Assessing Depression in Neurodivergent Adults

Assessing depression in a neurodivergent adult can be complicated because depressive symptoms may overlap with ADHD traits, autistic characteristics, burnout, shutdown, sleep problems, and executive dysfunction. The key question is often not only which symptoms are present, but what has changed from the person’s usual functioning.

This article explains what a careful assessment should examine. It covers recognized depressive symptoms, baseline change, diagnostic overshadowing, alexithymia, communication and accessibility needs, depression questionnaires, information from other people, physical-health and medication review, bipolar screening, and suicide risk.

The aim is not to offer a new “neurodivergent depression test.” It is to show how established depression assessment can become more contextual, accessible, and accurate without treating lifelong neurodevelopmental characteristics as illness or dismissing genuine deterioration as “just neurodivergence.”

🧭 Key Points

🌧️ Recognized depressive symptoms remain the clinical starting point.
📉 Change from personal baseline can help distinguish new deterioration from lifelong ADHD or autistic characteristics.
💬 Accessible communication can improve the information available without changing the clinical meaning of depression.
📝 Questionnaires can support screening and monitoring, but no score independently establishes a diagnosis or explains its cause.
🧩 Diagnostic overshadowing can work in both directions: depression may be attributed to neurodivergence, while neurodevelopmental traits may be mislabelled as depression.
🩺 A full assessment also considers bipolar disorder, anxiety, trauma, grief, sleep, physical illness, medication, substances, burnout, and other possible explanations.
🚨 Suicide risk, possible mania, psychosis, immediate danger, or severe loss of basic self-care requires prompt assessment regardless of the presumed diagnosis.

🎯 What Is a Depression Assessment Trying to Establish?

A depression assessment is more than a symptom checklist. NICE guidance for adult depression recommends a comprehensive assessment that does not rely simply on counting symptoms. Duration, severity, functioning, history, current circumstances, physical health, and safety all affect interpretation.

An assessor may explore:

🌧️ Depressed mood, emptiness, irritability, hopelessness, or loss of interest and pleasure
⏳ When the changes began, how persistent they are, and whether they are episodic
📉 Effects on work, relationships, interests, communication, self-care, and basic daily tasks
🔎 Which difficulties are longstanding and which are new, intensified, or more widespread
🕳️ Thoughts about death, suicide, self-harm, or being unable to remain safe
🌓 Previous periods of unusually elevated or irritable mood, activation, or reduced need for sleep
🌊 Anxiety, trauma, grief, substance use, and current stressors
🩺 Sleep, pain, illness, hormones, medication, and withdrawal effects
📅 Previous episodes, diagnoses, treatments, and responses

Professional assessment is appropriate when changes in mood, pleasure, hope, functioning, sleep, eating, or self-care persist, recur, cause significant distress, or become difficult to understand. Urgent assessment is needed when safety, possible mania, psychosis, severe confusion, or basic self-care is at risk.

Neurodivergence may affect the person’s starting point, how changes appear, how questions are understood, and whether services are accessible. It does not create one alternative set of depressive criteria shared by every autistic adult, adult with ADHD, and AuDHD adult.

For the clinical foundation—including symptoms, episodes, disorders, duration, and common types—read What Is Depression? Symptoms, Types, and When to Seek Help.

📉 Why Change From Personal Baseline Matters

Several depressive symptoms overlap with lifelong characteristics. An adult with ADHD may have long experienced concentration, sleep, organization, and task-initiation difficulties. An autistic adult may routinely need substantial solitude, show limited facial expression, depend on predictability, or have an uneven daily-living profile.

These characteristics should not automatically be counted as evidence of depression. The reverse error is equally important: substantial deterioration should not be dismissed as “normal ADHD,” “just autism,” or an unavoidable part of neurodivergence.

Rather than looking at a symptom in isolation, compare the person’s current experience with their own longer-term pattern.

