Autism, in a decade 'jump' of cases between 15 and 39 years old but lack of answers

Who will take care of autistic children once they become adults and what answers are already being given to people with a late diagnosis? The subject is one to make one's wrists shake, as the writer Daniele Mencarelli recalled in his investigative book 'No Tu No. Che fine fa un Paese se la salute non è per tutti' (ed Il Sole-24Ore). "What politicians fail to understand is that from here to twenty years from now the issue of health will be the great emergency of this country in the face of new disorders such as neurodevelopment,' Mencarelli warns. 'In Italy we have 700 thousand families living with the issue of autism and from here to 20 years we will have 700 thousand adults who will represent a civil and economic responsibility for this country. We must start thinking about all this today'.

The issue is not only an Italian one, but also in Italy there is a lack of early diagnosis, homogeneous and appropriate responses, and above all a long-term vision. Family associations such as Angsa and experts dealing with autism are well aware of the extent of the problem, but today it is a global analysis of the Global Burden of Disease data, published in the journal Frontiers in Public Health, that is turning the spotlight on the 'silent crisis' of autism in adulthood. For decades, the efforts of doctors and scientists against autism have focused almost exclusively on children. Far too little attention is paid to autistic children who become young adults, or to adults who discover their condition late in life.

Between 1990 and 2021, the global number of people with an autism spectrum disorder (ASD) in the 15-39 age group jumped from 17.52 million to 24.13 million. An increase that is certainly linked to population growth and a better diagnostic capacity but which, as the experts of the Italian Society of Psychiatry (Sip) explaining the topic at the 50th congress underway in Bari, 'imposes a dramatic reflection on the inadequacy of the support provided to this segment of the population'.

As Liliana Dell'Osso, president of Sip and professor of psychiatry in Pisa, recalls, 'autism does not only concern childhood, but is a condition that accompanies the individual throughout life. Autistic children become adults and often autism itself remains invisible until adulthood. In many cases, these hidden forms only emerge when faced with stressful situations or major changes, especially in women, who learn early on to mask their communication and relational difficulties through camouflaging strategies'. Elements that 'hinder the diagnostic process and, consequently, the taking charge of adults with autism', adds Emi Bondi, outgoing president of Sip and head of the Mental Health Department of the Papa Giovanni XXIII Hospital in Bergamo.

The data of the new study show a critical situation, especially in the age group between 30 and 39, where the sharpest increase in disability was recorded (+56%). "This phenomenon," explains Antonio Vita, vice-president of Sip and professor of Psychiatry in Brescia, "supports the hypothesis of a 'second peak' of difficulties for people with autism, which occurs in adulthood when school support runs out and the challenge of entering the world of work, gaining independence, and navigating complex adult social relationships becomes more pressing." In Italy, people on the autism spectrum are estimated to be at least 1% of the population, a total of about 500,000 individuals, but we have no specific data on how many adults there are.