̽��ֱ�� of Cambridge - Autism Research Trust

Autistic individuals may be more likely to use recreational drugs to self-medicate their mental health

cjb250 — Thu, 01 Jul 2021 22:30:48 +0000

There is significant debate about substance use of autistic adolescents and adults. Some studies indicate that autistic individuals are less likely to use substances, whereas others suggest that autistic individuals are at greater risk of substance misuse or abuse. ̽��ֱ��team at the Autism Research Centre in Cambridge used a ‘mixed methods’ design to consider both the frequency of substance use among autistic individuals, as well as their self-reported experiences of substance use.

Overall, 1,183 autistic and 1,203 non-autistic adolescents and adults (aged 16-90 years) provided information about the frequency of their substance use via an anonymous, online survey; of this group, 919 individuals also gave more in-depth responses about their experiences of substance use.

Autistic adults were less likely than non-autistic peers to use substances. Only 16% of autistic adults, compared to 22% of non-autistic adults, reported drinking on three or more days per week on average. Similarly, only 4% of autistic adults reported binge-drinking compared to 8% of non-autistic adults.

There were also some sex differences in patterns of substance use: autistic males were less likely than non-autistic males to report ever having smoked or used drugs. In contrast, the team did not find differences in the patterns of frequency of smoking or drug use between autistic and non-autistic females.

However, despite lower rates of substance use overall, the qualitative findings of the study provide a much less hopeful picture: autistic adults were nearly nine times more likely than non-autistic peers to report using recreational drugs (such as marijuana, cocaine and amphetamines) to manage unwanted symptoms, including autism-related symptoms.

Drugs were used to reduce sensory overload, help with mental focus, and provide routine, among other reasons. Several autistic participants also indirectly referenced using substances to mask their autism. Past research has shown that this behavioural management (also known as ‘camouflaging’ or ‘compensating’) has been linked to emotional exhaustion, worse mental health, and even increased risk of suicide among autistic adults.

Autistic adolescents and adults were also over three times more likely than others to report using substances to manage mental health symptoms, including anxiety, depression, and suicidal thoughts. Several participants specifically noted that they used drugs for self-medication. However, this self-medication was not always viewed as negative by participants, and several noted that using recreational drugs allowed them to reduce the doses of prescribed medications for mental health conditions, which was a welcome change due to the sometimes significant side effects from their prescribed medications.

Another area of concern was the strong association between vulnerability and substance use among autistic teenagers and adults. Previous work from the Cambridge team suggests that autistic adults may be much more likely to have adverse life experiences and be at greater risk of suicide than others. ̽��ֱ��findings of the new study indicate that autistic individuals are over four times more likely to report vulnerability associated with substance use compared to their non-autistic peers, including dependence/addiction, using drugs to deal with past trauma, and substance use associated with suicide.

In addition, the study identified two new areas of vulnerability not been previously reported: being forced, tricked, or accidentally taking drugs; and childhood use of substances (at the age of 12 years or younger).

Elizabeth Weir, a PhD student at the Autism Research Centre in Cambridge, and the lead researcher of the study, said: “Whether or not the substances currently classed as ‘recreational’ could be used medically remains an open question. It is evident that the current systems of health and social care support are not meeting the needs of many autistic teenagers and adults.

“No one should feel that they need to self-medicate for these issues without guidance from a healthcare professional. Identifying new forms of effective support is urgent considering the complex associations between substance use, mental health, and behaviour management—particularly as camouflaging and compensating behaviours are associated with suicide risk among autistic individuals.”

Dr Carrie Allison, Director of Research Strategy at the Autism Research Centre and a member of the research team, said: “While some of our results suggest lower likelihood of substance use overall, physicians should not assume that their autistic patients aren’t using drugs. Drug use can be harmful so healthcare providers should aim to establish trusting relationships with autistic and non-autistic patients alike to foster frank and honest conversations about substance use.”

Professor Simon Baron-Cohen, Director of the Autism Research Centre and a member of the team, said: “We continue to see new areas in which autistic adults experience vulnerability: mental health, physical health, suicide risk, lifestyle patterns, the criminal justice system, and so on. Substance use is now another area that we need to consider when developing new forms of support for autistic individuals. It is essential that we ensure that autistic people have equal access to high quality social and healthcare that can appropriately support their specific needs; and, unfortunately, it seems clear that our current systems are still not meeting this mark.”

