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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

EV0177

Autistic burnout: clinical significance for psychiatric practice

AUTISTIC BURNOUT: CLINICAL RELEVANCE FOR PSYCHIATRIC PRACTICE

Autistic burnout is a context-dependent clinical condition that is distinct from depression and occupational burnout, carries a high risk of suicide, and is frequently misdiagnosed.

The study aimed to synthesize current scientific knowledge and clinical insight on autistic burnout to clarify its nature, contributing factors, and relevance to everyday psychiatric practice. The methodology combined a narrative review of the current literature (empirical studies, qualitative reports, and theoretical contributions) with semi-structured interviews with autistic adults who self-reported experiencing burnout; published evidence and firsthand experience were triangulated to develop a clinical framework. The core of the concept is pervasive physical, cognitive, and emotional exhaustion and interpersonal withdrawal, accompanied by at least one of the following: markedly reduced daily functioning, executive functioning difficulties, or more pronounced autistic traits (Higgins et al., Delphi consensus, n = 23 experts by experience). Quantitative findings indicate that 72% of autistic adults score above the suicide risk threshold on the SBQ-R, more than twice the rate of 33% in the general population (n = 365). By burnout status, 88.2% of those currently experiencing burnout score above the PHQ-9 depression cutoff, and 63.2% endorse the suicidal ideation item; these rates are 78.6% and 35.7% among those who are unsure, and 50.9% and 22.0% among those not currently experiencing burnout (n = 238). Perceived diagnostic overshadowing is reported by 61.0% of adults who have experienced burnout (n = 141), while 24.6% of all autistic adults screened report at least one perceived psychiatric misdiagnosis before their autism diagnosis (n = 1211); autistic women report perceived prior misdiagnosis approximately twice as often as autistic men (31.7% versus 16.7%), most commonly involving personality, anxiety, or mood disorders. Autism-specific instruments (ABM, ABSI) and standard mood and anxiety scales measure overlapping but distinct constructs (r approximately 0.55). The clinical implications are that autistic patients presenting with exhaustion, functional decline, or an apparent treatment-resistant depression should be screened for burnout as well as mood disorders, explicitly asked about masking behaviors, and offered approaches that prioritize reducing demands, sensory accommodations, and autonomy before escalating pharmacological treatment.

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