Male and Female Healthcare Trajectories in Autism: Are There Any Differences Considering Age at Diagnosis and Intellectual or Developmental Disabilities Status? / Mélanie COUTURE in Autism Research, 18-8 (August 2025)  

Public ISBD [article]  inAutism Research > 18-8 (August 2025) . - p.1674-1692 Titre : Male and Female Healthcare Trajectories in Autism: Are There Any Differences Considering Age at Diagnosis and Intellectual or Developmental Disabilities Status? Type de document : texte imprimé Auteurs : Mélanie COUTURE, Auteur ; Josiane COURTEAU, Auteur ; Sébastien BRODEUR, Auteur ; Yohann M. CHIU, Auteur ; Mireille COURTEAU, Auteur ; Émilie DUBÉ, Auteur ; Nina THOMAS, Auteur ; Lesage ALAIN, Auteur ; Eric FOMBONNE, Auteur ; Isabelle DUFOUR, Auteur Article en page(s) : p.1674-1692 Langues : Anglais (eng) Mots-clés : autism spectrum disorders  care trajectory  healthcare utilization  mental health  state sequence analysis Index. décimale : PER Périodiques Résumé : ABSTRACT The aim of this study was to compare the healthcare trajectories (HCTs) 2 years after a first diagnosis of autism according to sex, age at diagnosis, and intellectual or developmental disabilities (IDD) status. This is a retrospective cohort study using health administrative data from Québec, Canada. The cohort included all individuals with a first diagnosis of autism registered by a physician between April 2012 and March 2015. HCTs were stratified by sex, presence of IDD, and age at diagnosis (youth, adult), and analyzed using state sequence analysis across healthcare settings, providers, and reasons for use. Our cohort included 5289 individuals, 76.6% were male, and 26.3% were adults at the time of diagnosis. The healthcare use decreased slightly over time, though intensity was higher in females. Sex differences in HCTs were strongly influenced by IDD status and age at diagnosis. While no significant sex differences were observed in HCTs for individuals with IDD diagnosed with autism in adulthood, the psychiatric condition profiles showed notable differences between males and females. Hospital days nearly doubled for females diagnosed in childhood compared to males, while males with IDD diagnosed with autism in childhood and males without IDD diagnosed in adulthood had fewer physical illness visits. Although physical and mental health challenges appear largely managed in ambulatory care during youth, high hospitalization rates in those diagnosed in adulthood, particularly females and those with IDD, highlight concerns about continuity of care and avoidable hospitalizations for these subgroups of patients. En ligne : https://doi.org/10.1002/aur.70072 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=566 [article] Male and Female Healthcare Trajectories in Autism: Are There Any Differences Considering Age at Diagnosis and Intellectual or Developmental Disabilities Status? [texte imprimé] / Mélanie COUTURE, Auteur ; Josiane COURTEAU, Auteur ; Sébastien BRODEUR, Auteur ; Yohann M. CHIU, Auteur ; Mireille COURTEAU, Auteur ; Émilie DUBÉ, Auteur ; Nina THOMAS, Auteur ; Lesage ALAIN, Auteur ; Eric FOMBONNE, Auteur ; Isabelle DUFOUR, Auteur . - p.1674-1692. Langues : Anglais (eng) in Autism Research > 18-8 (August 2025) . - p.1674-1692 Mots-clés : autism spectrum disorders  care trajectory  healthcare utilization  mental health  state sequence analysis Index. décimale : PER Périodiques Résumé : ABSTRACT The aim of this study was to compare the healthcare trajectories (HCTs) 2 years after a first diagnosis of autism according to sex, age at diagnosis, and intellectual or developmental disabilities (IDD) status. This is a retrospective cohort study using health administrative data from Québec, Canada. The cohort included all individuals with a first diagnosis of autism registered by a physician between April 2012 and March 2015. HCTs were stratified by sex, presence of IDD, and age at diagnosis (youth, adult), and analyzed using state sequence analysis across healthcare settings, providers, and reasons for use. Our cohort included 5289 individuals, 76.6% were male, and 26.3% were adults at the time of diagnosis. The healthcare use decreased slightly over time, though intensity was higher in females. Sex differences in HCTs were strongly influenced by IDD status and age at diagnosis. While no significant sex differences were observed in HCTs for individuals with IDD diagnosed with autism in adulthood, the psychiatric condition profiles showed notable differences between males and females. Hospital days nearly doubled for females diagnosed in childhood compared to males, while males with IDD diagnosed with autism in childhood and males without IDD diagnosed in adulthood had fewer physical illness visits. Although physical and mental health challenges appear largely managed in ambulatory care during youth, high hospitalization rates in those diagnosed in adulthood, particularly females and those with IDD, highlight concerns about continuity of care and avoidable hospitalizations for these subgroups of patients. En ligne : https://doi.org/10.1002/aur.70072 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=566

Pathways to autism diagnosis in adulthood / Isabelle DUFOUR in Journal of Neurodevelopmental Disorders, 17 (2025)  

