Patterns of Mortality among People with Autism Spectrum Disorder in South Korea
Abstract
Background: Detailed statistics on the death status of persons with autism spectrum disorder (ASD) are lacking. We aimed to identify and compare recent mortality rates in persons with ASD in Korea.
Methods: From 2012 to 2021, databases were established by linking data on persons with ASD registered in Korea with data on cause of death from the National Statistical Office.
Results: Between 2012 and 2021, the mortality rate of persons with ASD and age-standardized mortality rates fluctuated annually. The crude mortality rates in the population with ASD were 91.6, 113.8, and 74.5 in 2012, 2016, and 2021, respectively, which were lower than the rates in the general population; however, the age-standardized mortality rate was observed to be five times higher. Intentional self-harm, as a cause of death in persons with ASD, was ranked high annually. The mortality rates in persons with ASD from diseases (50.7%) and injury (49.3%) were in a ratio of 1:1. Diseases and injury were more causes of death in males with ASD. The average age of persons with ASD at death was confirmed to be approximately 50 years lower than that of the general population.
Conclusion: Deaths and causes of death in persons with ASD differ from those of the general population. Therefore, preventive measures and efforts are required to reduce avoidable deaths among persons with ASD.
1. Autism and Developmental Disabilities Monitoring Network Surveillance Year 2006 Principal Investigators; Centers for Disease Control and Prevention (CDC) (2009). Prevalence of autism spectrum disorders-autism and developmental disabilities monitoring network, United States, 2006. MMWR Surveill Summ, 58 (10): 1-20.
2. Canitano R (2007). Epilepsy in autism spec-trum disorders. Eur Child Adolesc Psychia-try, 16 (1): 61-6.
3. Poustka L, Poustka F (2007). Psychophar-macology of autistic disorders. Z Kinder Jugendpsychiatr Psychother, 35 (2): 87-94.
4. Crane JL, Winsler A (2008). Early Autism Detection: Implications for Pediatric Practice and Public Policy. J Disabil Policy Stud, 18 (4): 245-53.
5. Korean Statistical Information Service (2023). Database: Status of registered persons with disabilities. Available online: https://kosis.kr/statHtml/statHtml.do?orgId=117&tblId=DT_11761_N004. (ac-cessed on 1 February 2024)
6. National Rehabilitation Center (2022). 2021 Healthcare and Health Management Project of people with disabilities. Available online: (accessed on 5 Febru-ary 2024). https://www.nrc.go.kr/eng/html/content.do?depth=n_id&menu_cd=05_03
7. Gillberg C, Billstedt E, Sundh V, Gillberg IC (2010). Mortality in autism: a prospec-tive longitudinal community-based study. J Autism Dev Disord, 40 (3): 352-7.
8. Hirvikoski T, Mittendorfer-Rutz E, Boman M, Larsson H, Lichtenstein P, Bölte S (2016). Premature mortality in autism spectrum disorder. Br J Psychiatry, 208 (3): 232-8.
9. Mouridsen SE, Brønnum-Hansen H, Rich B, Isager T (2008). Mortality and causes of death in autism spectrum disorders: An update. Autism, 12 (4): 403-14.
10. Shattuck PT, Durkin M, Maenner M, et al (2009). Timing of identification among children with an autism spectrum disor-der: Findings from a population-based surveillance study. J Am Acad Child Ado-lesc Psychiatry, 48 (5): 474-83.
11. Bilder D, Botts EL, Smith KR, et al (2013). Excess mortality and causes of death in autism spectrum disorders: a follow up of the 1980s Utah/UCLA autism epide-miologic study. J Autism Dev Disord, 43 (5): 1196-204.
12. Mouridsen S (2013). Mortality and Factors Associated with Death in Autism Spec-trum Disorders - a Review. Am J Autism, 1: 17–25.
13. Schendel DE, Overgaard M, Christensen J, Hjort L, Jørgensen M, Vestergaard M, Parner ET (2016). Association of Psy-chiatric and Neurologic Comorbidity with Mortality Among Persons With Au-tism Spectrum Disorder in a Danish Population. JAMA Pediatrics, 170 (3): 243-50.
14. McCarron M, Carroll R, Kelly C, McCallion P (2015). Mortality Rates in the General Irish Population Compared to those with an Intellectual Disability from 2003 to 2012. J Appl Res Intellect Disabil, 28 (5): 406-13.
