Alcohol use among populations with autism spectrum disorder: narrative systematic review
Alcohol use among populations with autism spectrum disorder: narrative systematic review
Background: alcohol use in autism spectrum disorder (ASD) is under-researched. Previous reviews have explored substance use as a whole, but this neglects individual characteristics unique to different substances. Alcohol use in non-clinical samples is associated with diverse responses. To advance practice and policy, an improved understanding of alcohol use among people with ASD is crucial to meet individual needs.
Aims: this was a narrative systematic review of the current literature on the association between alcohol use and ASD, focusing on aetiology (biological, psychological, social, and environmental risk factors) and implications (consequences and protective factors) of alcohol use in autistic populations who utilise clinical services. We sought to identify priority research questions and offer policy and practice recommendations.
Method: PROSPERO Registration: CRD42023430291. The search was conducted across five databases: CINAHL, EMBASE, MEDLINE, PsychINFO, and Global Health. Included studies explored alcohol use and ASD within clinical samples.
Results: A total of 22 studies were included in the final review. The pooled prevalence of alcohol-use disorder in ASD was 1.6% and 16.1% in large-population registers and clinical settings, respectively. Four components were identified as possible aetiological risk factors – age, co-occurring conditions, gender, and genetics. We identified 10 implications for co-occurring alcohol use disorder in ASD, summarised as a concept map.
Conclusion: emerging trends in the literature suggest direction and principles for research and practice. Future studies should use a standardised methodological approach—including psychometrically validated instruments and representative samples—to inform policy and improve the experience for autistic populations with co-occurring alcohol use.
Autistic spectrum disorders, alcohol disorders, comorbidity, mental health services, neurodevelopmental disorders
Barber, William
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Aslan, Betul
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Meynen, Tim
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Marsden, John
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Chamberlain, Samuel R.
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Paleri, Vigneshwar
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Sinclair, Julia
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Barber, William
50a16038-b08c-4450-8fe6-8a7c46cbc16b
Aslan, Betul
bea5e723-54ca-483c-9817-7428e53e53b9
Meynen, Tim
2fc5ecc9-2cdb-40c9-a5ec-049a1014a84b
Marsden, John
fc0da710-cf2d-45f8-8505-e6e8cbb85b04
Chamberlain, Samuel R.
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Paleri, Vigneshwar
87fcbfff-606a-4584-ab6e-a6ce0f5d9190
Sinclair, Julia
be3e54d5-c6da-4950-b0ba-3cb8cdcab13c
Barber, William, Aslan, Betul, Meynen, Tim, Marsden, John, Chamberlain, Samuel R., Paleri, Vigneshwar and Sinclair, Julia
(2025)
Alcohol use among populations with autism spectrum disorder: narrative systematic review.
BJPsych Open, 11 (1), [e15].
(doi:10.1192/bjo.2024.824).
Abstract
Background: alcohol use in autism spectrum disorder (ASD) is under-researched. Previous reviews have explored substance use as a whole, but this neglects individual characteristics unique to different substances. Alcohol use in non-clinical samples is associated with diverse responses. To advance practice and policy, an improved understanding of alcohol use among people with ASD is crucial to meet individual needs.
Aims: this was a narrative systematic review of the current literature on the association between alcohol use and ASD, focusing on aetiology (biological, psychological, social, and environmental risk factors) and implications (consequences and protective factors) of alcohol use in autistic populations who utilise clinical services. We sought to identify priority research questions and offer policy and practice recommendations.
Method: PROSPERO Registration: CRD42023430291. The search was conducted across five databases: CINAHL, EMBASE, MEDLINE, PsychINFO, and Global Health. Included studies explored alcohol use and ASD within clinical samples.
Results: A total of 22 studies were included in the final review. The pooled prevalence of alcohol-use disorder in ASD was 1.6% and 16.1% in large-population registers and clinical settings, respectively. Four components were identified as possible aetiological risk factors – age, co-occurring conditions, gender, and genetics. We identified 10 implications for co-occurring alcohol use disorder in ASD, summarised as a concept map.
Conclusion: emerging trends in the literature suggest direction and principles for research and practice. Future studies should use a standardised methodological approach—including psychometrically validated instruments and representative samples—to inform policy and improve the experience for autistic populations with co-occurring alcohol use.
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e-pub ahead of print date: 13 January 2025
Keywords:
Autistic spectrum disorders, alcohol disorders, comorbidity, mental health services, neurodevelopmental disorders
Identifiers
Local EPrints ID: 502363
URI: http://eprints.soton.ac.uk/id/eprint/502363
ISSN: 2056-4724
PURE UUID: d6e884c5-89a5-4db3-ba8e-ea398a06ec4f
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Date deposited: 24 Jun 2025 16:38
Last modified: 22 Aug 2025 02:29
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Contributors
Author:
William Barber
Author:
Betul Aslan
Author:
Tim Meynen
Author:
John Marsden
Author:
Samuel R. Chamberlain
Author:
Vigneshwar Paleri
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