TY - JOUR
T1 - The global epidemiology and health burden of the autism spectrum
T2 - findings from the Global Burden of Disease Study 2021
AU - Global Burden of Disease Study 2021 Autism Spectrum Collaborators
AU - Santomauro, Damian F.
AU - Erskine, Holly E.
AU - Mantilla Herrera, Ana M.
AU - Miller, Paul Anthony
AU - Shadid, Jamileh
AU - Hagins, Hailey
AU - Addo, Isaac Yeboah
AU - Adnani, Qorinah Estiningtyas Sakilah
AU - Ahinkorah, Bright Opoku
AU - Ahmed, Ayman
AU - Alhalaiqa, Fadwa Naji
AU - Ali, Mohammed Usman
AU - Al-Marwani, Sabah
AU - Almazan, Joseph Uy
AU - Almustanyir, Sami
AU - Alvi, Farrukh Jawad
AU - Amer, Yasser Sami Abdel Dayem
AU - Ameyaw, Edward Kwabena
AU - Amiri, Sohrab
AU - Andrei, Catalina Liliana
AU - Angappan, Dhanalakshmi
AU - Antony, Catherine M.
AU - Aravkin, Aleksandr Y.
AU - Ashraf, Tahira
AU - Ayuso-Mateos, Jose L.
AU - Barrow, Amadou
AU - Batra, Kavita
AU - Bemanalizadeh, Maryam
AU - Bhagavathula, Akshaya Srikanth
AU - Bhaskar, Sonu
AU - Bhatti, Jasvinder Singh Singh
AU - Bolla, Srinivasa Rao
AU - Britton, Gabrielle
AU - Castaldelli-Maia, Joao Mauricio
AU - Catalá-López, Ferrán
AU - Caye, Arthur
AU - Chattu, Vijay Kumar
AU - Chong, Yuen Yu
AU - Ciobanu, Liliana G.
AU - Cortese, Samuele
AU - Cruz-Martins, Natalia
AU - Dachew, Berihun Assefa
AU - Dai, Xiaochen
AU - Darwish, Amira Hamed
AU - Dashti, Mohsen
AU - de la Torre-Luque, Alejandro
AU - Diaz, Daniel
AU - Ding, Delaney D.
AU - Dy, Angel Belle Cheng
AU - Ferreira, Nuno
N1 - Publisher Copyright:
© 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
PY - 2025
Y1 - 2025
N2 - Background: High-quality estimates of the epidemiology of the autism spectrum and the health needs of autistic people are necessary for service planners and resource allocators. Here we present the global prevalence and health burden of autism spectrum disorder from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 following improvements to the epidemiological data and burden estimation methods. Methods: For GBD 2021, a systematic literature review involving searches in PubMed, Embase, PsycINFO, the Global Health Data Exchange, and consultation with experts identified data on the epidemiology of autism spectrum disorder. Eligible data were used to estimate prevalence via a Bayesian meta-regression tool (DisMod-MR 2.1). Modelled prevalence and disability weights were used to estimate health burden in years lived with disability (YLDs) as the measure of non-fatal health burden and disability-adjusted life-years (DALYs) as the measure of overall health burden. Data by ethnicity were not available. People with lived experience of autism were involved in the design, preparation, interpretation, and writing of this Article. Findings: An estimated 61·8 million (95% uncertainty interval 52·1–72·7) individuals (one in every 127 people) were on the autism spectrum globally in 2021. The global age-standardised prevalence was 788·3 (663·8–927·2) per 100 000 people, equivalent to 1064·7 (898·5–1245·7) autistic males per 100 000 males and 508·1 (424·6–604·3) autistic females per 100 000 females. Autism spectrum disorder accounted for 11·5 million (7·8–16·3) DALYs, equivalent to 147·6 (100·2–208·2) DALYs per 100 000 people (age-standardised) globally. At the super-region level, age-standardised DALY rates ranged from 126·5 (86·0–178·0) per 100 000 people in southeast Asia, east Asia, and Oceania to 204·1 (140·7–284·7) per 100 000 people in the high-income super-region. DALYs were evident across the lifespan, emerging for children younger than age 5 years (169·2 [115·0–237·4] DALYs per 100 000 people) and decreasing with age (163·4 [110·6–229·8] DALYs per 100 000 people younger than 20 years and 137·7 [93·9–194·5] DALYs per 100 000 people aged 20 years and older). Autism spectrum disorder was ranked within the top-ten causes of non-fatal health burden for people younger than 20 years. Interpretation: The high prevalence and high rank for non-fatal health burden of autism spectrum disorder in people younger than 20 years underscore the importance of early detection and support to autistic young people and their caregivers globally. Work to improve the precision and global representation of our findings is required, starting with better global coverage of epidemiological data so that geographical variations can be better ascertained. The work presented here can guide future research efforts, and importantly, decisions concerning allocation of health services that better address the needs of all autistic individuals. Funding: Queensland Health and the Bill & Melinda Gates Foundation.
