Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Mar 31:16:1536361.
doi: 10.3389/fpsyt.2025.1536361. eCollection 2025.

Investigating the attenuated psychosis syndrome in youth with autism spectrum disorder: results from an observational study

Assia Riccioni #  1 , Maria Pontillo #  2 , Lenardo Emberti Gialloreti  3 , Mariagrazia Cicala  3 , Michelangelo Vasta  4   5 , Mattia Gatto  1   4 , Lucrezia Arturi  4 , Martina Siracusano  1   3 , Michelangelo Di Luzio  2 , Stefano Vicari #  2   6 , Luigi Mazzone #  1   4
Affiliations

Investigating the attenuated psychosis syndrome in youth with autism spectrum disorder: results from an observational study

Assia Riccioni et al. Front Psychiatry. .

Abstract

Introduction: Despite evidence suggesting increased rates of psychosis in individuals with autism spectrum disorder (ASD), the detection of prodromal psychotic symptoms, including attenuated psychosis syndrome (APS), remains underexplored in this population.

Methods: The primary aim of the present study was to characterize the clinical phenotype of young individuals with ASD who also present with APS (ASD/APS; n = 48) in comparison with individuals with APS only (n = 93) and those with ASD only (n = 30) (age range 9-23 years). Assessments included standardized measures of autistic symptoms (Autism Diagnostic Observation Schedule-Second Edition; ADOS-2), pre-psychotic symptoms (Structured Interview for Psychosis-Risk Syndromes; SIPS), and cognitive and adaptive functioning.

Results: Overall, the ASD/APS group demonstrated significantly poorer general adaptive skills compared with the APS group (p = 0.006) and the ASD group (p = 0.005). Compared with the APS group, the ASD/APS group exhibited lower scores across all SIPS domains, with the exception of SIPS-P1 (unusual thought content/delusional ideas; p = 0.062; t = -1.882; F = 5.44) and SIPS-P3 (grandiosity; p = 0.156; t = -1.435; F = 22.6). In contrast, the ASD/APS group displayed significantly higher scores in the repetitive and restricted behavior domain compared with the ASD group (p < 0.001). Notably, there were no significant differences in the age of APS onset across groups (p = 0.601; t = 0.525; F = 0.253).

Discussion: These findings provide a more nuanced characterization of APS features in individuals with ASD and emphasize the importance of screening for APS in this population, particularly those considered at increased risk. Early detection and intervention could facilitate timely therapeutic support, potentially improving long-term outcomes for these individuals.

Keywords: autism; clinical high risk; neurodevelopment; prodrome; psychosis; schizophrenia.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Figures

Figure 1
Figure 1
Mean clinical differences between the ASD/APS group and the ASD and APS groups, respectively.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Sawyer SM, Azzopardi PS, Wickremarathne D, Patton GC. The age of adolescence. Lancet Child Adolesc Health. (2018) 2(3):223–8. doi: 10.1016/S2352-4642(18)30022-1 - DOI - PubMed
    1. Solmi M, Radua J, Olivola M, Croce E, Soardo L, Salazar de Pablo G, et al. . Age at onset of mental disorders worldwide: large-scale meta-analysis of 192 epidemiological studies. Mol Psychiatry. (2022) 27(1):281–95. doi: 10.1038/s41380-021-01161-7 - DOI - PMC - PubMed
    1. Jutla A, Califano A, Dishy G, Hesson H, Kennedy L, Lundgren B, et al. . Neurodevelopmental predictors of conversion to schizophrenia and other psychotic disorders in adolescence and young adulthood in clinical high risk individuals. Schizophr Res. (2020) 224:170–2. doi: 10.1016/j.schres.2020.10.008 - DOI - PubMed
    1. Guerrera S, Pontillo M, Chieppa F, Passarini S, Di Vincenzo C, Casula L, et al. . Autism Spectrum Disorder and Early Psychosis: a narrative review from a neurodevelopmental perspective. Front Psychiatry. (2024) 15:1362511. doi: 10.3389/fpsyt.2024.1362511 - DOI - PMC - PubMed
    1. Raballo A, Poletti M, Preti A. Clinical High Risk for Psychosis (CHR-P) in children and adolescents: a roadmap to strengthen clinical utility through conceptual clarity. Eur Child Adolesc Psychiatry. (2024) 33(6):1997–9. doi: 10.1007/s00787-023-02139-2 - DOI - PubMed

LinkOut - more resources