Current and Lifetime Somatic Symptom Burden Among Transition-aged Young Adults on the Autism Spectrum

Background and Objectives: Somatic symptoms are the most common cause of outpatient medical visits in the general population, yet their presence and severity in individuals on the autism spectrum has rarely been studied. We sought to assess the prevalence, impact, and clinical correlates of fourteen commonly-reported somatic symptoms in a sample of transition-aged autistic young adults. Methods: A sample of 290 independent and cognitively able autistic young adults (aged 18-26 years; mean [SD]: 23.10 [2.38] years) was recruited from the Simons Foundation SPARK participant pool. A modified version of the Patient Health Questionnaire-15 was used to assess somatic symptom prevalence/impact, along with measures of depression, anxiety, autistic traits, and quality of life. Results: Somatic symptom burden was much higher in autistic young adults than previously reported in the general population. The most commonly reported current symptoms were fatigue (72.8%), sleep problems (69.0%), and menstrual problems (61.4% of females). Moderate or severe symptom levels were reported by 53.9% of females and 18.75% of males in our cohort, with the odds of females of endorsing any given symptom being 2-4 times greater than males. Both individual symptoms and total symptom burden were related to higher levels of depression, anxiety, and autistic traits, along with lower quality of life. Conclusion: Despite little research on this topic previously, somatic symptoms are highly prevalent in autistic young adults, particularly women. Future research is needed to investigate links between somatic symptoms, medical and psychiatric morbidity, and health care utilization in the autistic population. What's Known on This Subject Somatic symptoms are highly prevalent in the general population and account for a large proportion of health system visits and health care costs. However, few studies have investigated the prevalence, impact, or correlates of these symptoms in individuals on the autism spectrum. What This Study Adds To our knowledge, this is the first study to specifically assess current and lifetime somatic symptom burden, symptom onset patterns, and the clinical correlates of multisystem symptom distress in transition-aged young adults on the autism spectrum.