My son, 27, was diagnosed with high functioning autism five years ago, which was more helpful than previous diagnoses. But it’s recently become clear he suffers from schizophrenia. I am so perplexed about why the autism experts almost never talk about schizophrenia, and the schizophrenia experts almost never talk about autism, when the amount of overlap is massive.
It’s been important for me to learn that currently schizophrenia is considered to have positive symptoms (things that are present that shouldn’t be, basically psychosis), negative symptoms ( things that are lacking—severe disorganization, lack of awareness about the symptoms, difficulties with planning and goal-setting, depression, anxiety), and cognitive impairments with higher order things like theory of mind (eg interpreting others’ body language). What seems to happen is once the positive symptoms appear during frontal lobe maturation in the late teens some doctor says, “Ah, it’s schizophrenia” and it turns out the negative symptoms and cognitive impairments have been there from early childhood and showed up on neuropsych evaluations from childhood. At least that’s what’s happened to us, and I’ve heard so many similar stories.
In the same boat. Daughter diagnosed with autism and now 22 and it is schizophrenia. Does she have 2 things or just one? Need more research. Very difficult situation when psychosis hits. Try using the autism help plus added in the help for persons with alzheimer’s disease. Their suggestions on how to help have worked for us. Not sure why this is the case but have DH with perhaps mild cognitive impairment so while researching that found ways to help our daughter. Psychiatrists have not been that helpful but working with a new one so maybe help is on the way. Are these diagnoses all connected in some way?
I believe that this might help with the history of diagnostic criteria from PsychCentral:
“Autism wasn’t conceptually separated from SSD until 1971Trusted Source. The change wasn’t technically acknowledged in the Diagnostic and Statistical Manual of Mental Disorders (DSM) until the 4th edition was released in 1994.
Nowadays, each condition has different diagnostic criteria. You need to meet these criteria in order to get a diagnosis from a health professional. These criteria include causes, symptoms, age of onset, and, in some cases, need for symptom management.“
As a parent, however, the diagnosis is one step in the walk along a winding road of finding help for our loved ones.
My son used to call himself autistic in high school. I didn’t think anything of it at the time; I thought he was using the phrase to express his discomfort with high school social anxiety. Much like I experienced in high school.
We are a family of various degrees of social anxiety. I mean that in the most loving way. I was a nerd girl who liked animals and snakes before it was cool. My husband is borderline autistic but never formally diagnosed. It runs in his family. So does schizophrenia.
I wasn’t aware of the correlation, but thanks to your post I started looking into it. I found this: Autism Spectrum Disorders and Schizophrenia Spectrum Disorders: Excitation/Inhibition Imbalance and Developmental Trajectories
It’s a highly technical article that won’t be of much use to most of us, but it starts off this way:
Autism spectrum disorders (ASD) and schizophrenia spectrum disorders (SSD) share clinical and genetic components that have long been recognized. The two disorders co-occur more frequently than would be predicted by their respective prevalence, suggesting that a complex, multifactor association is involved. However, DSM-5 maintains the distinction between ASD, with core social and communication impairments, and SSD, including schizophrenia (SCZ), with hallucinations, delusions, and thought disorder as essential features. ASD and SSD have common biological underpinnings that may emerge early in development and unfold over time.
Thank you It may true in some cases such as my daughter’s case. Need more research into all the mental health disorders. My daughter also has a seizure disorder and a lower IQ. Very difficult for professionals to come up with a diagnosis that sticks.
In my case, they don’t need the DSM-V. There are signs they look for when observing me during a psychological appointment. For example, one time, my Psychiatrist took me to another Psychiatrist to have a brief meeting with all 3 of us in the same room. Once he saw me “disconnect” while talking, that was enough to diagnose me with Schizophrenia/Schizoaffective. He could tell I did not have Autism/Asperger disorder just by observing how I reacted to his questions. Apparently, if the patient has a delayed reaction to external stimuli, that is a sign of Autism/Asperger.
I don’t think SSD and ASD are closely related; they’re like diametric opposites. Schizophrenia is internalized; Austim is externalized. Schizophrenia is absent-mindedness; Autism is absence of theory of mind.
I have both schizophrenia and ASD. I was dxed with the latter at the age of 62 in May 2019.
How did they diagnose your ASD? What specific signs/symptoms did they see?
As a child preferred to play on my own.I didn’t spontaneously join in play with others. Wasn’t interest in joining in play with my younger brother and sister. Physically awkward and clumsy. Problems making friends. Solitary activities. Change in routine makes me anxious. Poor sense of direction… Poor road safety skills.Talk across people without thinking. Problems with boundaries.Take things very literally. Find it hard to put myself in other people’s shoes. Difficulty picking up other people’s emotions from their facial expressions and body language. Don’t initiate conversations. When talking about something important to me I’ll keep on doing so regardless of whether the other person is still interested or not.
Don’t seem to have a filter.Take sarcasm very literally. No role or pretend play. Didn’t know how to play.Was obsessed with facts and figures as a child.Rigid set routine,except for meals. Poor planning and organisational skills. Have difficulty seeing the whole picture
Poor balance and coordination. Awkward when I move. Stand too close to people. Not aware of social boundaries. Bump into people and objects. Poor fine motor skills. Don’t like crowded,noisy, places. Quite sensitive to sunlight.
Empathy quotient =24, RAADS-R= 177, Reading the mind in the eye=20. ADOS 2- Social communication -3( classical autism) social interaction -5(Asperger’s)
ADOS 2- Answered questions but answers provided few leads for the assessor. Speech had little inflexion or musicality. Can increase in volume when I get passionate about a topic. Eye contact not well modulated with speech. Not much reciprocal conversation. Didn’t display any curiosity in the examiner,nor ask for more information when given some obvious verbal prompts. Qualities of social responses were awkward at times. Social overtures mainly related to my own interests.
Deficits in imagination/creativity, Had stereotyped/repetitive behaviours
Why didn’t they diagnose you with ASD when you were a child? That’s illogical to diagnose you with Autism at that age. A mental health professional would have seen this well before 62. Well before.
It wasn’t until 1992(UK) and 1994(USA) that Asperger’s became an official dx, up until then autism was a very rare diagnosis consisting of those who were extremely disabled. I sensed there was more going on with me than just SMI, but didn’t look into it until the late 1990’s. I did a search for ‘low spatial and high verbal intelligence’. That lead to articles about NVLD, and from there Asperger’s. The next 19 years I tried in vain to get my then mental health team to see there was more going on than just severe mental illness. It was a fruitless task, as they just saw everything as being related to the severe mental illness.
In 2017 I moved to be near my daughter. She has done care work with a wide range of people with care needs, including those on the spectrum . At my first psych appointment here in Oct 2018 , she was the one to raise the question re autism. Instead of ignoring the question, as previous pdocs and other mental health pros had done, he asked a lot of questions. At the end he said that the most likely diagnoses were ASD and schizophrenia. I started to be assessed in Feb 2019 , and was given the dx of Asperger’s 3 months later.
My daughter is of the firm belief that the schizophrenia is secondary to the ASD, with it being caused by the stress of having undiagnosed ASD., and the severe, verbal, bullying I’d been subjected to as a teenager.
10 sides of a main report, and 2 sides of an ADOS-2 says otherwise.
https://scholar.google.com/scholar?as_ylo=2019&q=schizophrenia+autism+comorbidity&hl=en&as_sdt=0,5
schizophrenia + autism +comorbidity