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Study protocol: an investigation of the prevalence of autism among adults admitted to acute mental health wards: a cross-sectional pilot study
  1. Sam Tromans1,2,
  2. Guiqing Lily Yao1,
  3. Reza Kiani1,2,
  4. Regi Alexander1,3,
  5. Mohammed Al-Uzri1,4,
  6. Traolach Brugha1,4
  1. 1 Department of Health Sciences, University of Leicester, Leicester, UK
  2. 2 Learning Disability Psychiatry, Leicestershire Partnership NHS Trust, Leicester, UK
  3. 3 Learning Disability Psychiatry, Hertfordshire Partnership University NHS Foundation Trust, Norwich, UK
  4. 4 General Adult Psychiatry, Leicestershire Partnership NHS Trust, Leicester, UK
  1. Correspondence to Dr Sam Tromans; sjt56{at}


Introduction Autism spectrum disorders (ASDs) are associated with difficulties in social interaction, communication and restricted, repetitive behaviours. Much is known about their community prevalence among adults, data on adult inpatients within an acute mental health setting is lacking.

This pilot study aimed to estimate the prevalence of ASDs among adults admitted to acute mental health wards and to examine the association between ASDs and psychiatric and physical comorbidities within this group.

Methods and analysis A multiple-phase approach will be used. Phase I will involve testing of 200 patients and corresponding informants, using the autism quotient (AQ), the informant version of the Social Responsiveness Scale, second edition—Adult, the self and informant versions of the Adult Social Behaviour Questionnaire and the EuroQol-5D-5L. Patients with intellectual disability (ID) will bypass Phase I.

Phase II will involve diagnostic testing of a subgroup of 40 patients with the Diagnostic Interview for Social and Communication Disorders, the Autism Diagnostic Observation Schedule version 2 and the ASD interview within the Schedules for Clinical Assessment in Neuropsychiatry version 3. 25±5 patients will not have ID and be selected via stratified random sampling according to AQ score; 15±5 patients will have ID. Phase II patients will be interviewed with the Physical Health Conditions and Mental Illness Diagnoses and Treatment sections of the 2014 Adult Psychiatric Morbidity Survey.

Prevalence estimates will be based on the proportion of Phase II participants who satisfy the 10th revision of the International Statistical Classification of Diseases and Related Health Problems Diagnostic Criteria for Research (ICD-10-DCR) and the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnostic criteria for ASD, adjusting for selection and non-response. Univariate analysis will be conducted for comorbidities to identify the level of their association with an ASD diagnosis.

Ethics and dissemination Study oversight is provided by the University of Leicester. The National Health Service Health Research Authority have provided written approval. Study results will be disseminated via conference presentations and peer-reviewed publications.

Trial registration number ISRCTN27739943

  • adult psychiatry
  • public health
  • epidemiology
  • mental health
  • autism

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  • Contributors ST, TB, GLY, RK, RA and MA-U were involved in drafting the study protocol. TB and ST conceived of the idea for this study. ST is the principal investigator for the study, under the supervision of TB. ST led in writing the manuscript, TB and GLY contributed revisions and all authors approved the final manuscript.

  • Funding This study was supported by funding awarded by an NIHR Senior Investigator, as well as receiving funding and resource support from the NIHR, as a result of the study being adopted onto the NIHR Clinical Research Network Portfolio of studies. GLY's research is partly funded by an MRC grant.

  • Competing interests TB is directly involved with the development of the autism spectrum disorder (ASD) interview questions for the Schedules for Assessment in Neuropsychiatry version 3, which have not yet been formally published; this study is involved in testing the clinical utility of these questions. Additionally, TB and RK were authors of the 2014 APMS, from which two questionnaires are being used. Neither TB nor RK will be receiving any monetary payment as a result of the inclusion of the ASD interview questions or the 2014 APMS questionnaires within this study.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.