Uncovering Autism: The Hidden Prevalence of ASD in Females with Mental Illness

A secondary-data Bayesian reanalysis of aggregated case-ascertainment datasets recalibrates female autism spectrum disorder (ASD) prevalence to about 6% overall, with roughly 80% undiagnosed by age 18 and an estimated prevalence near 20% among women with mental illness, exposing a large, previously unrecognized detection gap in females.

Historical diagnostic bias and diagnostic overshadowing have long suppressed female diagnosis. The recalibrated prevalence reframes how clinicians weigh comorbidity in adult women presenting with mood or anxiety disorders.

The authors pooled and reweighted national administrative records and clinical cohort data and applied explicit priors within an inductive Bayes framework to estimate true prevalence and the undetected fraction. Primary endpoints were estimated female prevalence and the proportion undetected by age 18; sensitivity analyses varied prior assumptions and compared modelled prevalence to observed ascertainment rates to test robustness.

Higher-than-expected maternal ASD prevalence intersects with perinatal depression and parenting stress in ways that may amplify intergenerational mental-health risk. Relevant care-coordination steps include adapted psychosocial supports, targeted family-planning counseling, and focused attention to parent–infant interaction in affected dyads.

Earlier, accurate ASD recognition can shorten diagnostic cycling, reduce ineffective mono-diagnostic treatments, and streamline referrals to neurodevelopmental-informed therapies—delivering measurable efficiency gains in perinatal mental-health pathways.