🎯 Interest and pleasure
Longstanding pattern: Interests may be intense, narrow, changeable, or strongly dependent on motivation.
Change worth exploring: Familiar activities feel empty, pointless, or much less rewarding than before.

🧠 Initiation and concentration
Longstanding pattern: Task initiation, attention, working memory, or organization may always have been difficult.
Change worth exploring: These difficulties have become substantially worse or now affect more tasks and settings.

👥 Social contact
Longstanding pattern: The person may prefer solitude, limited interaction, or significant recovery time after social contact.
Change worth exploring: Withdrawal has increased and is accompanied by lost connection, reduced pleasure, distress, or hopelessness.

💬 Communication
Longstanding pattern: Communication style, facial expression, speech access, or processing speed may differ from conventional expectations.
Change worth exploring: The person has become much less able to communicate thoughts, needs, or distress than is usual for them.

🛌 Sleep and eating
Longstanding pattern: Sleep or eating may already be irregular because of sensory preferences, routines, medication, or interoceptive difficulties.
Change worth exploring: There is a sustained and meaningful departure from the person’s usual sleeping or eating pattern.

🔋 Movement and energy
Longstanding pattern: Restlessness, stimming, variable energy, motor differences, or periods of exhaustion may be familiar.
Change worth exploring: New slowing, agitation, physical heaviness, or pervasive loss of energy has developed.

🪞 Self-evaluation
Longstanding pattern: The person may experience recurring frustration about executive, sensory, social, or daily-living difficulties.
Change worth exploring: This has shifted towards persistent worthlessness, excessive guilt, self-hatred, or hopelessness.

🚨 Safety
Longstanding pattern: There may be no history of suicidal thoughts, or thoughts may previously have been brief and manageable.
Change worth exploring: Thoughts about death, suicide, or self-harm are new, more frequent, more compelling, or harder to manage.

These comparisons cannot diagnose depression. Change from baseline provides important context, but it is not a replacement diagnostic criterion.

🗓️ Baseline Is More Than “How You Usually Look”

A useful baseline includes internal experience, accessible functioning, and required effort—not only outward appearance. Someone may still work while using every evening and weekend to recover. Another person may continue engaging with an interest through routine or habit while no longer experiencing pleasure or emotional connection.

Baseline can also change with support, stress, sensory demands, sleep, illness, relationships, and environment. Assessment therefore needs a timeline rather than one fixed description of how the person normally appears.

Questions that may help include:

📅 What could the person access six months or a year ago that is no longer accessible?
🔋 Has the amount of effort required for familiar activities changed?
🎯 Are valued activities still rewarding, or merely continuing?
🏠 Are basic tasks being missed more often or becoming harder to recover?
👥 Have other people noticed a meaningful change?
🌤️ Are there environments or periods in which functioning or emotional connection improves?

🌫️ What If There Is No Obvious Recent Change?

Not all depression begins with a dramatic decline. Symptoms may develop gradually, recur so often that they begin to feel normal, or persist for years. Someone may have difficulty identifying a clear “before” period, particularly if depression began during adolescence or followed repeated periods of stress and exhaustion.

Assessment can then explore earlier periods of greater pleasure, connection, hope, or functioning; whether life has progressively narrowed; previous episodes; family observations; and how symptoms change across environments or over time.

No clear before-and-after moment rules depression neither in nor out. It simply means that course and history require more careful exploration.

🧩 Diagnostic Overshadowing Can Work in Both Directions

Diagnostic overshadowing occurs when one known diagnosis or disability dominates how other symptoms are interpreted. New concentration problems, withdrawal, reduced speech, or declining self-care may be attributed entirely to autism or ADHD without assessing depression, pain, medication effects, or another condition.