̽��ֱ��research was funded by the Autism Research Trust, Rosetrees Trust, Cambridge and Peterborough NHS Foundation Trust, Corbin Charitable Trust, Medical Research Council, Wellcome and the Innovative Medicines Initiative.

Reference
Weir, E, Allison, C, & Baron-Cohen, S. Understanding the substance use of autistic adolescents and adults: a mixed methods approach. ̽��ֱ��Lancet Psychiatry (2021).

While autistic individuals are less likely to use substances, those who do so are more likely to self-medicate for their mental health symptoms, according to new research from the ̽��ֱ�� of Cambridge and published today in ̽��ֱ��Lancet Psychiatry.

It is essential that we ensure that autistic people have equal access to high quality social and healthcare that can appropriately support their specific needs; and, unfortunately, it seems clear that our current systems are still not meeting this mark

Simon Baron-Cohen

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Unhealthy patterns of diet, exercise, and sleep linked to high risk of cardiovascular disease in autistic people

cjb250 — Mon, 10 May 2021 15:34:45 +0000

̽��ֱ��results are published today in the journal Molecular Autism.

Earlier research suggests that autistic people die 16-35 years younger than expected, and that greater health problems may contribute to this risk. ̽��ֱ��present study is the first to consider the diet, exercise, and sleep patterns of autistic adults and how these patterns may relate to health outcomes.

̽��ֱ��team at the Autism Research Centre in Cambridge developed an anonymous, online survey about lifestyle choices and daily habits, personal medical history, and family medical history. ̽��ֱ��final study included 1,183 autistic adults and 1,203 non-autistic adults aged 16-90 years.

̽��ֱ��results showed that autistic adults were far less likely than non-autistic adults to meet very minimal health recommendations for diet, exercise, and sleep. Autistic adults were also far more likely to have atypical eating patterns (including limited diet) and sleep disturbance. They were more likely to be underweight or obese than non-autistic individuals.

These poor lifestyle habits were associated with greater risk of cardiovascular conditions such as high blood pressure, heart disease, and stroke among autistic males, and this was a stronger association even than a family history of a cardiovascular condition. Though it is not possible to say conclusively that a poorer lifestyle led to cardiovascular problems, the findings provide the first indication that promoting healthy choices regarding diet, exercise, and sleep may help to reduce the excess risks of health conditions in autistic adults.

While the results indicate that there may be other biological or environmental factors that leave autistic individuals at greater risk of health conditions, they also provide a clear target for intervention. Difficulties with maintaining a healthy lifestyle may also have knock-on effects beyond physical health, including limiting opportunities for social interaction (which may centre around mealtimes or exercise), and could contribute to worsening mental health, and affect employment or education.

̽��ֱ��lead researcher of the study, Elizabeth Weir, a PhD student at the Autism Research Centre in Cambridge, said: “These findings help us to better understand the experiences of autistic adults, and have wider implications for quality of life. We need to understand the reasons for restricted diet, limited exercise, and lack of sleep, to provide better support. This may include programmes for health education, and additional mental health support or supported living and working schemes.”

Dr Carrie Allison, Director of Research Strategy at the Autism Research Centre and a member of the research team, said: “ ̽��ֱ��challenges we see among autistic children regarding lifestyle behaviours extend into adulthood. Given the implications for risk of chronic disease and length of life, it is critical that we work to identify effective strategies for supporting health choices by autistic people of all ages.”

Professor Simon Baron-Cohen, Director of the Autism Research Centre and a member of the team, said: “ ̽��ֱ��wider picture suggests that autistic adults experience vulnerability in a variety of contexts, and this is just one new area that we should consider. Seeing that autistic adults are having such a hard time comparatively with healthy lifestyle habits has clear healthcare and policy implications: we need to create new and better support systems tailored to the specific needs of autistic people.”

