New research analysing thousands of therapy cases across England suggests many autistic adults see little improvement from standard treatments, highlighting the need for more tailored mental health care.
A study published in Nature Mental Health suggests that autistic adults experience mixed outcomes when receiving standard psychological therapies for depression and anxiety. While some individuals improve, many see little change in their symptoms and a smaller group experience worsening mental health.
The researchers analysed data from the MODIFY dataset, which includes information from routine mental health services across England. The study focused on 7,175 autistic adults who accessed therapy for anxiety or depression between 2012 and 2019 and attended at least three treatment sessions. Changes in symptoms were tracked across the first eight sessions using widely used questionnaires that measure depression and anxiety severity.
Using statistical modelling, the researchers identified several patterns in how symptoms changed over time. For depression, five different trajectories emerged. Most autistic individuals with moderate to severe depression showed little improvement or only limited progress during treatment. A smaller group experienced gradual improvement, while a small number recovered quickly. A minority saw their symptoms worsen.
For anxiety, seven different patterns of change were identified. As with depression, most participants experienced minimal improvement. Some showed gradual or rapid improvements, while a small proportion began therapy with moderate anxiety that later worsened into severe anxiety.
Explaining the study’s aim, researcher Pender said:
“We used large-scale data from routine mental health services across England to explore how symptoms of depression and anxiety changed for autistic people during therapy. We looked at different patterns of improvement, worsening, or little change, and examined which factors were linked to direction or speed of change.”