Open AccessTesting adults by questionnaire for social and communication disorders, including autism spectrum disorders, in an adult mental health service population
Author(s) -
Brugha Traolach,
Tyrer Freya,
Leaver Andrew,
Lewis Samantha,
Seaton Sarah,
Morgan Zoe,
Tromans Samuel,
Rensburg Kobus
Publication year - 2020
Publication title -
international journal of methods in psychiatric research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.275
H-Index - 73
eISSN - 1557-0657
pISSN - 1049-8931
DOI - 10.1002/mpr.1814
Subject(s) - autism , autism diagnostic observation schedule , psychiatry , mental health , mood disorders , clinical psychology , medicine , mood , population , psychology , autism spectrum disorder , anxiety , environmental health
Abstract Objectives Autism is difficult to identify in adults due to lack of validated self‐report questionnaires. We compared the effectiveness of the autism‐spectrum quotient (AQ) and the Ritvo autism–Asperger's diagnostic scale‐revised (RAADS‐R) questionnaires in adult mental health services in two English counties. Methods A subsample of adults who completed the AQ and RAADS‐R were invited to take part in an autism diagnostic observation schedule (ADOS Module 4) assessment with probability of selection weighted by scores on the questionnaires. Results There were 364 men and 374 women who consented to take part. Recorded diagnoses were most commonly mood disorders (44%) and mental and behavioural disorders due to alcohol/substance misuse (19%), and 4.8% (95% CI [2.9, 7.5]) were identified with autism (ADOS Module 4 10+). One had a pre‐existing diagnosis of autism; five (26%) had borderline personality disorders (all female) and three (17%) had mood disorders. The AQ and RAADS‐R had fair test accuracy (area under receiver operating characteristic [ROC] curve 0.77 and 0.79, respectively). AQ sensitivity was 0.79 (95% CI [0.54, 0.94]) and specificity was 0.77 (95% CI [0.65, 0.86]); RAADS‐R sensitivity was 0.75 (95% CI [0.48, 0.93]) and specificity was 0.71 (95% CI [0.60, 0.81]). Conclusions The AQ and RAADS‐R can guide decisions to refer adults in mental health services to autism diagnostic services.