Differential diagnosis between schizophrenia and autism in adulthood: a case report

Exploring the landscape of adult autism research in psychology: a bibliometric and network analysis

The global prevalence of autism spectrum disorder (ASD) is increasing. ASD manifests with persistent social communication and interaction challenges, limited interests, and repetitive behaviors. As the scientific literature on ASD in adults varies greatly, mapping the recent global research becomes valuable for enhancing comprehension of this subject. This study aims to map recent global scientific publications on ASD in adults. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, bibliometrics, and network analyses, we assessed 850 articles indexed in the Web of Science Core Collection between 2013 and 2022 assigned to the research area of psychology. Findings indicate an annual average growth of 11.69%. Key keywords include Emotion, Anxiety, and Depression, with Anxiety, Depression, and Mental Health as central nodes in the network. Rehabilitation, Behavioral Sciences, and Psychiatry frequently co-occur, and Psychology, Psychiatry, and 'Neurosciences and Neurology' are central nodes in the network of research areas. The United States of America and the United Kingdom lead in publications, with the United Kingdom being the most central country in the network. King's College London and the University of California are the main research organizations, with King's College London as the central node in the network. The American Psychiatric Association's DSM-5-TR was the most cited reference in the period. This comprehensive analysis contributes to understanding the landscape of ASD research in adults, providing insights for future research and fostering collaborations.

Beyond what clinicians see: missed diagnosis and misdiagnosis of a woman with autism spectrum disorder

A young woman with autism spectrum disorder was admitted to the hospital via the emergency care unit. On being admitted, she was improperly diagnosed with a psychotic disorder due to her erratic behaviour and incomprehensible refusal to eat. As a result, the patient was hospitalised against her will. For accurate and correct diagnosis and treatment, it was necessary to collect the patient's detailed clinical history, while being hospitalised.

Self-Disorders in Individuals with Autistic Traits: Contribution of Reduced Autobiographical Reasoning Capacities

The present web-based study (N = 840) aimed to illuminate the cognitive mechanisms underlying self-disorders in autism. Initially, participants selected three self-defining memories. Then, we assessed their capacity to give meaning to these events (i.e., meaning making), their tendency to scrutinize autobiographical memory to better understand themselves (i.e., self-continuity function of autobiographical memory) and their clarity of self-concept. The results showed that individuals with high autistic traits (ATs) had a lower clarity of self-concept than control participants. Meaning making was also reduced in AT individuals and mediated the relation between AT and self-concept clarity. Our results suggest that the reduced clarity of self-concept in AT individuals is related to an impaired capacity to make meaning of important past life events.

Personality development and intellectual disability

PURPOSE OF REVIEW

This review examines the factors that shape personality and how they can inform on the behaviour of people with intellectual disability both to help them function at least at their cognitive level and add a developmental dimension to treatment plans.

RECENT FINDINGS

People with intellectual disability experience more failure, rejection and social deprivation leading to personality traits that may impede their ability to learn and predispose them to depression. Brain changes due to genetic conditions may be responsible for the behavioural phenotypes, although the autism phenotype is associated with different causes. Schizophrenia has a strong neurodevelopmental component and it could be on a gradient of decreasing neurodevelopmental impairment between intellectual disability and autism on one hand and bipolar disorder on the other.

SUMMARY

Understanding how early-life experience and current-life situations give rise to personality traits and taking a developmental perspective, for example, mental age, could clarify the clinical presentation. Developments in molecular genetics and brain imaging may clarify how brain changes lead to personality features. Finally, it may be time to address whether it is still helpful to have categorical diagnoses when there is increasing evidence from genetic studies supporting a continuum of neurodevelopmental disorders.

Factor Analysis Demonstrates a Common Schizoidal Phenotype within Autistic and Schizotypal Tendency: Implications for Neuroscientific Studies

Behavioral and cognitive dysfunction, particularly social and communication impairments, are shared between autism and schizophrenia spectrum disorders, while evidence for a diametric autism-positive schizophrenia symptom profile is inconsistent. We investigated the shared phenotype at a personality trait level, particularly its resemblance to schizoid personality disorder, as well as differential aspects of the autism-schizophrenia model. Items of the autism spectrum quotient (AQ) and schizotypal personality questionnaire (SPQ) were pseudo-randomly combined, and were completed by 449 (162 male, 287 female) non-clinical participants aged 18-40. A factor analysis revealed three factors; the first represented a shared social disorganization phenotype, the second reflected perceptual oddities specific to schizotypy while the third reflected social rigidity specific to autism. The AQ and SPQ were strongly correlated with Factor 1 (AQ: r = 0.75, p < 0.001; SPQ: r = 0.96, p < 0.001), SPQ score was correlated with Factor 2 (r = 0.51, p < 0.001), particularly in cognitive-perceptual features (r = 0.66, p < 0.001), and AQ score was strongly correlated with Factor 3 (r = 0.76, p < 0.001). Furthermore, there was no relationship between Factor 1 and Factor 2. Thus, there is robust evidence for a shared social disorganization phenotype in autistic and schizotypal tendency, which reflects the schizoid phenotype. Discriminating and independent dimensions of schizotypal and autistic tendency exist in Factors 2 and 3, respectively. Current diagnostic protocols could result in different diagnoses depending on the instrument used, suggesting the need for neuromarkers that objectively differentiate autistic and schizotypal traits and resolve the question of commonality versus co-morbidity.