Risk Factors for Suicide in Adults with Autism: An Integrative Review

Abstract

Introduction:Autism Spectrum Disorder (ASD) is a neurodevelopmental condition associated with challenges in social relations, communication, and emotional regulation. In adults, factors such as social isolation, late diagnosis, and psychiatric comorbidities may increase susceptibility to suicidal behavior, constituting an important public health concern. Objective: To investigate the main risk factors associated with suicide in adults with ASD through an integrative literature review. Methods: The research was conducted in the databases National Center for Biotechnology Information (PubMed), Med Search Portal for Life Sciences (LIVIVO), and Scientific Electronic Library Online (SciELO), encompassingstudies published between 2016 and 2026 in Portuguese and English. After applying the inclusion and exclusion criteria, 23 studies made up the final sample. Results: There was a preponderance of cross-sectional studies and a greater concentration of publications originating from the United Kingdom and the United States. Social factors were present in all analyzed studies, especially social isolation, bullying, inclusion barriers, social camouflaging, and limited support networks. In addition, psychiatric factors, particularly depression, anxiety, and alexithymia, showed a strong association with suicidal ideation. Psychocognitive aspects, such as cognitive rigidity, rumination, and difficulties in emotional regulation, also contributed significantly to the increased suicide risk. Conclusion: The findings demonstrate that the risk of suicide in adults with ASD results from the interaction between social, psychiatric, and psychocognitive factors. Therefore, strategies aimed at early identification, strengthening social support, and expanding mental health care are essential for preventing suicidal behavior in this population.