LANCET PSYCHIATRY, cilt.12, sa.2, ss.111-121, 2025 (SCI-Expanded, SSCI, Scopus)
Background High-quality estimates of the epidemiology of the autism spectrum and the health needs of autistic people are necessary for service planners and resource allocators. Here we present the global prevalence and health burden of autism spectrum disorder from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 following improvements to the epidemiological data and burden estimation methods. Methods For GBD 2021, a systematic literature review involving searches in PubMed, Embase, PsycINFO, the Global Health Data Exchange, and consultation with experts identified data on the epidemiology of autism spectrum disorder. Eligible data were used to estimate prevalence via a Bayesian meta-regression tool (DisMod-MR 2.1). Modelled prevalence and disability weights were used to estimate health burden in years lived with disability (YLDs) as the measure of non-fatal health burden and disability-adjusted life-years (DALYs) as the measure of overall health burden. Data by ethnicity were not available. People with lived experience of autism were involved in the design, preparation, interpretation, and writing of this Article. Findings An estimated 61 center dot 8 million (95% uncertainty interval 52 center dot 1-72 center dot 7) individuals (one in every 127 people) were on the autism spectrum globally in 2021. The global age-standardised prevalence was 788 center dot 3 (663 center dot 8-927 center dot 2) per 100 000 people, equivalent to 1064 center dot 7 (898 center dot 5-1245 center dot 7) autistic males per 100 000 males and 508 center dot 1 (424 center dot 6-604 center dot 3) autistic females per 100 000 females. Autism spectrum disorder accounted for 11 center dot 5 million (7 center dot 8-16 center dot 3) DALYs, equivalent to 147 center dot 6 (100 center dot 2-208 center dot 2) DALYs per 100 000 people (age-standardised) globally. At the super-region level, age-standardised DALY rates ranged from 126 center dot 5 (86 center dot 0-178 center dot 0) per 100 000 people in southeast Asia, east Asia, and Oceania to 204 center dot 1 (140 center dot 7-284 center dot 7) per 100 000 people in the high-income super-region. DALYs were evident across the lifespan, emerging for children younger than age 5 years (169 center dot 2 [115 center dot 0-237 center dot 4] DALYs per 100 000 people) and decreasing with age (163 center dot 4 [110 center dot 6-229 center dot 8] DALYs per 100 000 people younger than 20 years and 137 center dot 7 [93 center dot 9-194 center dot 5] DALYs per 100 000 people aged 20 years and older). Autism spectrum disorder was ranked within the top-ten causes of non-fatal health burden for people younger than 20 years. Interpretation The high prevalence and high rank for non-fatal health burden of autism spectrum disorder in people younger than 20 years underscore the importance of early detection and support to autistic young people and their caregivers globally. Work to improve the precision and global representation of our findings is required, starting with better global coverage of epidemiological data so that geographical variations can be better ascertained. The work presented here can guide future research efforts, and importantly, decisions concerning allocation of health services that better address the needs of all autistic individuals.