AB - Background: High-quality estimates of the epidemiology of the autism spectrum and the health needs of autistic people are necessary for service planners and resource allocators. Here we present the global prevalence and health burden of autism spectrum disorder from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 following improvements to the epidemiological data and burden estimation methods. Methods: For GBD 2021, a systematic literature review involving searches in PubMed, Embase, PsycINFO, the Global Health Data Exchange, and consultation with experts identified data on the epidemiology of autism spectrum disorder. Eligible data were used to estimate prevalence via a Bayesian meta-regression tool (DisMod-MR 2.1). Modelled prevalence and disability weights were used to estimate health burden in years lived with disability (YLDs) as the measure of non-fatal health burden and disability-adjusted life-years (DALYs) as the measure of overall health burden. Data by ethnicity were not available. People with lived experience of autism were involved in the design, preparation, interpretation, and writing of this Article. Findings: An estimated 61·8 million (95% uncertainty interval 52·1–72·7) individuals (one in every 127 people) were on the autism spectrum globally in 2021. The global age-standardised prevalence was 788·3 (663·8–927·2) per 100 000 people, equivalent to 1064·7 (898·5–1245·7) autistic males per 100 000 males and 508·1 (424·6–604·3) autistic females per 100 000 females. Autism spectrum disorder accounted for 11·5 million (7·8–16·3) DALYs, equivalent to 147·6 (100·2–208·2) DALYs per 100 000 people (age-standardised) globally. At the super-region level, age-standardised DALY rates ranged from 126·5 (86·0–178·0) per 100 000 people in southeast Asia, east Asia, and Oceania to 204·1 (140·7–284·7) per 100 000 people in the high-income super-region. DALYs were evident across the lifespan, emerging for children younger than age 5 years (169·2 [115·0–237·4] DALYs per 100 000 people) and decreasing with age (163·4 [110·6–229·8] DALYs per 100 000 people younger than 20 years and 137·7 [93·9–194·5] DALYs per 100 000 people aged 20 years and older). Autism spectrum disorder was ranked within the top-ten causes of non-fatal health burden for people younger than 20 years. Interpretation: The high prevalence and high rank for non-fatal health burden of autism spectrum disorder in people younger than 20 years underscore the importance of early detection and support to autistic young people and their caregivers globally. Work to improve the precision and global representation of our findings is required, starting with better global coverage of epidemiological data so that geographical variations can be better ascertained. The work presented here can guide future research efforts, and importantly, decisions concerning allocation of health services that better address the needs of all autistic individuals. Funding: Queensland Health and the Bill & Melinda Gates Foundation.
UR - http://www.scopus.com/inward/record.url?scp=85214346726&partnerID=8YFLogxK
U2 - 10.1016/S2215-0366(24)00363-8
DO - 10.1016/S2215-0366(24)00363-8
M3 - Article
C2 - 39709974
AN - SCOPUS:85214346726
SN - 2215-0366
JO - The Lancet Psychiatry
JF - The Lancet Psychiatry
ER -