Original scientific paper

AUTISTIC SPECTRUM DISORDERS AND SCHIZOPHRENIA IN THE ADULT PSYCHIATRIC SETTING: DIAGNOSIS AND COMORBIDITY

Michele Raja ; Servizio Psichiatrico di Diagnosi e Cura, Ospedale Santo Spirito, Rome, Italy
Antonella Azzoni ; Servizio Psichiatrico di Diagnosi e Cura, Ospedale Santo Spirito, Rome, Italy

Abstract

Background: The relationship between Autism Spectrum Disorders (ASDs) and schizophrenia is currently unclear. We aimed to
(a) assess psychotic symptoms in a consecutive series of adult patients with ASDs, (b) evaluate the comorbidity diagnosed to account
for the concurrent psychotic symptoms in patients with ASDs, and (c) compare the clinical features between the patients with
schizophrenia and patients with comorbid schizophrenia and ASDs.
Subjects and methods: We included patients with ASD that were seen in adult psychiatric clinical settings during a 15-year
period. The sample was further grouped according to the existence of a comorbid diagnosis of schizophrenia. Clinical and
epidemiological features were assesed in in the whole sample, and further compared between the two groups.
Results: We identified 26 patients with first-time diagnosed ASDs. Among the 22 cases who manifested psychotic symptoms
(84.6%), 16 had a concurrent diagnosis of schizophrenia (72.73%) and 6 of mood disorders (27.27%). Compared with patients with
schizophrenia patients with comorbid ASDs and schizophrenia were more often men, of younger age, and more frequently developed
motor side effects to antipsychotics.
Conclusions: Adult psychiatric service users with ASDs are often misdiagnosed. This could be in part due to the fact that adult
psychiatrists are not familiar with the diagnosis of ASDs. The high prevalence of psychotic symptoms in this sample is likely to
depend on the specific setting of the study, i.e., that people with more severe forms of ASD than those typically followed-up in the
national health service were reaching our public inpatient and private outpatient services. The high comorbidity rate between ASDs
and schizophrenia could be related to shared neurobiology, but also to arbitrary restrictions imposed by current diagnostic systems.

Keywords

Asperger’s syndrome; autism; comorbidity; diagnosis; pervasive development disorder; schizophrenia

Hrčak ID:

76372

URI

https://hrcak.srce.hr/76372

Publication date:

8.12.2010.

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