Changes in the profile of adults diagnosed as autistic since 2010: population based studies in the United Kingdom and Sweden

Sadik, Aws, Lundberg, Michael, Khandaker, Golam M., Pardiñas, Antonio F. ORCID: https://orcid.org/0000-0001-6845-7590, Lee, Brian K., Madley-Dowd, Paul, Magnusson, Cecilia and Rai, Dheeraj 2026. Changes in the profile of adults diagnosed as autistic since 2010: population based studies in the United Kingdom and Sweden. BMJ Mental Health Item availability restricted.

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Abstract

Background: Autism diagnoses have risen consistently over time. Characterising the backgrounds of adults being diagnosed with autism can help to clarify why. Objective: To understand if sociodemographic and neuropsychiatric characteristics of adults diagnosed with autism in the United Kingdom (UK) and Sweden have changed since 2010. Methods: Using UK primary care records from 2010-2023 and Swedish population-wide register linkages from 2010-2021, we calculated annual age-standardised incidence and prevalence of adult autism diagnoses within different sociodemographic groups. We also calculated annual age-standardised proportion of adults with prior records of other neuropsychiatric conditions or medications, by autism diagnosis status. Findings: In the UK, 24,537,039 adults contributed to the study, including 141,119 with an autism diagnosis. In Sweden, 9,096,874 adults contributed, including 100,817 with an autism diagnosis. Incident (first recorded) adult autism diagnoses were consistently higher in Sweden than the UK, however incidence increased rapidly in the UK after 2020. Incident diagnoses increased fastest for 16-20-year-olds and females, in both nations, as well as people in White ethnic groups in the UK and people with Swedish-born parents in Sweden. Over time there has been a consistent decline in the proportion of autistic adults with a prior diagnosis of epilepsy, psychosis and intellectual disability and an increase in the proportion with a prior diagnosis of ADHD, anxiety, depression and several other mental illnesses. For example, in the UK between 2010 and 2023, a history of epilepsy among adults with newly recorded autism decreased from 10% (95%CI: 7.6, 13) to 4% (95%CI: 3.6, 4.5), while a history of anxiety increased from 28.7% (95%CI: 24.4, 33.6) to 58.3% (95%CI: 56.6, 60.1). Trends were broadly consistent between females and males. Conclusions: The characteristics of individuals diagnosed as autistic have changed dramatically since 2010, in both the UK and Sweden. Clinical implications: Service design and clinical practice around autistic healthcare should account for: inequitable distribution of autism diagnoses in society, the diagnostic complexity associated with other mental health conditions, and apparent changes in the average health needs of autistic groups. The extent to which these changes indicate nuanced recognition of autism or broadening of diagnostic practice needs investigation.

Item Type:	Article
Status:	In Press
Schools:	Schools > Medicine
Publisher:	BMJ Publishing Group
Date of First Compliant Deposit:	29 September 2026
Date of Acceptance:	23 September 2026
Last Modified:	29 Sep 2026 13:45
URI:	https://orca.cardiff.ac.uk/id/eprint/189893

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