Reference
Weir, E., et al. An investigation of the diet, exercise, sleep, BMI, and health outcomes of autistic adults. Molecular Autism 12, 31 (2021). DOI: 10.1186/s13229-021-00441-x

Funding
Funding for this project was generously provided by the Autism Research Trust, the Rosetrees Trust, and the Cambridge and Peterborough NHS Foundation Trust, the Corbin Charitable Trust, the MRC, the Wellcome Trust and the Innovative Medicines Initiative.

Autistic people have far greater risks of long term physical health conditions than others, but the reasons for this remain unclear. New research from the ̽��ֱ�� of Cambridge suggests that unhealthy lifestyle habits may be an important contributing factor.

These findings help us to better understand the experiences of autistic adults, and have wider implications for quality of life. We need to understand the reasons for restricted diet, limited exercise, and lack of sleep, to provide better support

Elizabeth Weir

Peter Burdon

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Autism rates have increased and show differences in ethnic minorities and links to social disadvantage

cjb250 — Mon, 29 Mar 2021 15:00:20 +0000

Black and Chinese pupils were 26% and 38% more likely to be autistic respectively and autistic children were much more likely to face significant social disadvantage. ̽��ֱ��results are published today in JAMA Pediatrics.

̽��ֱ��team drew on data from the School Census from the National Pupil Database, collected by the Department for Education from individuals aged 2-21 years old in state-funded schools in England. Of more than seven million pupils studied, 119,821 pupils had a diagnosis of autism in their record in the English state educational system, of whom 21,660 also had learning difficulties (18.1%). Boys showed a prevalence of autism of 2.8% and girls showed a prevalence of 0.65%, with a boy-to-girl ratio of 4.3:1.

Prevalence was highest in pupils of black ethnicity (2.1%) and lowest in Roma/Irish Travellers (0.85%), with these estimates being the first to be published for these populations. Pupils with a record of autism in schools were 60% more likely to also be socially disadvantaged, and 36% less likely to speak English. ̽��ֱ��findings reveal significant differences in autism prevalence, as recorded in formal school systems, across ethnic groups and geographical location.

̽��ֱ��lead researcher of the study, Dr Andres Roman-Urrestarazu from the Autism Research Centre (ARC) and Cambridge Public Health at the ̽��ֱ�� of Cambridge, said: “We can now see that autism is much more common than previously thought. We also found significant variations in autism diagnosis in different ethnic minorities, though the reason why this should be the case isn’t clear and warrants further research.”

Previous estimates of the prevalence of autism in the UK by the same research group in Cambridge, and based on a school-based survey, suggested that one in 64 children (1.57%) were autistic. ̽��ֱ��new study, based on school records that usually underestimate the actual proportion of children who meet diagnostic criteria, shows a considerable increase in the autism prevalence in England. ̽��ֱ��researchers say the increase is likely to be because autism has become better recognised by both parents and schools in recent years.

Professor Carol Brayne, Co-chair of Cambridge Public Health and Professor of Public Health Medicine, said: “This study shows how we can draw on large datasets in a way that is rigorous and valuable for our understanding of autism.”

Professor Fiona Matthews from Newcastle ̽��ֱ�� added: “This study highlights the need for more attention to the unrecognised and differing needs of autistic children from disadvantaged and diverse backgrounds.”

Professor Simon Baron-Cohen, Director of the ARC, said: “We can now see a snapshot of how many autistic children there are, and can drill down into local and ethnic variation, and reveal links with vulnerability. It is important that we safeguard the rights of children to access diagnostic services and education, tailored to their needs.”

This research was made possible by a generous donation for a Global Public Health Leadership programme by Dennis and Mireille Gillings Fellowship awarded to Dr Andres Roman-Urrestarazu. This study was also supported by the Autism Research Trust, the Wellcome Trust, the Innovative Medicines Initiative 2 Joint Undertaking (JU), the NIHR Cambridge Biomedical Research Centre and the NIHR Collaboration for Leadership in Applied Health Research and Care East of England at Cambridgeshire and Peterborough NHS Foundation Trust.

Reference
Roman-Urrestarazu, R et al. Association of Race/Ethnicity and Social Disadvantage With Autism Prevalence in 7 Million School Children in England. JAMA Pediatrics; 29 March 2021; DOI: 10.1001/jamapediatrics.2021.0054

Around one in 57 (1.76%) children in the UK is on the autistic spectrum, significantly higher than previously reported, according to a study of more than seven million children carried out by researchers from the ̽��ֱ�� of Cambridge’s Department of Psychiatry, in collaboration with researchers from Newcastle ̽��ֱ�� and Maastricht ̽��ֱ��.

