Health-related quality of life and associated factors among autistic adolescents and young adults, and their peers with mental disorders, and without autism or mental disorders in Chile

BACKGROUND: Prior studies suggest that autistic individuals have a lower health-related quality of life (HRQoL) than non-autistic populations. However, few studies have compared autistic individuals to peers with mental disorders. Furthermore, little is known about HRQoL in autistic individuals in Latin America, where distinct social, cultural, and health system contexts may substantially determine well-being and access to support. METHODS: This cross-sectional study compared HRQoL across three groups of community-dwelling adolescents and young adults aged 16-39 years from Chile, enrolled between 2022 and 2023: autistic (n = 102), with mental disorders (n = 464), and without autism or mental disorders (n = 478). HRQoL was assessed using the EuroQol-5D-3L and compared across groups using linear regression. RESULTS: Autistic participants reported more problems with mobility (9.8% vs 4.3% and 2.3%), self-care (7.8% vs 1.7% and 0.6%), usual activities (28.4% vs 18.1% and 3.1%), and pain/discomfort (53.9% vs 50.2% and 27.8%) versus those with mental disorders and without autism or mental disorders, respectively. Participants with mental disorders reported more anxiety/depression (81.2%) than autistic participants (56.9%) and those without autism or mental disorders (49.3%). The mean ± SD HRQoL index was 72.3 ± 17.7, 69.8 ± 19.9, and 84.8 ± 14.4 among autistic participants, those with mental disorders, and those without autism or mental disorders, respectively (p-value <0.001). The multivariable-adjusted difference in HRQoL index associated with autism and mental disorders was -6.53 (95%CI -10.41, -2.64) and -9.63 (95%CI -11.77, -7.59), respectively. CONCLUSION: Autistic adolescents and young adults in Chile experience a low HRQoL with distinct functional and emotional impairments, underscoring the need for inclusive and contextually relevant interventions.