Examples include:

🧠 “Concentration is always difficult with ADHD,” despite a clear new decline
💬 “They are minimally expressive because they are autistic,” despite a marked communication change
🛌 “It is only burnout,” without exploring pleasure, mood, hopelessness, physical health, or safety
🏠 “Daily tasks have always been hard,” although eating, hygiene, or medication access has deteriorated sharply

The reverse also occurs. Lifelong autistic solitude, ADHD restlessness, variable speech, limited facial expression, or executive dysfunction may be treated as evidence of a mood disorder. This can obscure the person’s neurodevelopmental profile and the support they already needed before depression was considered.

A systematic review of broad mental-health assessment tools identified symptom overlap, limited evidence, and possible clinician bias as contributors to assessment difficulty. However, only 12% of the included studies involved adult participants, and the instruments were general rather than depression-specific. The review supports caution and the need for better adult evidence—not the conclusion that every standard assessment is invalid. Halvorsen et al., 2025.

Avoiding diagnostic overshadowing means keeping more than one possibility open. Depression can coexist with ADHD, autism, chronic pain, trauma, anxiety, burnout, sleep disruption, or physical illness. Identifying one explanation does not make the others disappear.

💬 Communication Is Clinical Information

Assessment depends heavily on descriptions of mood, pleasure, thoughts, bodily changes, and functioning. Important information may be missed when questions are abstract, processing time is short, the environment is overwhelming, or speech is treated as the only valid form of communication.

Communication differences do not create different depressive criteria. They can influence how effectively relevant experiences are identified and described.

🧠 Alexithymia May Affect How Distress Is Described

Alexithymia involves difficulty identifying, differentiating, or describing emotions. A systematic review and meta-analysis found it considerably more common in autistic samples than comparison groups, although it was neither universal nor synonymous with autism. Kinnaird et al., 2019.

Someone who cannot readily label sadness may instead report:

🪨 A heavy or slowed body
🔋 No energy or drive, even for familiar activities
🧊 Blankness, disconnection, or feeling emotionally absent
📉 Loss of routines or abilities before recognizing a mood change
🌪️ Irritability or agitation without a clear emotional name
🕳️ A future that feels closed off or inaccessible

These descriptions can contain useful information, but none is specific to depression. Anxiety, overload, dissociation, pain, illness, medication effects, and sleep problems may feel similar. The evidence in this area is mainly autism-specific and should not automatically be generalized to every adult with ADHD or AuDHD.

🗣️ Concrete Questions Can Improve Accuracy

“How do you feel?” may be too broad. More specific questions can connect symptoms to time, situations, and change:

🎯 “Do activities you usually value feel as rewarding as they did three months ago?”
🛌 “How does your current sleep differ from your usual sleep?”
🏠 “Which daily tasks have become harder or stopped happening?”
📅 “When did you or someone close to you first notice a change?”
🧠 “Is concentration difficult in the familiar way, or does it feel different now?”
🕳️ “When you think about the future, what thoughts appear?”
🛑 “Have you had thoughts about death, suicide, or harming yourself?”

Concrete questions do not lower the clinical standard. They make the intended meaning clearer and may produce more accurate information.

📝 Making Assessment More Accessible

Possible adjustments include:

📋 Receiving the appointment structure or key questions in advance
✍️ Answering in writing, verbally, or through a combination
⏳ Having additional processing time and unhurried pauses
1️⃣ Discussing one question at a time
📅 Using dates, examples, and specific situations
🔎 Explaining ambiguous emotional or clinical terms
🎧 Reducing avoidable sensory demands
🤝 Bringing a trusted person when the individual wants this
📄 Receiving a written summary of conclusions and next steps

NHS England guidance for autistic adults in mental-health services identifies processing time, communication, sensory needs, executive functioning, physical health, and risk assessment as relevant to accessible care. This is autism-specific guidance rather than a universal protocol for every neurodivergent adult.

The person should be asked what helps. A diagnosis alone cannot reveal their communication preferences, sensory needs, processing speed, or preferred appointment format.

⚠️ Accessibility Is Not the Same as Changing a Test

Written answers, additional processing time, or lower sensory demands may improve access without altering what an assessment question means. Rewording items, changing response options, substituting proxy answers, or changing scoring can modify the instrument itself.