It is important that we safeguard the rights of children to access diagnostic services and education, tailored to their needs

Simon Baron-Cohen

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Autistic adults have a higher rate of physical health conditions

Anonymous — Thu, 10 Sep 2020 15:22:52 +0000

Earlier research has shown that autistic people on average die younger than others and that this may be, in part, due to chronic physical health conditions. Previous studies have also shown that autistic people are at higher risk of a variety of health conditions, but we don’t know what is driving these increased risks. Thus, better understanding of the physical health of autistic adults may help us improve both their quality and length of life.

1,156 autistic individuals and 1,212 non-autistic individuals took part in an anonymous, online survey developed by the team about their lifestyle choices and daily habits, personal and family medical history. ̽��ֱ��results indicate that autistic individuals are, on average, 1.5 to 4.3 times as likely to have a wide variety of health conditions, including low blood pressure, arrhythmias, asthma, and prediabetes.

This new study is also the first to examine the influence of smoking, alcohol use, and BMI. Surprisingly, the results show that these lifestyle factors (which increase the risk of chronic physical health problems in the general population) do not account for the heightened risk of heart, lung, and diabetic conditions seen among autistic adults.

̽��ֱ��study also explored the experiences of female respondents and of older adults, both of whom remain understudied groups. ̽��ֱ��results revealed that autistic females, even more so than autistic males, are more likely to report increased risks of physical health conditions. In addition, the types of conditions of risk depend on the person’s biological sex. For example, autistic females are 4.3 times more likely to have prediabetes than non-autistic females; however, autistic and non-autistic males are equally likely to have prediabetes. These results suggest that a “one size fits all” approach to the healthcare of autistic people may not be effective.

Elizabeth Weir, the PhD student who led the study, said: “This is a first step in better understanding why autistic individuals are so much more likely to have chronic physical health problems. While smoking, alcohol, and BMI may play a role, we now need to focus on what other biological (e.g. genetic, hormonal, etc), environmental, lifestyle (e.g. diet, exercise, sleep, etc) or healthcare-related factors are contributing to these health disparities.”

Professor Simon Baron-Cohen, Director of the Autism Research Centre at Cambridge, who was part of the team, said: “This new study highlights the physical health risks to autistic individuals, and has important implications for their healthcare. Understanding the reasons why these disparities exist will allow us to better support autistic individuals and improve the quality and length of their lives.”

Funding for this project was provided by the Autism Research Trust, the Rosetrees Trust, and the Cambridge and Peterborough NHS Foundation Trust.

Reference
Weir, E at al. Increased prevalence of non-communicable physical health conditions among autistic adults. Autism; 9 Sept 2020; DOI: 10.1177/1362361320953652

Autistic individuals are more likely to have chronic physical health conditions, particularly heart, lung, and diabetic conditions, according to a new study by researchers at the ̽��ֱ�� of Cambridge. ̽��ֱ��results are published in the journal Autism.

This is a first step in better understanding why autistic individuals are so much more likely to have chronic physical health problems

Elizabeth Weir

tomwieden

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Transgender and gender-diverse individuals are more likely to be autistic and report higher autistic traits

cjb250 — Fri, 07 Aug 2020 08:50:07 +0000

This research, conducted using data from over 600,000 adult individuals, confirms previous smaller scale studies from clinics. ̽��ֱ��results are published today in Nature Communications.

A better understanding of gender diversity in autistic individuals will help provide better access to health care and post-diagnostic support for autistic transgender and gender-diverse individuals.

̽��ֱ��team used five different datasets, including a dataset of over 500,000 individuals collected as a part of the Channel 4 documentary “Are you autistic?”. In these datasets, participants had provided information about their gender identity, and if they received a diagnosis of autism or other psychiatric conditions such as depression or schizophrenia. Participants also completed a measure of autistic traits.

