Objectives
Revision of Autism Spectrum Disorder (ASD) comorbid with Depression; depressive symptoms in ASD; treatment strategies.

Background and aims
ASD is characterized by persistent difficulties in social relations, communication and restricted/repetitive patterns of behavior and interests. They often present with a variety of co-occurring medical and psychiatric conditions. Depression is one of the most frequent psychiatric comorbidities of ASD.

Materials and methods
Literature revision using Pubmed with “Depression”; “Autism”; “Neurobiology”.

Results
It is widely accepted that Depression occurs frequently in ASD. The risk for comorbid Depression increases during adolescence and early adulthood and in high-functioning autism. Depressive symptoms differ accordingly to age, intelligence and communication capacities. Clinicians must be alert for common and specific symptoms such as irritability and restlessness; further social isolation; change on the usual character of obsessions; increase in compulsive behavior. Individuals with ASD taking selective serotonin re-uptake inhibitors (SSRIs) may be especially prone to side effects, such as akathisia, behavioural activation, disinhibition or manic-like symptoms.

Conclusions
Despite being one of the most frequent comorbidities of ASD, Depression represents a diagnostic challenge in these individuals as some of the typical symptoms of ASD may obscure it. Depression has a direct impact in functioning and quality of life through worsening of ASD core symptoms and increasing mortality. Treatment of comorbid Depression should be made case-by-case, with evaluation of possible benefits and risks. There is a need to further research of effective psychopharmacologic and psychosocial treatment strategies.

RAISING THE CURTAIN – DEPRESSION IN AUTISM