Treatment of Depression in Individuals with Autism Spectrum Disorder: A Systematic Review

Abstract Background Given the prevalence of depression in persons with autism spectrum disorder (ASD), effective treatment is crucial; however, a systemic review on the topic has not been published in over a decade. This study aimed to systematically examine the efficacy of psychosocial and pharmacological treatments for depression in youth and adults with ASD to inform clinical practice. Method PsycINFO, PubMed, and CINAHL online databases were searched for peer-reviewed journal articles containing any combination of the following terms in the abstract: (1) autism, autistic, Asperger, or “pervasive developmental disorder,” (2) depression or depressive and (3) treatment, intervention, trial, therapy, medication, drug, or antidepressant. Evidence from studies meeting the predetermined criteria of inclusion was assessed for its strength to inform clinical decision-making. Results Twenty psychosocial treatment studies and five pharmacological treatment studies met the criteria of inclusion. Psychosocial interventions studied the effectiveness of cognitive remediation therapy, behavioral therapy, cognitive-behavioral therapy (CBT), combined psychosocial intervention, mindfulness-based therapy (MBT), and social, academic, and/or vocational skills training. Pharmacological interventions studied the effectiveness of anti-epileptic drug, norepinephrine reuptake inhibitor, stimulant, atypical antipsychotic, and NMDA receptor antagonist treatment. Conclusions Although much recent research has investigated potentially effective treatments for depression in individuals with ASD, the strength of the evidence remains generally poor. However, studies indicate preliminary efficacy for MBT. A number of investigations have examined the effect of CBT on depression in persons with ASD; however, the results are inconsistent. Further research is needed to advance clinical practice for individuals with ASD and comorbid depression.