Strikingly, across all five datasets, the team found that transgender and gender-diverse adult individuals were between three and six times more likely to indicate that they were diagnosed as autistic compared to cisgender individuals. While the study used data from adults who indicated that they had received an autism diagnosis, it is likely that many individuals on the autistic spectrum may be undiagnosed. As around 1.1% of the UK population is estimated to be on the autistic spectrum, this result would suggest that somewhere between 3.5.-6.5% of transgender and gender-diverse adults is on the autistic spectrum.

Dr Meng-Chuan Lai, a collaborator on the study at the ̽��ֱ�� of Toronto, said: “We are beginning to learn more about how the presentation of autism differs in cisgender men and women. Understanding how autism manifests in transgender and gender-diverse people will enrich our knowledge about autism in relation to gender and sex. This enables clinicians to better recognize autism and provide personalised support and health care.”

Transgender and gender-diverse individuals were also more likely to indicate that they had received diagnoses of mental health conditions, particularly depression, which they were more than twice as likely as their cisgender counterparts to have experienced. Transgender and gender-diverse individuals also, on average, scored higher on measures of autistic traits compared to cisgender individuals, regardless of whether they had an autism diagnosis.

Dr Varun Warrier, who led the study, said: “This finding, using large datasets, confirms that the co-occurrence between being autistic and being transgender and gender-diverse is robust. We now need to understand the significance of this co-occurrence, and identify and address the factors that contribute to well-being of this group of people.”

̽��ֱ��study investigates the co-occurrence between gender identity and autism. ̽��ֱ��team did not investigate if one causes the other.

Professor Simon Baron-Cohen, Director of the Autism Research Centre at Cambridge, and a member of the team, said: “Both autistic individuals and transgender and gender-diverse individuals are marginalized and experience multiple vulnerabilities. It is important that we safe-guard the rights of these individuals to be themselves, receive the requisite support, and enjoy equality and celebration of their differences, free of societal stigma or discrimination.”

Dr Warrier is a Research Fellow at St Catharine's College and Professor Baron Cohen is a Fellow at Trinity College.

This study was supported by the Autism Research Trust, the Medical Research Council, the Wellcome Trust, and the Templeton World Charity Foundation., Inc. It was conducted in association with the NIHR CLAHRC for Cambridgeshire and Peterborough NHS Foundation Trust, and the NIHR Cambridge Biomedical Research Centre.

Reference
Warrier, V et al. Elevated rates of autism, other neurodevelopmental and psychiatric diagnoses and autistic traits in transgender and gender-diverse individuals. Nat Comms; 7 Aug 2020; DOI: 10.1038/s41467-020-17794-1

Transgender and gender-diverse adults are three to six times more likely as cisgender adults (individuals whose gender identity corresponds to their sex assigned at birth) to be diagnosed as autistic, according to a new study by scientists at the ̽��ֱ�� of Cambridge’s Autism Research Centre.

Both autistic individuals and transgender and gender-diverse individuals are marginalized and experience multiple vulnerabilities. It is important that we safe-guard the rights of these individuals to be themselves, receive the requisite support, and enjoy equality and celebration of their differences, free of societal stigma or discrimination

Simon Baron Cohen

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Higher rates of post-natal depression among autistic mothers

Anonymous — Wed, 15 Jan 2020 09:37:39 +0000

̽��ֱ��team recruited an advisory panel of autistic mothers with whom they co-developed an anonymous, online survey. After matching, this was completed by 355 autistic and 132 non-autistic mothers, each of whom had at least one autistic child.

Sixty percent of autistic mothers in the study reported they had experienced post-natal depression. By comparison, only 12% of women in the general population experience post-natal depression. In addition, autistic mothers had more difficulties in multi-tasking, coping with domestic responsibilities, and creating social opportunities for their child.

̽��ֱ��study also found that when autistic mothers disclosed their autism diagnosis to a professional, they were not believed the majority of the time. Autistic women felt misunderstood by professionals more frequently during pre- and post-natal appointments and found motherhood an isolating experience. Despite these challenges, autistic mothers reported they were able to act in the best interest of their child, putting their child’s needs first and seeking opportunities to boost their child’s self-confidence.

