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Comparative Study
. 2017 Apr;210(4):269-275.
doi: 10.1192/bjp.bp.116.187682. Epub 2016 Dec 15.

Psychosis in autism: comparison of the features of both conditions in a dually affected cohort

Felicity V Larson  1 , Adam P Wagner  2 , Peter B Jones  2 , Digby Tantam  2 , Meng-Chuan Lai  2 , Simon Baron-Cohen  2 , Anthony J Holland  2
Affiliations
Comparative Study

Psychosis in autism: comparison of the features of both conditions in a dually affected cohort

Felicity V Larson et al. Br J Psychiatry. 2017 Apr.

Abstract

BackgroundThere is limited information on the presentation and characteristics of psychotic illness experienced by people with autism spectrum disorder (ASD).AimsTo describe autistic and psychotic phenomenology in a group of individuals with comorbid ASD and psychosis (ASD-P) and compare this group with populations affected by either, alone.MethodWe studied 116 individuals with ASD-P. We compared features of their ASD with people with ASD and no comorbid psychosis (ASD-NP), and clinical characteristics of psychosis in ASD-P with people with psychosis only.ResultsIndividuals with ASD-P had more diagnoses of atypical psychosis and fewer of schizophrenia compared with individuals with psychosis only. People with ASD-P had fewer stereotyped interests/behaviours compared with those with ASD-NP.ConclusionsOur data show there may be a specific subtype of ASD linked to comorbid psychosis. The results support findings that psychosis in people with ASD is often atypical, particularly regarding affective disturbance.

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Conflict of interest statement

Declaration of interest

None.

Figures

Fig. 1
Fig. 1
Broad symptom categories and their prevalence in the autism spectrum disorder and psychosis (ASD–P) group. a. Mania includes both hypomanic and manic symptoms (defined by duration).
Fig. 2
Fig. 2
Prevalence of DSM-IV-TR diagnosis by group. This figure compares the prevalence of DSM-IV-TR-diagnosed psychosis between a general psychiatric sample (ÆSOP study – psychosis) and the ASD and comorbid psychosis (ASD–P) group. ‘Schizophrenia’ here includes schizophrenia, schizophreniform and schizoaffective disorders. Affective psychosis includes those with major depressive episode with psychotic features, manic episode with psychotic features and bipolar disorder with psychosis. ‘Other psychosis’ includes psychotic disorder not otherwise specified, which was present in 52% of the ASD–P sample. a. Of the full ASD–P data-set (n = 75), four had a DSM-IV-TR diagnosis of major depressive episode without psychotic features and were thus excluded from this comparison.
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