Vol. 14 No. 3 (2021): Silver Jubilee
Mental Health

Impact of COVID-19 on Mental Health of Adults with Autism in India: A case series

Amaan Javed
University College of Medical Sciences
Ritwika Roy
Neuroscientist, Independent Researcher

Published 2021-09-15


  • Coronavirus,
  • COVID-19,
  • Autism spectrum disorder,
  • Neuropsychiatric presentations,
  • Mental Health,
  • India
  • ...More

How to Cite

Javed, A., & Roy, R. . (2021). Impact of COVID-19 on Mental Health of Adults with Autism in India: A case series. Sushruta Journal of Health Policy & Opinion, 14(3), 1–9. https://doi.org/10.38192/14.3.4




This study focuses on the direct and indirect implications of the COVID-19 pandemic on adults with Autism in India. This study took into account the social isolation during the global pandemic in 2020 and its effect on the emotional well-being of the community.


We designed a survey involving Indian residents. Part I involved questionnaires for different cohorts: 1) educated, 2) employed and 3) unemployed. The questions were based on proposed life models to maintain the heterogeneity according to the preferences of the target group. Part II of  involved online interviews conducted in English. Qualitative and quantitative analyses were performed.


The analyses of participants’ responses (N=10) stipulated that the impact of the COVID-19 pandemic on autistic people's mental health has been variable. Participants encountered both positive and negative emotions. Factors such as disrupted schedules, fear of job loss, poor domestic support system and inconsistency in transition were important. These were associated with development of new or worsening of pre-existing psychological as well as behavioural conditions including depression, anxiety, panic attacks and high-stress levels. At the same time, reduced interactions with decreased social insistence led to an improvement for some participants.


Our results illustrate the deterioration of mental health and well-being for Autistic adults due to the impact of the COVID-19 pandemic. These findings emphasise the need for the development of innovative approaches and investment in the creation of support systems to address mental distress in this population.