Dr Alexa Pohl, who led the study, said: “Autistic mothers face unique challenges during the perinatal period and parenthood. Despite these challenges, an overwhelming majority of autistic mothers reported that parenting overall was a rewarding experience. This research highlights the need for increased awareness of the experiences of motherhood for autistic women and the need for more tailored support.”

Professor Simon Baron-Cohen, Director of the Autism Research Centre at Cambridge, and part of the team, said: “This worryingly high number of autistic mothers who experience post-natal depression means we are failing them and their infants at a critical point in their lives. We now need more research into why the rates are so much higher, whether they are seeking help and not getting it, or if they are not seeking help and for what reasons. A new research priority is to develop autism-relevant screening tools and interventions for post-natal depression in these mothers.”

Monique Blakemore, an autistic advocate and member of the team, said: “This vital study was initiated by the autistic community, who collaborated as equal partners with researchers in the design, dissemination and interpretation of the survey. This is an excellent example of what can be achieved through such partnership.”

The study was supported by the National Institute of Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC), East of England, at Cambridgeshire and Peterborough NHS Foundation Trust, the Autism Research Trust, the MRC, the NIHR Cambridge Biomedical Research Centre, and Autistica.

Reference
A comparative study of autistic and nonautistic women’s experience of motherhood by Alexa Pohl, Sarah Crockford, Monique Blakemore, Carrie Allison and Simon Baron-Cohen. Molecular Autism. DOI: 10.1186/s13229-019-0304-2

Autistic mothers are more likely to report post-natal depression compared to non-autistic mothers, according to a new study of mothers of autistic children carried out by researchers at the ̽��ֱ�� of Cambridge. A better understanding of the experiences of autistic mothers during pregnancy and the post-natal period is critical to improving wellbeing. ̽��ֱ��results are published in Molecular Autism.

Autistic mothers face unique challenges during the perinatal period and parenthood. Despite these challenges, an overwhelming majority of autistic mothers reported that parenting overall was a rewarding experience

Alexa Pohl

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Genetic variants for autism linked to higher rates of self-harm and childhood maltreatment

cjb250 — Tue, 29 Oct 2019 01:03:43 +0000

Previous studies by the Cambridge team established that autistic individuals experience higher levels of self-harm, including suicidal thoughts and feelings, and higher rates of childhood maltreatment. This new study shows that the findings hold true even for those with a higher genetic likelihood of autism rather than a formal diagnosis.

̽��ֱ��team calculated the genetic likelihood for autism in 100,000 individuals from the UK Biobank Study who had their DNA analysed and who had also provided self-reported information about childhood maltreatment, suicidal ideation, and self-harm. They found that individuals with higher number of genetic variants associated with autism are more likely to report childhood maltreatment, self-harm and suicidal ideation. Those with the highest genetic predisposition to autism on average have a 28% increase in childhood maltreatment, and a 33% increase in self-harm and suicidal ideation, compared to those with the lowest genetic predisposition to autism.

Dr Varun Warrier, who led the study, said: “While we have found an association between a genetic likelihood for autism and adverse life events, we cannot conclude the former causes the latter. We suspect this association reflects that genes partly influence how many autistic traits you have, and some autistic traits such as difficulties in social understanding may lead to a person to be vulnerable to maltreatment. This research highlights the risks of such adverse outcomes for those with a high number of autistic traits, if adequate safe-guarding and support aren’t provided.”

Professor Simon Baron-Cohen, Director of the Autism Research Centre at Cambridge, said: “This new study extends our earlier work by showing that individuals who carry more of the genes associated with autism have higher risks for maltreatment and self-harm. Our work highlighting unacceptably high rates of suicide in autistic people was published 5 years ago, yet almost no new support has been provided. Governments need to provide far greater support for autistic individuals and for those with a high number of autistic traits.”

He added: “Autistic individuals may need a variety of interventions – there’s no ‘one size fits all’ – and these may include an individual support worker, a mentor, opportunities to build social and communication skills and self confidence through activities that the person enjoys, peer support groups, and supported employment schemes. Schools may also need to increase safe-guarding given the risks of victimisation.”

This study was supported by the Autism Research Trust, the Medical Research Council, Wellcome, and the Templeton World Charity Foundation., Inc. It was conducted in association with the NIHR CLAHRC for Cambridgeshire and Peterborough NHS Foundation Trust, and the NIHR Cambridge Biomedical Research Centre.