A 2026 systematic review found that only 8% of studies using mood or anxiety measures with autistic adults reported adaptations. Reported changes commonly included administering measures developed for children to adults or converting self-report measures into proxy-report without clear justification. Few adapted tools received new psychometric validation. Wilkinson et al., 2026.

This does not mean adaptations should never be made. It means that the type of change matters. If a standardized measure is modified, the change should be recorded, and the original validation evidence and cut-off scores should not automatically be assumed to transfer.

📊 What Can Depression Questionnaires Tell You?

Measures such as the PHQ-9 can identify symptoms, structure a conversation, support screening, and monitor change over time. They cannot independently establish a depressive disorder, determine why symptoms are present, or identify the most appropriate treatment.

An individual-participant-data meta-analysis found that the PHQ-9 can be useful for detecting possible major depression but remains imperfect. Some people who screen positive will not meet diagnostic criteria, while some people with depression will be missed. Negeri et al., 2021.

Autism-specific evidence is developing:

📚 A 2018 systematic review found very limited evidence concerning depression tools in autistic adults. Cassidy et al., 2018.
📝 A later study supported using the PHQ-9 as a measure of depressive symptoms in autistic adults, but not as a standalone diagnosis. Arnold et al., 2020.
🎓 A study of 477 self-identified autistic and 429 non-autistic university students aged 18–29 found that most PHQ-9 items operated similarly, but the suicidality item showed non-invariance. The young university sample limits generalization to other autistic adults. Robeson et al., 2024.

The balanced conclusion is neither that standard measures are useless nor that they are unquestionably valid for everyone:

📊 Use the score as one source of information.
💬 Clarify how the person understood important or ambiguous items.
📉 Interpret results alongside baseline, duration, context, and functioning.
🛑 Never use one questionnaire item as the complete suicide-risk assessment.
📝 Record modifications to wording, administration, response options, or scoring.
🔄 Repeated scores may help show change even when a cut-off remains uncertain.

No standard or autism-specific questionnaire independently diagnoses depression. Research on the performance of depression measures specifically in adults with ADHD is much thinner, while direct AuDHD-specific assessment evidence is extremely limited.

👥 Can Information From Other People Help?

With the adult’s knowledge and agreement where appropriate, someone close to them may help establish when observable changes began and how current functioning differs from baseline.

They may notice changes in:

📅 Timing and progression
🛌 Sleep, eating, movement, or communication
🏠 Daily functioning and basic care
🎯 Engagement with interests and relationships
🛑 Safety, impulsivity, confusion, or markedly altered behaviour

Other people usually observe behaviour more easily than internal experience. Withdrawal could reflect depression, overload, pain, conflict, or chosen recovery. Continuing to work may say very little about pleasure, hopelessness, exhaustion, or safety.

Supporting information should therefore add to the person’s account rather than automatically override it. Differences between accounts may themselves be useful. They can show that distress is hidden, that functioning varies between environments, or that two people have interpreted the same change differently.

Records, medication histories, calendars, notes, messages, and earlier questionnaire scores may also help reconstruct a timeline. Lack of an available informant should not prevent assessment.

🔬 What Does Autism-Specific Research Actually Support?

A 2024 systematic review found recognized depressive symptoms alongside possible additional or differently expressed indicators in autistic people. It covered only 24 studies and 243 autistic participants, with mixed ages, methods, reporters, and study quality. Some findings came from case studies. Hinze et al., 2024.

The review supports careful attention to recognized symptoms, personal baseline, communication, and meaningful behavioural change. It does not establish an alternative diagnostic system or prove that any additional sign is specific to autistic depression.

A 2026 qualitative study interviewed 20 psychologists experienced in working with autistic adults. Participants described using standard depressive criteria while considering baseline, context, communication, co-occurring conditions, and possible autism-informed indicators. Because the study examined clinicians’ experiences and interpretations rather than diagnostic accuracy, its findings are emerging evidence rather than proof that additional indicators diagnose depression. Hinze et al., 2026.