  1. Cascella M, Rajnik M, Cuomo A, Dulebohn SC, Di Napoli R. Features, Evaluation and Treatment Coronavirus (COVID-19) [Internet]. StatPearls. StatPearls Publishing; 2020 [cited 2020 Jun 23]. Available from: http://www.ncbi.nlm.nih.gov/pubmed/32150360
  2. WHO Coronavirus (COVID-19) Dashboard | WHO Coronavirus (COVID-19) Dashboard With Vaccination Data [Internet]. [cited 2021 May 22]. Available from: https://covid19.who.int/
  3. Hao F, Tan W, Jiang L, Zhang L, Zhao X, Zou Y, et al. Do psychiatric patients experience more psychiatric symptoms during COVID-19 pandemic and lockdown? A case-control study with service and research implications for immunopsychiatry-Singapore (Chongqing) Demonstration Initiative on Strategic Connectivity Think Tank. 2020 [cited 2021 May 23]; Available from: https://doi.org/10.1016/j.bbi.2020.04.069
  4. Gleason J, Ross W, Fossi A, Blonsky H, Tobias J, Stephens M. The Devastating Impact of Covid-19 on Individuals with intellectual disabilities in the United States. Innov Care Deliv. 2021;
  5. Kantamneni N. The impact of the COVID-19 pandemic on marginalized populations in the United States: A research agenda [Internet]. Vol. 119, Journal of Vocational Behavior. Academic Press Inc.; 2020 [cited 2021 May 22]. p. 103439. Available from: /pmc/articles/PMC7205696/
  6. Al-Sadeq DW, Nasrallah GK. The incidence of the novel coronavirus SARS-CoV-2 among asymptomatic patients: A systematic review. Int J Infect Dis. 2020 Sep 1;98:372–80.
  7. Whittaker A, Anson M, Harky A. Neurological Manifestations of COVID-19: A systematic review and current update. Acta Neurol Scand. 2020;142(1):14–22.
  8. Greenberg N, Docherty M, Gnanapragasam S, Wessely S. Managing mental health challenges faced by healthcare workers during covid-19 pandemic [Internet]. Vol. 368, The BMJ. BMJ Publishing Group; 2020 [cited 2021 May 23]. Available from: http://group.bmj.com/group/rights-licensing/
  9. Thompson JR, Nygren MA. COVID-19 and the field of intellectual and developmental disabilities: Where have we been? Where are we? Where do we go? Intellect Dev Disabil. 2020 Aug 1;58(4):257–61.
  10. Green J, Gilchrist A, Burton D, Cox A. Social and psychiatric functioning in adolescents with Asperger syndrome compared with conduct disorder. J Autism Dev Disord [Internet]. 2000 [cited 2021 May 26];30(4):279–93. Available from: https://pubmed.ncbi.nlm.nih.gov/11039855/
  11. Mutluer T, Doenyas C, Aslan Genc H. Behavioral Implications of the Covid-19 Process for Autism Spectrum Disorder, and Individuals’ Comprehension of and Reactions to the Pandemic Conditions. Front Psychiatry [Internet]. 2020 Nov 16 [cited 2021 May 26];11:561882. Available from: www.frontiersin.org
  12. Patel JA, Badiani AA, Nielsen FBH, Assi S, Unadkat V, Patel B, et al. COVID-19 and autism: Uncertainty, distress and feeling forgotten. Public Heal Pract [Internet]. 2020 Nov [cited 2021 May 26];1:100034. Available from: /pmc/articles/PMC7392884/
  13. Bellomo TR, Prasad S, Munzer T, Laventhal N. The impact of the COVID-19 pandemic on children with autism spectrum disorders. J Pediatr Rehabil Med [Internet]. 2020 [cited 2021 May 26];13(3):349–54. Available from: https://pubmed.ncbi.nlm.nih.gov/32986631/
  14. Boat TF, Wu JT, Disorders C to E the SSIDP for C with M, Populations B on the H of S, Board on Children Y and F, Medicine I of, et al. Clinical Characteristics of Autism Spectrum Disorder. 2015 Oct 28 [cited 2021 May 22]; Available from: https://www.ncbi.nlm.nih.gov/books/NBK332891/
  15. Hodges H, Fealko C, Soares N. Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation. Transl Pediatr [Internet]. 2020 Feb [cited 2021 May 22];9(S1):S55–65. Available from: /pmc/articles/PMC7082249/
  16. Mukherjee SB, Malhotra MK, Aneja S, Chakraborty S, Deshpande S. Diagnostic accuracy of Indian Scale for Assessment of Autism (ISAA) in chidren aged 2–9 years. Indian Pediatr. 2015 Mar 1;52(3):212–6.
  17. Rudra A, Belmonte MK, Soni PK, Banerjee S, Mukerji S, Chakrabarti B. Prevalence of autism spectrum disorder and autistic symptoms in a school-based cohort of children in Kolkata, India. Autism Res [Internet]. 2017 Oct 1 [cited 2021 May 27];10(10):1597–605. Available from: /pmc/articles/PMC5655917/
  18. Randolph-Gips M, Srinivasan P. Modeling autism: a systems biology approach. J Clin Bioinforma [Internet]. 2012 [cited 2021 May 31];2(1):17. Available from: https://pubmed.ncbi.nlm.nih.gov/23043674/
  19. McDougall F, Willgoss T, Hwang S, Bolognani F, Murtagh L, Anagnostou E, et al. Development of a patient-centered conceptual model of the impact of living with autism spectrum disorder. Autism [Internet]. 2018 Nov 1 [cited 2021 May 31];22(8):953–69. Available from: https://pubmed.ncbi.nlm.nih.gov/28914085/
  20. Mason D, McConachie H, Garland D, Petrou A, Rodgers J, Parr JR. Predictors of quality of life for autistic adults. Autism Res [Internet]. 2018 Aug 1 [cited 2021 May 31];11(8):1138–47. Available from: /pmc/articles/PMC6220831/
  21. Yu L, Zhu X. Effectiveness of a SCERTS Model-Based Intervention for Children with Autism Spectrum Disorder (ASD) in Hong Kong: A Pilot Study. J Autism Dev Disord. 2018 Nov 1;48(11):3794–807.
  22. Wiltshire G, Ronkainen N. A realist approach to thematic analysis: making sense of qualitative data through experiential, inferential and dispositional themes. J Crit Realis [Internet]. 2021 [cited 2021 May 31]; Available from: https://www.tandfonline.com/doi/abs/10.1080/14767430.2021.1894909
  23. McHugh ML. Interrater reliability: The kappa statistic. Biochem Medica [Internet]. 2012 [cited 2021 May 31];22(3):276–82. Available from: /pmc/articles/PMC3900052/