Wednesday, 25 April 2018

Autistic traits in adult schizophrenia

"Results of this study indicate the existence, in a sample of patients with a diagnosis of schizophrenia, of a distinct group of subjects with ASD [autism spectrum disorder] features, characterized by specific symptomatological and cognitive profile."

So said the findings reported by Stefano Barlati and colleagues [1] continuing a research theme from this group [2] looking at the potential overlap between autism spectrum disorder and schizophrenia.

Reiterating my interest in how the autism and schizophrenia spectrums can and do collide (see here) both at a condition and trait level, the Barlati findings provide some pretty in-depth analysis of what autism *might* look like in the context of schizophrenia. They report evaluation of their cohort - "Seventy-five schizophrenia patients (20 females, mean age 42 ± 12)" - with two of the gold-standard autism assessment instruments: the Autism Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview-Revised (ADI-R) alongside other "clinical, neuropsychological, and psychosocial functioning measures."

It's important to say that, in these days of pluralisation of behavioural and/or psychiatric labels (see here and see here), quite a few participants (47/75) assessed as part of the Barlati study turned up "negative to all the autism scales administered." This tells us that it's not necessarily a straight-forward nor universal relationship when it comes to autism and schizophrenia (and vice-versa). More likely is the possibility that there either may be subgroups within the diagnosis of schizophrenia that present with significant autistic traits or possibly even that the timing or severity or grading of schizophrenia and its symptoms may predispose to autistic traits being more or less likely to be presented. That last point relies on the idea that various traits or characteristics of labels like schizophrenia and autism might not be as immutable as many people believe...

For however the participants diagnosed with schizophrenia who turned up clinically significant autistic traits in one or other or total domains/scores using the ADOS and ADI, further research is indicated. Further research on what this phenotype might look like longitudinally, how frequent it might manifest, and whether there may be unique challenges associated with it. It also might have some implications for intervention too (see here).

And yet again, such findings provide more fodder for the idea that autistic traits are not exclusively just part and parcel of a diagnosis of autism (see here), and the pressing need for formal, professional assessment when autism is suspected...

Oh, and then there's more...

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[1] Barlati S. et al. Autistic traits in a sample of adult patients with schizophrenia: prevalence and correlates. Psychol Med. 2018 Mar 20:1-9.

[2] Barlati S. et al. Autism Spectrum Disorder and Schizophrenia: Do They Overlap? International Journal of Emergency Mental Health and Human Resilience. 2016; 18: 760-763.

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