Public ISBD [article]  inJournal of Neurodevelopmental Disorders > 17 (2025) Titre : Pathways to autism diagnosis in adulthood Type de document : texte imprimé Auteurs : Isabelle DUFOUR, Auteur ; Yohann CHIU, Auteur ; Sébastien BRODEUR, Auteur ; Mireille COURTEAU, Auteur ; Josiane COURTEAU, Auteur ; Émilie DUBÉ, Auteur ; Alain LESAGE, Auteur ; Eric FOMBONNE, Auteur ; Mélanie COUTURE, Auteur Langues : Anglais (eng) Mots-clés : Humans  Adult  Male  Female  Retrospective Studies  Quebec/epidemiology  Middle Aged  Autistic Disorder/diagnosis/epidemiology  Young Adult  Adolescent  Neurodevelopmental Disorders/epidemiology/diagnosis  Attention Deficit Disorder with Hyperactivity/epidemiology  Aged  Autism spectrum disorder  Healthcare use  Mental healthcare  Neurodevelopmental disorder  Psychiatric disorder  State sequence analysis  by the Research Ethics Board Committee of the Université de Sherbrooke and by the  Commission d'accès à l'information of Quebec. Competing interests: The authors  declare no competing interests. Index. décimale : PER Périodiques Résumé : BACKGROUND: This study explored Trajectories of Diagnoses (TDs) preceding a first diagnosis of autism in adulthood. METHODS: This retrospective cohort study used health administrative data from Quebec, Canada, and included all adults with a first recorded diagnosis of autism between 2012 and 2017. A TDs was defined as a succession of medical records of psychiatric and/or neurodevelopmental conditions over time. These TDs were retrospectively analyzed from 2002 to 2017, using a state sequence analysis of diagnoses, in order: Autism, Intellectual or developmental disabilities (IDDs), Schizophrenia spectrum disorder (SSD), Bipolar Disorder (BD), Depressive Disorder (DD), Anxiety Disorder (AD), Attention-deficit/hyperactivity disorder (ADHD), and Other psychiatric and/or neurodevelopmental conditions. RESULTS: The cohort included 2799 adults with a first recorded diagnosis of autism between 2012 and 2017. Several psychiatric and/or neurodevelopmental conditions were recorded since 2002, including AD (77.5%), DD (58.0%), SSD (49.4%), BD (48.3%), and IDDs (33.2%). Results revealed 5 distinct types of TDs. Types 1 (63.8%), 2 (17.6%) and 3 (6%) represented individuals in younger age groups with similar characteristics but with very different sequences of diagnoses, characterized by mixed diagnoses in type 1, SSD and AD in Type 2, and IDDs, DD, AD, and ADHD in type 3. Types 4 and 5 (9.0% and 3.6%), representing middle-aged/older groups, displayed distinctive TDs associated with high healthcare use, almost entirely associated with SSD (Type 4) and BD (Type 5). CONCLUSION: This study proposes a complementary examination of the multiple pathways to diagnosis experienced by adults, highlighting the need to address differential diagnosis and co-occurring psychiatric and neurodevelopmental conditions. En ligne : https://dx.doi.org/10.1186/s11689-025-09627-3 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=576 [article] Pathways to autism diagnosis in adulthood [texte imprimé] / Isabelle DUFOUR, Auteur ; Yohann CHIU, Auteur ; Sébastien BRODEUR, Auteur ; Mireille COURTEAU, Auteur ; Josiane COURTEAU, Auteur ; Émilie DUBÉ, Auteur ; Alain LESAGE, Auteur ; Eric FOMBONNE, Auteur ; Mélanie COUTURE, Auteur. Langues : Anglais (eng) in Journal of Neurodevelopmental Disorders > 17 (2025) Mots-clés : Humans  Adult  Male  Female  Retrospective Studies  Quebec/epidemiology  Middle Aged  Autistic Disorder/diagnosis/epidemiology  Young Adult  Adolescent  Neurodevelopmental Disorders/epidemiology/diagnosis  Attention Deficit Disorder with Hyperactivity/epidemiology  Aged  Autism spectrum disorder  Healthcare use  Mental healthcare  Neurodevelopmental disorder  Psychiatric disorder  State sequence analysis  by the Research Ethics Board Committee of the Université de Sherbrooke and by the  Commission d'accès à l'information of Quebec. Competing interests: The authors  declare no competing interests. Index. décimale : PER Périodiques Résumé : BACKGROUND: This study explored Trajectories of Diagnoses (TDs) preceding a first diagnosis of autism in adulthood. METHODS: This retrospective cohort study used health administrative data from Quebec, Canada, and included all adults with a first recorded diagnosis of autism between 2012 and 2017. A TDs was defined as a succession of medical records of psychiatric and/or neurodevelopmental conditions over time. These TDs were retrospectively analyzed from 2002 to 2017, using a state sequence analysis of diagnoses, in order: Autism, Intellectual or developmental disabilities (IDDs), Schizophrenia spectrum disorder (SSD), Bipolar Disorder (BD), Depressive Disorder (DD), Anxiety Disorder (AD), Attention-deficit/hyperactivity disorder (ADHD), and Other psychiatric and/or neurodevelopmental conditions. RESULTS: The cohort included 2799 adults with a first recorded diagnosis of autism between 2012 and 2017. Several psychiatric and/or neurodevelopmental conditions were recorded since 2002, including AD (77.5%), DD (58.0%), SSD (49.4%), BD (48.3%), and IDDs (33.2%). Results revealed 5 distinct types of TDs. Types 1 (63.8%), 2 (17.6%) and 3 (6%) represented individuals in younger age groups with similar characteristics but with very different sequences of diagnoses, characterized by mixed diagnoses in type 1, SSD and AD in Type 2, and IDDs, DD, AD, and ADHD in type 3. Types 4 and 5 (9.0% and 3.6%), representing middle-aged/older groups, displayed distinctive TDs associated with high healthcare use, almost entirely associated with SSD (Type 4) and BD (Type 5). CONCLUSION: This study proposes a complementary examination of the multiple pathways to diagnosis experienced by adults, highlighting the need to address differential diagnosis and co-occurring psychiatric and neurodevelopmental conditions. En ligne : https://dx.doi.org/10.1186/s11689-025-09627-3 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=576

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