dans la bibliographie citée
632
À partir du DOI ou de métadonnées externes
632
À partir du texte brut validé de la bibliographie
0
Noms bruts déjà validés
0
Noms bruts restant à vérifier
13
229 / 632 (36,2 %) noms sont associés à un·e auteurice déjà présent·e dans AutiHub. 403 / 632 (63,8 %) noms ne sont pas encore associés.
Noms associés à une personne identifiée comme autiste
28 / 632 (4,4 %)
Calculé sur l’ensemble des noms d’auteurices détectés dans la bibliographie citée. Parmi les noms associés à un·e auteurice déjà présent·e dans AutiHub : 28 / 229 (12,2 %). Personnes distinctes identifiées comme autistes : 18 / 532 (3,4 %).
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