Prevalence of co-occurring conditions in children and adults with autism spectrum disorder: A systematic review and meta-analysis

Neurosci Biobehav Rev. 2023 Dec:155:105436. doi: 10.1016/j.neubiorev.2023.105436. Epub 2023 Oct 31.


This systematic review estimates the prevalence of co-occurring conditions (CCs) in children and adults with autism. A comprehensive search strategy consulting existing guidelines, diagnostic manuals, experts, carers, and autistic people was developed. PubMed and PsycInfo databases from inception to May 2022 were searched. PROSPERO registration: CRD42019132347. Two blind authors screened and extracted the data. Prevalence estimates for different CCs were summarized by using random effects models. Subgroup analyses were performed for age groups (children/adolescents vs adults) and study designs (population/registry-based vs clinical sample-based). Of 19,932 studies, 340 publications with about 590,000 participants were included and meta-analyzed to estimate the prevalence of 38-point prevalence, 27-lifetime, and 3 without distinction between point and lifetime prevalence. Point prevalence of developmental coordination disorder, sleep-wake problem, gastrointestinal problem, ADHD, anxiety disorder, overweight/obesity, feeding and eating disorder, elimination disorder, disruptive behavior, and somatic symptoms and related disorder were the most frequent CCs. Prevalence differed depending on the age group and study design. Knowing specific CCs linked to autism helps professional investigations and interventions for improved outcomes.

Keywords: Autism spectrum disorder; Co-occurring Condition; Comorbidity; Dual diagnosis; Frequency; Incidence; Meta-analysis; Multimorbidity; Prevalence; Systematic review.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Autism Spectrum Disorder* / epidemiology
  • Autistic Disorder*
  • Child
  • Humans
  • Obesity
  • Overweight
  • Prevalence