The Presentation of Depression in Depressed Autistic Individuals: A Systematic Review

This systematic literature review examines the varied presentations of depression in depressed autistic individuals, including symptoms beyond DSM-5-TR criteria. A search of five databases (updated February 2024) identified 24 studies, encompassing 243 autistic individuals. Study quality varied, assessed using QuADS. The review was pre-registered with PROSPERO (CRD42022355322). Results were synthesised based on DSM-5-TR criteria and additional presentations, including who reported them. Findings showed 91.66% of studies reported presentations beyond DSM-5-TR criteria. Additionally, some DSM-5-TR symptoms may present differently in autistic individuals. Variations in depressive signs were noted across self-reports, informant-reports, interviews, and questionnaires. Clarifying whether these additional presentations are autism-specific, arise from the intersection of autism and depression, or manifestations of a depressive disorder is necessary for refining diagnostic tools.