The current evidence picture is therefore uneven:

✅ General adult depression-assessment guidance is strong.
🟡 Autism-specific presentation and measurement evidence is developing but limited.
🟠 ADHD-specific depression-assessment evidence is thinner.
🔴 Direct AuDHD-specific assessment evidence is extremely limited.

For a profile-by-profile comparison rather than an assessment guide, read Depression in ADHD, Autism, and AuDHD.

🔄 What Else Should Be Considered?

A careful assessment should not stop when one plausible explanation appears. Several conditions and circumstances can resemble, contribute to, or coexist with depression.

🌓 Bipolar Disorder

Depressive episodes can occur within bipolar disorder. Assessment should ask about past periods of unusually elevated or intensely irritable mood, significantly reduced need for sleep, increased activity, accelerated speech or thinking, impulsive decisions, and behaviour representing a clear episodic change.

Lifelong ADHD restlessness, rapid thinking, emotional variability, or impulsivity should not automatically be treated as hypomania. Timing, duration, sleep need, associated changes, consequences, and treatment response require professional interpretation. This distinction can affect medication decisions and longer-term care.

🌊 Anxiety, Trauma, Grief, and Substance Use

Anxiety may contribute to avoidance, agitation, disrupted sleep, fatigue, concentration difficulty, and reduced functioning. Trauma-related difficulties may involve numbness, withdrawal, disconnection, threat sensitivity, or hopelessness.

Grief can include many depressive symptoms without automatically being a depressive disorder. Grief and depression can also coexist, particularly when symptoms become persistent, pervasive, or accompanied by marked worthlessness, loss of pleasure, or safety concerns.

Alcohol and other substances may affect mood, sleep, impulsivity, withdrawal, and safety. Assessment should explore their role factually and without moral judgment.

🩺 Physical Health and Medication

Fatigue, cognitive change, sleep disruption, appetite change, pain, and functional decline can also have physical or medication-related explanations.

A review may include:

💊 Prescribed medication, recent dose changes, missed doses, and withdrawal effects
🧪 Alcohol, drugs, supplements, caffeine, and other stimulants
🌙 Sleep quality and possible sleep disorders
🩸 Anaemia, nutritional problems, or other relevant laboratory considerations
🦋 Hormonal or thyroid conditions
🩹 Pain, infection, chronic illness, or neurological symptoms

The appropriate medical investigation depends on the person’s history and presentation. This is not a recommendation to request every possible test or change medication independently. New, rapidly worsening, or physically pronounced changes deserve medical review.

🔥 Burnout, Shutdown, and Executive Dysfunction

Burnout, shutdown, overload, sleep loss, and executive dysfunction can overlap with depressive fatigue, withdrawal, cognitive difficulty, and reduced functioning. They can also coexist with depression.

Triggers, breadth across environments, changes in pleasure, persistence, response to reduced demands, self-evaluation, and safety may provide clues. No single feature can separate every case, and temporary improvement following reduced demands does not automatically exclude depression.

For the broad comparison, read Neurodivergent Burnout vs Depression. For a narrower phenomenological comparison, see Emotional Numbness vs Shutdown vs Depression.

🚨 Safety Assessment Should Be Direct

A person can remain articulate, employed, productive, calm, or outwardly composed while experiencing serious suicidal thoughts. Visible functioning should never be treated as evidence of low risk.

A safety assessment may ask directly about:

🕳️ Thoughts about death or not wanting to exist
🛑 Thoughts of suicide or self-harm
📈 Their frequency, persistence, intensity, and recent change
⚠️ Current intent, preparation, access to means, or recent actions
🤝 What helps the person remain safe and who can support them
🏠 Whether food, fluids, essential medication, shelter, and basic care remain accessible
🌫️ Psychotic symptoms, severe confusion, or rapidly changing behaviour
🌓 Possible mania or extreme activation

Direct questions do not require the person to use particular emotional language. Questions can be repeated, clarified, or answered in writing when needed. A questionnaire response should lead to further discussion rather than serve as the entire risk assessment.