15. Ministry of Government Legislation (2023). Database: Act on Guarantee of Rights of and Support for Persons with Devel-opmental Disabilities. Available online: https://www.law.go.kr/법령/ (accessed 1 February 2024).
16. Ministry of Government Legislation (2023). Database: Act on Welfare of Persons with Disabilities. Available online: https://www.law.go.kr/법령/ (accessed 15 February 2024).
17. Korean Statistical Information Service (2023). Database: Classification of cause of disease in Korea. Available online: http://kssc.kostat.go.kr/ksscNew_web/kssc/common/ClassificationContent.do?gub-un=1&strCategoryNameCode=004&categoryMenu=007&addGubun=no (ac-cessed 15 February 2024).
18. World Health Organization (2016). Data-base: International Classification of Diseases-10. Available online: https://www.who.int/standards/classifications/classification-of-diseases/list-of-official-icd-10-updates
19. World Health Organization (2023). Data-base: Cause of death. Available online: https://www.who.int/standards/classifications/classification-of-diseases/cause-of-death
20. Woolfenden S, Sarkozy V, Ridley G, Coory M, Williams K (2012). A systematic re-view of two outcomes in autism spec-trum disorder–epilepsy and mortality. Dev Med Child Neurol, 54 (4): 306-12.
21. Pickett JA, Paculdo DR, Shavelle RM, Strauss DJ (2006). 1998-2002 Update on “Causes of death in autism”. J Autism Dev Disord, 36 (2): 287-11288.
22. Shavelle RM, Strauss DJ, Pickett J (2001). Causes of death in autism. J Autism Dev Disord, 31 (6): 569-76.
23. Hossain MM, Khan N, Sultana A, Ma P, McKyer ELJ, Ahmed HU, Purohit N (2020). Prevalence of comorbid psychi-atric disorders among people with au-tism spectrum disorder: An umbrella re-view of systematic reviews and meta-analyses. Psychiatry Res, 287: 112922.
24. Pickett J, Xiu E, Tuchman R, Dawson G, Lajonchere C (2011). Mortality in indi-viduals with autism, with and without ep-ilepsy. J Child Neurol, 26 (8), 932-39.
25. Lunsky Y, Lai MC, Balogh R, et al (2022). Premature mortality in a population‐based cohort of autistic adults in Cana-da. Autism Res, 15 (8): 1550-9.
26. Hwang YIJ, Srasuebkul P, Foley KR, Arnold S, Trollor JN (2019). Mortality and cause of death of Australians on the autism spectrum. Autism Res, 12 (5), 806-15.
27. Richa S, Fahed M, Khoury E, Mishara B (2014). Suicide in autism spectrum disor-ders. Arch Suicide Res, 18 (4): 327-39.
28. Guan J, Li G (2017). Injury Mortality in In-dividuals with Autism. Am J Public Health, 107 (5): 791-3.
2. Canitano R (2007). Epilepsy in autism spec-trum disorders. Eur Child Adolesc Psychia-try, 16 (1): 61-6.
3. Poustka L, Poustka F (2007). Psychophar-macology of autistic disorders. Z Kinder Jugendpsychiatr Psychother, 35 (2): 87-94.
4. Crane JL, Winsler A (2008). Early Autism Detection: Implications for Pediatric Practice and Public Policy. J Disabil Policy Stud, 18 (4): 245-53.
5. Korean Statistical Information Service (2023). Database: Status of registered persons with disabilities. Available online: https://kosis.kr/statHtml/statHtml.do?orgId=117&tblId=DT_11761_N004. (ac-cessed on 1 February 2024)
6. National Rehabilitation Center (2022). 2021 Healthcare and Health Management Project of people with disabilities. Available online: (accessed on 5 Febru-ary 2024). https://www.nrc.go.kr/eng/html/content.do?depth=n_id&menu_cd=05_03
7. Gillberg C, Billstedt E, Sundh V, Gillberg IC (2010). Mortality in autism: a prospec-tive longitudinal community-based study. J Autism Dev Disord, 40 (3): 352-7.
8. Hirvikoski T, Mittendorfer-Rutz E, Boman M, Larsson H, Lichtenstein P, Bölte S (2016). Premature mortality in autism spectrum disorder. Br J Psychiatry, 208 (3): 232-8.
9. Mouridsen SE, Brønnum-Hansen H, Rich B, Isager T (2008). Mortality and causes of death in autism spectrum disorders: An update. Autism, 12 (4): 403-14.
