Excess Mortality in Individuals with Autism Spectrum Disorder: A Population-Based Cohort Study

Yu-Hsin Huang,1,2,* Shu-I Wu,1,2 Min-Jing Lee,3– 5,* Yi-Lung Chen,6,7,* Yao-Hsu Yang,8,9 Ting-Yu Kuo,8 Tai-Hsin Hung,3,4 Michael E Dewey,10 Robert Stewart,11,12 Vincent Chin-Hung Chen3,4 1Department of Medicine, MacKay Medical College, New Taipei City, Taiwan; 2Department of Psychiatry, MacKay Memorial Hospital, Taipei City, Taiwan; 3Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan; 4School of Medicine, Chang Gung University, Taoyuan, Taiwan; 5Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; 6Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan; 7Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan; 8Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan; 9Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan; 10Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK; 11Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK; 12South London and Maudsley National Health Services Foundation Trust, London, UK*These authors contributed equally to this workCorrespondence: Vincent Chin-Hung Chen, Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan, Tel +886-5-3621000 ext2303, Fax +886-5-3622188, Email cch1966@gmail.comPurpose: Autism spectrum disorder (ASD) may be associated with increased mortality, but relevant findings have been inconsistent. The modifying effects of gender and intellectual disability on excess mortality in individuals with ASD are underexplored.Patients and Methods: Using Taiwan’s National Health Insurance Research Database and the National Death Registry, this population-based cohort study selected the