If you think you may act on suicidal or self-harm thoughts, cannot keep yourself safe, or are in immediate danger, contact local emergency services now.

If suicidal thoughts are present without immediate danger, tell a trusted person and contact a clinician or crisis service today. Find A Helpline lists verified support services in more than 175 countries.

You do not need to complete a depression assessment or determine the correct diagnosis before asking for urgent help.

📝 Preparing for an Assessment

You do not need to arrive with a polished explanation or a theory that accounts for every symptom. A short factual record may be more useful.

Consider bringing:

📅 A rough timeline of when changes began
🔎 Three examples of what differs from your usual baseline
🏠 Tasks or roles that have become harder or inaccessible
🎯 Changes in pleasure, interest, emotional connection, or hope
🛌 Changes in sleep, appetite, energy, movement, or concentration
💊 A medication and supplement list, including recent changes
🛑 Notes about thoughts of death, self-harm, suicide, or safety
📄 Previous diagnoses, treatments, and treatment responses
💬 A short explanation of your communication and accessibility needs

Possible requests include:

✍️ “I communicate some information more accurately in writing.”
⏳ “I need additional time before answering.”
1️⃣ “Please ask one question at a time.”
🔎 “Could you explain what you mean by that term?”
📄 “Could I receive the conclusions and next steps in writing?”

These requests do not determine the diagnosis. They can make it easier for the available information to be understood accurately.

If preparing this information feels unmanageable, one sentence can be enough to begin: “My mood or functioning has changed, and I need help working out why.”

🤝 What Should Happen After Assessment?

A useful assessment should produce more than a questionnaire score. It should clarify:

🌧️ Whether a depressive disorder or episode appears likely
🔄 Which co-occurring or alternative explanations need further assessment
🩺 Whether physical-health or medication review is appropriate
🛑 What the immediate safety plan and support route are
🎯 Which treatment or support options fit the person’s needs and preferences
💬 Which communication and accessibility adjustments are needed
📅 How symptoms, functioning, treatment effects, and risk will be reviewed

Uncertainty can be an appropriate outcome. Symptoms may need to be monitored over time, additional information may be required, or several conditions may need attention. Conclusions can be revised as the course becomes clearer.

For treatment evidence and accessibility considerations, read Therapy, Medication, and Adaptations for Depression in Autistic and ADHD Adults.

🎯 Conclusion

Assessing depression in a neurodivergent adult requires neither abandoning recognized depressive criteria nor applying them without context.

A careful assessment combines:

🌧️ Recognized depressive symptoms
📉 Change from the person’s baseline
⏳ Duration, course, and breadth across life
🏠 Functional impact, including hidden effort and loss of basic access
💬 Communication style and accessibility needs
📝 Careful use of screening measures
👥 Supporting information when appropriate and wanted
🩺 Physical-health, sleep, medication, and substance review
🌓 Bipolar disorder, anxiety, trauma, burnout, shutdown, and other differentials
🛑 Direct and proportionate safety assessment

The strongest evidence currently supports a comprehensive general adult depression assessment. Autism-specific research increasingly supports attention to baseline, communication, and contextual interpretation, but it has not established a replacement diagnostic system. Direct ADHD- and AuDHD-specific assessment evidence remains limited.

The goal is not to force every difficulty into one label. It is to understand what has changed, identify what may coexist, protect safety, and connect the person with appropriate care.

❓ Frequently Asked Questions

🧪 Is There a Neurodivergent Depression Test?

No validated test independently diagnoses “neurodivergent depression.” The phrase is descriptive rather than a separate diagnosis. Standard and autism-specific questionnaires can contribute to assessment, but none establishes a diagnosis by itself.