10. Shattuck PT, Durkin M, Maenner M, et al (2009). Timing of identification among children with an autism spectrum disor-der: Findings from a population-based surveillance study. J Am Acad Child Ado-lesc Psychiatry, 48 (5): 474-83.
11. Bilder D, Botts EL, Smith KR, et al (2013). Excess mortality and causes of death in autism spectrum disorders: a follow up of the 1980s Utah/UCLA autism epide-miologic study. J Autism Dev Disord, 43 (5): 1196-204.
12. Mouridsen S (2013). Mortality and Factors Associated with Death in Autism Spec-trum Disorders - a Review. Am J Autism, 1: 17–25.
13. Schendel DE, Overgaard M, Christensen J, Hjort L, Jørgensen M, Vestergaard M, Parner ET (2016). Association of Psy-chiatric and Neurologic Comorbidity with Mortality Among Persons With Au-tism Spectrum Disorder in a Danish Population. JAMA Pediatrics, 170 (3): 243-50.
14. McCarron M, Carroll R, Kelly C, McCallion P (2015). Mortality Rates in the General Irish Population Compared to those with an Intellectual Disability from 2003 to 2012. J Appl Res Intellect Disabil, 28 (5): 406-13.
15. Ministry of Government Legislation (2023). Database: Act on Guarantee of Rights of and Support for Persons with Devel-opmental Disabilities. Available online: https://www.law.go.kr/법령/ (accessed 1 February 2024).
16. Ministry of Government Legislation (2023). Database: Act on Welfare of Persons with Disabilities. Available online: https://www.law.go.kr/법령/ (accessed 15 February 2024).
17. Korean Statistical Information Service (2023). Database: Classification of cause of disease in Korea. Available online: http://kssc.kostat.go.kr/ksscNew_web/kssc/common/ClassificationContent.do?gub-un=1&strCategoryNameCode=004&categoryMenu=007&addGubun=no (ac-cessed 15 February 2024).
18. World Health Organization (2016). Data-base: International Classification of Diseases-10. Available online: https://www.who.int/standards/classifications/classification-of-diseases/list-of-official-icd-10-updates
19. World Health Organization (2023). Data-base: Cause of death. Available online: https://www.who.int/standards/classifications/classification-of-diseases/cause-of-death
20. Woolfenden S, Sarkozy V, Ridley G, Coory M, Williams K (2012). A systematic re-view of two outcomes in autism spec-trum disorder–epilepsy and mortality. Dev Med Child Neurol, 54 (4): 306-12.
21. Pickett JA, Paculdo DR, Shavelle RM, Strauss DJ (2006). 1998-2002 Update on “Causes of death in autism”. J Autism Dev Disord, 36 (2): 287-11288.
22. Shavelle RM, Strauss DJ, Pickett J (2001). Causes of death in autism. J Autism Dev Disord, 31 (6): 569-76.
23. Hossain MM, Khan N, Sultana A, Ma P, McKyer ELJ, Ahmed HU, Purohit N (2020). Prevalence of comorbid psychi-atric disorders among people with au-tism spectrum disorder: An umbrella re-view of systematic reviews and meta-analyses. Psychiatry Res, 287: 112922.
24. Pickett J, Xiu E, Tuchman R, Dawson G, Lajonchere C (2011). Mortality in indi-viduals with autism, with and without ep-ilepsy. J Child Neurol, 26 (8), 932-39.
25. Lunsky Y, Lai MC, Balogh R, et al (2022). Premature mortality in a population‐based cohort of autistic adults in Cana-da. Autism Res, 15 (8): 1550-9.
26. Hwang YIJ, Srasuebkul P, Foley KR, Arnold S, Trollor JN (2019). Mortality and cause of death of Australians on the autism spectrum. Autism Res, 12 (5), 806-15.
27. Richa S, Fahed M, Khoury E, Mishara B (2014). Suicide in autism spectrum disor-ders. Arch Suicide Res, 18 (4): 327-39.
28. Guan J, Li G (2017). Injury Mortality in In-dividuals with Autism. Am J Public Health, 107 (5): 791-3.
| Files | ||
| Issue | Vol 54 No 2 (2025) | |
| Section | Original Article(s) | |
| Keywords | ||
| Autism spectrum disorder Crude death rate Mortality Intentional self- harm South Korea | ||
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How to Cite
1.
Kim Y-S, Kwon S, Kim J-H, Ho SH. Patterns of Mortality among People with Autism Spectrum Disorder in South Korea. Iran J Public Health. 2025;54(2):396-403.
