Schizophrenia And Autism: Differential Diagnosis
Even now, experts sometimes have difficulty differentiating between these two disorders. Schizophrenia shouldn’t be diagnosed separately from autism, unless delusions and hallucinations are prominent.The main problem with the differential diagnosis of these two disorders is that the negative symptoms of schizophrenia and the symptoms of autism mimic one another. So when someone with autism is being considered for a schizophrenia diagnosis, the psychotic features and some negative symptoms are the the most important ones to be considered. People can avoid speaking for various reasons including language difficulties, speech difficulties, anxiety, etc. If a person does not speak, it doesnt mean they are autistic nor that they even have autistic traits.;In the last several decades, considerable evidence has suggested that autism and schizophrenia are unrelated. However, recent reports have suggested that individuals with autism may be at greater risk for schizophrenia and that the conditions may be more closely related than generally believed.;;
Theory Of Mind Problems In Schizophrenia And Autism /aspergers Syndrome
Theory of mind deficits means that patients with schizophrenia and Autism/Aspergers Syndrome have problems reading other peoples minds; empathizing with other people and recognising other peoples emotions and intensions. These lead to problems in interpersonal communications, misunderstandings, and misinterpretations of other peoples behaviours and disrupted emotional interchanges. Keefe and Eesley point out that individuals with schizophrenia perform poorly on measures of theory of mind abilities. The evidence regarding whether impairments in theory of mind skills are independent of general neurocognitive deficit is mixed. Facial affect recognition and social cue perception are two general areas into which studies of social perception and schizophrenia can be broken down. The literature on facial affect recognition suggest that the individual with schizophrenia has deficits in tests of facial affect perception compared with healthy controls and that perception of negative emotions and fear maybe particularly impaired. Patients with schizophrenia show consistent impairments on tests of social cue perception. They have in particular more difficulty discerning other individuals goals and intentions than what they are wearing or saying. This overlaps with Autism. Aspergers Syndrome High Functioning Autism. It is hardly surprising that persons with theory of mind difficulties misinterpret people and engage in paranoid thinking leading to paranoid delusions.
How Does It Feel To A Child
In the video below, Prof. Rochelle Caplan, an expert on childhood schizophrenia, talks about how the symptoms appear and the effect that they can have. The Child Mind Institute, a nonprofit organization, produced the video.
Prof. Caplan describes how symptoms appear gradually in most cases. She explains how the experience can be very scary for the child at first. To parents or caregivers, this may present similarly to anxiety.
The child may feel afraid, for example, because the hallucinations or delusions can feel threatening.
The child might also have trouble paying attention, and they may become irritable or have difficulty sleeping. Prof. Caplan notes that some of these changes can resemble rebellious behavior.
Understanding what the child is experiencing can help parents and caregivers react in a constructive way that can help the child.
According to the authors of one case study, early onset schizophrenia is when a child aged 1318 years experiences symptoms of schizophrenia.
Very early onset schizophrenia is when symptoms appear before the age of 13 years.
The researchers describe a child who experienced unusual perceptions from the age of 3 months.
There are no separate criteria to distinguish between childhood and adult schizophrenia.
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Microglia In Asd And Schizophrenia; In Vivo Studies
Studying the activation of microglia in live subjects is of great value, particularly to monitor the evolution of neuroinflammation in the brain with age and the effect of medication. This information, combined with the indirect assessment of glial activation via peripheral blood biomarkers, could provide a clear picture of the processes that are occurring in vivo.
With the advent of non-invasive methods of studying brain function, such as functional magnetic resonance imaging and PET, valuable information can be extracted. For instance, PET can be used to investigate activation of microglia in diseased brain . The specific application of this technique to identify activated microglia is based on the ability of some markers, e.g., isoquinoline PK11195 -PK11195), to selectively bind to microglia that are activated, but not to resting cells. Subtle glial responses occur in areas of the brain that are microanatomically unchanged, providing evidence for some plasticity of the injured brain .
In a study by Suzuki et al., the application of PET using -PK11195) revealed substantial activation of microglia in patients with ASD . However, the regional distribution was not different between these subjects and controls. No other studies dealing with in vivo imaging studies on the activity of microglia in individuals with autism could be found.
Deep Phenotyping One Mutation At A Time
Deletion at the 22q11.2 locus is the largest risk factor for schizophrenia and up to 30% of adolescents and adults will develop psychosis.,, Children with 22q11.2 deletion have also a high risk of developing ASD , ADHD, and anxiety disorders., Duplications are less severe and are inherited in 70% of the cases . While studies suggested a protective effect for schizophrenia , the duplication has been associated with a wide range of phenotypes, including ASD, psychomotor development, speech delay, and cognitive deficits. Ascertainment bias remains an issue in the study of genomic disorders which are often recruited in the clinic. Although this is particularly true for smaller effect size variants but may also apply to a lesser degree to 22q11.2.
Among the 50 genes within the 22q11.2 locus,,COMT, TBX1, , and DGCR8 were studied as putative critical drivers of the phenotype but results remain inconsistent. Importantly, an excess of de novo loss of function mutations has not been reported in any of the genes within the 16p11.2 and 22q11.2 regions. Overall, these studies show that association evidence for a CNV does not automatically imply that a single or even few genes are driving the effects.
