The Life Cycle of Mental Illness in Young People: Female Autism and Managing a Difficult Relationship

Aims. The primary aim is to explore intergenerational clinical issues caused by the underdiagnosis of female autistic spectrum disorder (ASD) in mental illness (MI) by calculating the proportion with a mental health problem who are autistic. Secondary aims are to derive further values for the true prevalence of female ASD, and to derive a mathematical model to estimate the improved efficiency of management based on the correct diagnostic formulation. Context. Review diagnosis problems and background issues relating to female autism which affect diagnosis and management of the ASD and associated MI. Methodology. An inductive process using Bayes’ theorem including a novel form akin to a medical test with secondary data from peer reviewed sources, and the key variable of the unbiased value for the prevalence of ASD in females. Derivation of a model for management efficiency based on the Pareto Principle. Results. Prevalence values for ASD in various mental illnesses and conditions consequent on or associated with ASD and MI. Further data for the prevalence of female ASD with a range of 19 values. Estimation of the efficiency gains as advocacy for revision of methods of treatment. Discussion. Components of the cycle. The centrality of diagnosing ASD in mothers with mental illness to break a common intergenerational cycle. Problems to overcome and aspects of effective management including environmental and therapeutic interventions. Summary. This paper will for the first time calculate the proportions of children and young women with a mental illness (MI) who are autistic, and consider the consequences. Recent information suggests female autistic spectrum disorder (ASD) is much more common than previously thought, with a likely prevalence of 6% and with 80% undiagnosed at the age of 18. ASD then becomes a common comorbidity of female mental illness with nearly one in five women who develop a mental illness being autistic. ASD has heretofore been regarded as a pediatric condition and though now thought to be lifelong it is still not well recognized by adult health services. Most mental illness first presents in the teens and early twenties, although anxiety can begin even earlier. Comorbid ASD is more difficult to diagnose due to diagnostic overshadowing, and ASD comorbidity makes the mental illness more severe and more difficult to treat. The consequences of perinatal depression are particularly concerning due to their intergenerational effects. Recognized ASD is readily treatable with an approach empathetic to neurodiversity. Improving the transition from adolescence to young adulthood by increasing knowledge of autism in adult health services would dramatically improve female mental health at surprisingly little effort or extra cost.