AUTISM diagnoses have risen 10-fold in the last decade or so, prompting fears of ‘overdiagnosis’.

But alongside the surge in cases, researchers have noticed a change in characteristics in people with the neurodevelopmental condition.

Since 2010, UK adults with are increasingly being diagnosed with conditions such as , anxiety and , new research has suggested.

Prior to that, autistic adults were more often diagnosed with conditions such as and intellectual .

Researchers analysed data from the UK and , and wrote in the journal BMJ Mental Health that “autism diagnoses have risen consistently over time”.

In the UK, rates of new diagnoses increased from six per 100,000 people in 2010 to 64 per 100,000 in 2023.

They also found a rapid rise in autism diagnoses among 16 to 20-year-olds since 2010 in the UK, alongside a rise in women and white people, compared to other ethnicities.

“Over time, there has been a consistent decline in the proportion of autistic adults with a prior diagnosis of epilepsy, psychosis and intellectual disability,” researchers observed.

This has coincided with “an increase in the proportion with a prior diagnosis of attention-deficit hyperactivity disorder (ADHD), anxiety, and several other mental illnesses”.

Overall, autism rose in people who had been previously diagnosed with anxiety, depression, disorders, ADHD, stress-related disorders, eating disorders, headaches and chronic fatigue.

Rises were also seen in people using antidepressants, melatonin (for sleeplessness), opioids and gabapentin (a drug for epilepsy and nerve pain).

The team, including experts from the University of Bristol and Avon and Wiltshire Mental Health Partnership NHS Trust, said conditions like ADHD and anxiety have risen in adults without autism – so “we can expect autistic adults to also be subject to these temporal trends,” they said.

Changes to diagnostic manuals may mean people with other conditions are now being diagnosed with autism.

“It is possible that there is greater appreciation of nuanced forms of autism that may have previously been labelled as other conditions due to overlapping features, particularly in females.”

But other conditions may also be “misidentified as autism”, the study team added.

Prof Dame Uta Frith, emeritus professor of cognitive development at UCL, who wasn’t involved in the research, said the shift in co-occurring conditions among people with autism could be linked to when people were diagnosed.

“The results provide further evidence of a split between early and late diagnosed autism,” she stated.

“Cases with early diagnosed autism are linked with neurological signs, such as epilepsy and cognitive impairments.

“Cases with late-diagnosed autism are instead linked with prior mental health problems, such as anxiety and depression.

“It is precisely this group that accounts for the increase.”

She added that “cultural changes in the meaning and use of the autism label, rather than biological changes,” may also be playing a role.

Around 700,000 people in the UK are believed to have autism – a lifelong condition that affects how they experience and interact with the wider world.

Features include difficulties with communication and interaction, repetitive behaviours or limited interests. It can also affect learning and development.

There are those who suggest autism – as well as ADHD – is being overdiagnosed in the UK.

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Autism and conditions like depression and anxiety often co-occur Source: Getty

The 10-question autism test

TO get an official autism diagnosis, you need to be assessed by a healthcare professional.

But if you think your or your child might have the condition, there is a simple quiz called the AQ-10 that you can use to help support your suspicions.

The AQ-10 was developed by The Autism Research Centre at The University of Cambridge, and it is recommended to be used as an autism screening tool by the National Institute for Health and Care Excellence (NICE).

The assessment tool — used by NHS doctors — does not confirm whether you are on the spectrum.

Instead, it is used to screen people who might be. A version for children is also available.

These questions are not symptoms. They are statements – some are indicative of autism and others are not – in which you agree or disagree on a scale.

For children

For each question, write down if you ‘Definitely Agree’, ‘Slightly Agree’, ‘Slightly Disagree’ or ‘Definitely Disagree’.

  1. S/he often notices small sounds when others do not
  2. S/he usually concentrates more on the whole picture, rather than the small details
  3. In a social group, s/he can easily keep track of several different people’s conversations
  4. S/he finds it easy to go back and forth between different activities
  5. S/he doesn’t know how to keep a conversation going with his/her peers
  6. S/he is good at social chit-chat
  7. When s/he is read a story, s/he finds it difficult to work out the character’s intentions or feelings
  8. When s/he was in preschool, s/he used to enjoy playing games involving pretending with other children
  9. S/he finds it easy to work out what someone is thinking or feeling just by looking at their face
  10. S/he finds it hard to make new friends

Only 1 point can be scored for each question. Score 1 point for ‘Definitely Agree’ or ‘Slightly Agree’ on each of items 1, 5, 7 and 10.

Score 1 point for ‘Definitely Disagree’ or ‘Slightly Disagree’ on each of items 2, 3, 4, 6, 8 and 9.

If the individual scores more than 6 out of 10, they will be considered for a specialist diagnostic assessment.

For adults

For each question, write down if you ‘Definitely Agree’, ‘Slightly Agree’, ‘Slightly Disagree’ or ‘Definitely Disagree’.

  1. I often notice small sounds when others do not
  2. I usually concentrate more on the whole picture, rather than the small details
  3. I find it easy to do more than one thing at once
  4. If there is an interruption, I can switch back to what I was doing very quickly
  5. I find it easy to ‘read between the lines’ when someone is talking to me
  6. I know how to tell if someone listening to me is getting bored
  7. When I’m reading a story I find it difficult to work out the characters’ intentions
  8. I like to collect information about categories of things (e.g. types of car, types of bird, types of train, types of plant etc)
  9. I find it easy to work out what someone is thinking or feeling just by looking at their face
  10. I find it difficult to work out people’s intentions

Score 1 point for ‘Definitely Agree’ or ‘Slightly Agree’ on each of items 1, 7, 8, and 10.

Score 1 point for ‘Definitely Disagree’ or ‘Slightly Disagree’ on each of items 2, 3, 4, 5, 6, and 9.

If you score more than 6 out of 10, a healthcare professional will consider referring you for a specialist diagnostic assessment.

warned England is reaching “tipping point”, where people risk being wrongly told they have either of the two conditions.

It claimed ordinary, healthy, life experiences are being turned into medical problems, with Prof Sir Simon Wessely, of King’s College London, claiming this could “harm” children – making them believe they were incapable of doing something they might actually be able to do.

The new study used more than 24 million UK adults, including 141,119 with an autism diagnosis, and nine million people in Sweden, of whom around 100,000 had an autism diagnosis.

The number of people with autism who also had epilepsy decreased, from 10 per cent in 2010 to four per cent in 2023.

Meanwhile, those with a history of anxiety increased from 28.7 per cent to 58.3 per cent.

New diagnoses also rose fastest in females in both nations, as well as in people of white ethnicity in the UK.

The researchers said the findings on women “may indicate an improved recognition of female presentations of autism, including the use of masking and camouflaging behaviours, addressing historic underdiagnosis”.

Dr Monique Botha, associate professor in social and developmental at Durham University, who wasn’t involved in the research, pointed out that previous studies show that autistic adults are more likely to experience depression, anxiety, self-harm, and suicidal thoughts.

She explained these difficulties are likely linked to the “discrimination, exclusion and reduced quality of life” people with autism experience.

“This is particularly relevant to autistic women,” she added.

She said the “increasingly extensive psychiatric histories” seen in people who get an autism diagnosis may reflect “diagnostic inequalities rather than changing diagnostic boundaries”.