The impact of depressive and anxious symptoms on quality of life in adults on the autism spectrum

Quality of life (QoL) is lower in adults on the autism spectrum (AS) compared with typically developing (TD) adults. In this context, recent studies have examined the role of depression and anxiety in reducing QoL in AS adults. The aim of this study was to (1) replicate these findings of lower QoL and (2) assess the negative influence of depressive and anxious symptoms on QoL in an adult AS (N = 86) and TD (N = 87) German sample with a broad age range (18–70 years). For this, we used questionnaires that have been validated for the AS and TD population: the World Health Organization Quality of Life Brief Version, the Autism‐Specific QoL items, and the Hospital Anxiety and Depression Scale. We replicated previous findings and extended them to autism‐specific QoL. Our AS sample had lower QoL compared with the TD adults. However, depressive symptoms were the largest contributor to lower QoL in both samples, more so than group membership and anxious symptoms. We conclude that interventions to improve QoL in AS adults should specifically target depressive symptoms and for this, improvements to the diagnostic process and treatment of depression in AS are necessary. Lay Summary Adults on the autism spectrum reported lower quality of life (QoL) in comparison to typically developing adults. Depressive symptoms were a more relevant aspect in reducing QoL in both study groups than group membership or anxious symptoms. We conclude that interventions to improve QoL in adults on the autism spectrum should specifically address depressive symptoms. For this, improvements in recognizing and treating depression in autism spectrum are necessary.