Updated Systematic Review of Suicide in Autism: 2018–2024

The purpose of this review is to provide a comprehensive update of literature published between January 2018 and April 2024, examining suicidal thoughts and behavior (STB) prevalence, risk factors, theoretical models, and interventions in autism.

We identified four recent meta-analyses and two systematic reviews. Pooled prevalence estimates in autism ranged from 34.2% for suicide ideation to 24.3% for suicide attempts. Autistic traits, interpersonal factors, and depressive symptoms were identified as STB risk factors, with elevated risk observed across the lifespan.

We included 80 studies examining STB in diagnosed autistic people or autistic traits in non-clinical samples. Autistic people were found to have an up to eightfold increased risk of death by suicide compared to non-autistic people, although reported rates varied considerably between studies; co-occurring mental health conditions, social, psychological, and cognitive factors exacerbated risk. Validated STB assessment tools and interventions for autistic people were notably scarce.