Reference
Warrier, V and Baron-Cohen, S. Childhood trauma, life-time self-harm, and suicidal behaviour and ideation are associated with polygenic scores for autism. Molecular Psychiatry; 29 Oct 2019; DOI: 10.1038/s41380-019-0550-x

People with a higher genetic likelihood of autism are more likely to report higher childhood maltreatment, self-harm and suicidal thoughts according to a new study by researchers at the ̽��ֱ�� of Cambridge. A better understanding of these issues is critical to improving wellbeing in autistic people. ̽��ֱ��results are published today in Molecular Psychiatry.

Our work highlighting unacceptably high rates of suicide in autistic people was published 5 years ago, yet almost no new support has been provided. Governments need to provide far greater support for autistic individuals and for those with a high number of autistic traits

Simon Baron Cohen

Sasha Freemind

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High levels of oestrogen in the womb linked to autism

cjb250 — Mon, 29 Jul 2019 08:25:40 +0000

̽��ֱ��discovery adds further evidence to support the prenatal sex steroid theory of autism first proposed 20 years ago.

In 2015, a team of scientists at the ̽��ֱ�� of Cambridge and the State Serum Institute in Denmark measured the levels of four prenatal steroid hormones, including two known as androgens, in the amniotic fluid in the womb and discovered that they were higher in male foetuses who later developed autism. These androgens are produced in higher quantities in male than in female foetuses on average, so might also explain why autism occurs more often in boys. They are also known to masculinise parts of the brain, and to have effects on the number of connections between brain cells.

Today, the same scientists have built on their previous findings by testing the amniotic fluid samples from the same 98 individuals sampled from the Danish Biobank, which has collected amniotic samples from over 100,000 pregnancies, but this time looking at another set of prenatal sex steroid hormones called oestrogens. This is an important next step because some of the hormones previously studied are directly converted into oestrogens.

All four oestrogens were significantly elevated, on average, in the 98 foetuses who later developed autism, compared to the 177 foetuses who did not. High levels of prenatal oestrogens were even more predictive of likelihood of autism than were high levels of prenatal androgens (such as testosterone). Contrary to popular belief that associates oestrogens with feminisation, prenatal oestrogens have effects on brain growth and also masculinise the brain in many mammals.

Professor Simon Baron-Cohen, Director of the Autism Research Centre at the ̽��ֱ�� of Cambridge, who led this study and who first proposed the prenatal sex steroid theory of autism, said: “This new finding supports the idea that increased prenatal sex steroid hormones are one of the potential causes for the condition. Genetics is well established as another, and these hormones likely interact with genetic factors to affect the developing foetal brain.”

Alex Tsompanidis, a PhD student in Cambridge who worked on the study, said: “These elevated hormones could be coming from the mother, the baby or the placenta. Our next step should be to study all these possible sources and how they interact during pregnancy.”

Dr Alexa Pohl, part of the Cambridge team, said: “This finding is exciting because the role of oestrogens in autism has hardly been studied, and we hope that we can learn more about how they contribute to foetal brain development in further experiments. We still need to see whether the same result holds true in autistic females.”

However, the team cautioned that these findings cannot and should not be used to screen for autism. “We are interested in understanding autism, not preventing it,” added Professor Baron- Cohen.

Dr Arieh Cohen, the biochemist on the team, based at the State Serum Institute in Copenhagen, said: “This is a terrific example of how a unique biobank set up 40 years ago is still reaping scientific fruit today in unimagined ways, through international collaboration.”

̽��ֱ��research was supported by the Autism Research Trust, the Medical Research Council, and Wellcome.

Reference
Baron-Cohen, S et al. Foetal oestrogens and autism. Molecular Psychiatry; 29 July 2019; DOI: 10.1038/s41380-019-0454-9

Scientists have identified a link between exposure to high levels of oestrogen sex hormones in the womb and the likelihood of developing autism. ̽��ֱ��findings are published today in the journal Molecular Psychiatry.

This new finding supports the idea that increased prenatal sex steroid hormones are one of the potential causes for the condition

Simon Baron Cohen

Anders Printz

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