📊 Can a PHQ-9 Score Diagnose Depression?

No. A PHQ-9 score can identify symptoms and monitor change, but it cannot determine their cause, distinguish depression from every overlapping condition, or replace a comprehensive assessment.

🧩 What If I Have Always Struggled With Sleep, Concentration, or Daily Tasks?

That history is important. Assessment should establish what is longstanding, what has changed, and whether mood, pleasure, self-evaluation, functioning, or safety has deteriorated. Lifelong difficulties and depression can coexist.

💬 Does Difficulty Describing Emotions Make Assessment Impossible?

No. Concrete questions, timelines, written communication, behavioural changes, and functional information can help. Difficulty naming emotions is not evidence that distress is absent.

🔄 Can Depression, ADHD, Autism, and Burnout All Be Present Together?

Yes. These are not mutually exclusive explanations. A comprehensive assessment should consider co-occurrence rather than requiring one condition to explain every symptom.

🧭 Where to Go Next

For the broader recognition guide, read Neurodivergent Depression: Signs, Overlap, and Support. For the clinical foundation, see What Is Depression?. You can also explore the Neurodivergent Depression Learning Hub.

📚 Scientific References

National Institute for Health and Care Excellence. (2022). Depression in Adults: Treatment and Management.

NHS England. (2023). Meeting the Needs of Autistic Adults in Mental Health Services.

Simon, G. E., Moise, N., & Mohr, D. C. (2024). Management of Depression in Adults: A Review. JAMA, 332(2), 141–152.

Hinze, E., Paynter, J., Dargue, N., & Adams, D. (2024). The Presentation of Depression in Depressed Autistic Individuals: A Systematic Review. Review Journal of Autism and Developmental Disorders.

Wilkinson, E., Brewe, A. M., Hastings, R. P., Jahoda, A., White, S. W., & Bal, V. H. (2026). Adapting Measures of Anxiety and Mood Disorders for Use With Autistic Adults: A Systematic Review. Current Developmental Disorders Reports, 13, 4.

Cassidy, S. A., Bradley, L., Bowen, E., Wigham, S., & Rodgers, J. (2018). Measurement Properties of Tools Used to Assess Depression in Adults With and Without Autism Spectrum Conditions: A Systematic Review. Autism Research, 11(5), 738–754.

Halvorsen, M. B., Kildahl, A. N., Kaiser, S., Axelsdottir, B., Aman, M. G., & Helverschou, S. B. (2025). Applicability and Psychometric Properties of General Mental Health Assessment Tools in Autistic People: A Systematic Review. Journal of Autism and Developmental Disorders, 55, 1713–1726.

Negeri, Z. F., Levis, B., Sun, Y., et al. (2021). Accuracy of the Patient Health Questionnaire-9 for Screening to Detect Major Depression: Updated Systematic Review and Individual Participant Data Meta-analysis. BMJ, 375, n2183.

Arnold, S. R. C., Uljarević, M., Hwang, Y. I., Richdale, A. L., Trollor, J. N., & Lawson, L. P. (2020). Psychometric Properties of the Patient Health Questionnaire-9 in Autistic Adults. Journal of Autism and Developmental Disorders, 50(6), 2217–2225.

Robeson, M., Brasil, K. M., Adams, H. C., & Zlomke, K. R. (2024). Measuring Depression and Anxiety in Autistic College Students: A Psychometric Evaluation of the PHQ-9 and GAD-7. Autism, 28(11), 2793–2805.

Kinnaird, E., Stewart, C., & Tchanturia, K. (2019). Investigating Alexithymia in Autism: A Systematic Review and Meta-analysis. European Psychiatry, 55, 80–89.

Hinze, E., Adams, D., Dargue, N., & Paynter, J. (2026). How Psychologists Identify Depressive Symptoms in Autistic Adults: DSM-5-TR Criteria and Autism-Informed Indicators. Autism in Adulthood.