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Diagnosis Of Bipolar Disorder And Schizophrenia
There are no blood tests for diagnosing bipolar disorder or schizophrenia. Instead, your doctor will do a physical and psychological exam. During the exam, theyll ask you about any family history of mental disorders and your symptoms.
Your doctor may want to do a complete blood test to help rule out other conditions. They may also request an MRI or CT scan. Finally, they make ask you to agree to a drug and alcohol screening.
You may need to return for several visits before your doctor can make a diagnosis. These visits will help your doctor fully understand your symptoms. They may ask you to keep a daily record of your mood and sleep patterns. This can help your doctor see if any patterns emerge, such as manic and depressive episodes.
Treatment for both bipolar disorder and schizophrenia involves therapy and medication.
For bipolar disorder, psychotherapy may include:
- learning about changes in mood and how to effectively manage them
- educating family members about the disorder so they can be supportive and help with overcoming episodes
- helping you improve your relationships with friends and coworkers
- learning to manage your days to avoid possible triggers, such as a lack of sleep or stress
Your doctor may prescribe medications to control changes in mood and related symptoms, such as:
- mood stabilizers such as lithium
Intercorrelations Among Panss And Ados Symptom Domains
Table 3 shows intercorrelations between ADOS-Positive, ADOS-Negative, PANSS-Positive, and PANSS-Negative across the entire sample. Of particular interest, there was a strong, significant correlation between ADOS-Negative and PANSS-Negative, r = 0.58, p< .001, suggesting overlapping content between the two scales. In contrast, ADOS-Positive and PANSS-Positive had a low, nonsignificant correlation, r = 0.16, p = .077, suggesting the positive symptom domains from either scale are tapping relatively distinct constructs.
Table 3 Intercorrelations Among ADOS and PANSS Symptom Domains.
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Managing Schizophrenia & Autism For Adults
Many times, adults are diagnosed with a psychosis, such as schizophrenia, and put on antipsychotic medications when a diagnosis of autism would have better fit. It can be even more confusing when both disorders are present.
Medications often impact someone with autism differently than they would someone with schizophrenia alone. Sometimes, medications can actually be detrimental. This is part of the reason why accurate diagnosis and treatment are so important for people of any age.
Adults with high-functioning autism can benefit from social skills and support groups. These groups can aid their ability to hold down a job, communicate more effectively, and regulate emotions.
These groups also provide education and information as well as a safe space to socialize. Through peer support groups, people with autism often experience healthy peer interactions, helping them to make lasting friends.
The History Of The Connection Between Autism & Schizophrenia
The link between schizophrenia and autism goes back many years. Historically, autism was considered a feature or symptom of schizophrenia. It was not until 1943 that it was even considered to possibly be its own disorder.
The negative symptoms of schizophrenia, such as flat affect, social withdrawal and detachment, communication difficulties, little interest in other people and preference instead for objects, and rigid and repetitive behaviors were actually autistic traits.
Research in the 1970s showed that hallucinations, which are a common psychotic symptom of schizophrenia, were not common in children with autistic traits that manifested prior to age 3. Instead, these children often turned out to have difficulties with social relationships and language delays.
Finally, in 1980, autism and schizophrenia were recognized as two separate diagnoses with a big distinction age of onset. Children presenting with symptoms around age 4 or earlier were considered to have autism, while those with symptoms that began between the ages of 16 and 30 had schizophrenia.
In the 1990s, research began to shift the landscape again, indicating a potentially greater connection between the two disorders. It is now recognized that it is possible to have both schizophrenia and autism at the same time. This situation is called comorbid disorders.
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The Commonality Of Schizophrenia & Autism
People with autism are more likely to also have schizophrenia, and vice versa.
Rates of comorbidity are highly variable, but they range from 3.5% to just over 50%. This large range can be related to the fact that one disorder is commonly mistaken as the other. Since the symptoms can be so similar, it is also common for both disorders to be present but only one is diagnosed.
Typically, schizophrenia does not manifest until late adolescence to early adulthood. A severe form of the disorder that is also more rare, called child-onset schizophrenia , shows up prior to age 13. This form regularly co-occurs with autism spectrum disorder as well. When schizophrenia occurs earlier in life, it is more likely that the person already has autism as well.
Overlapping symptoms for schizophrenia and autism can include:
- Trouble relating socially.
- Occupational therapy practitioners.
- Speech-language pathologists.
A treatment plan will often include a combination of both medication and therapy. Treatment should be based on the specific symptoms of a person and not solely on the diagnosis of one or both disorders. Individual cases can be best managed by treating each person with a specialized care plan that focuses on the direct symptoms.
Usually, medications will be used to manage psychosis, and therapy will be used to regulate moods, emotions, and social communication deficits.
Treatments can include:
Aggression Schizophrenia And Autism/ Aspergers Syndrome
Patients with schizophrenia and Autism/ Aspergers Syndrome are more likely to be victims of aggression than perpetrators. . Lewis et al. points out that it also remains true that the evidence available indicates a small percentage of people with schizophrenia will commit a dispro- portionate amount of violence and even murder. The same is true of Autism/Aspergers Syndrome . Paranoid delusions can be a factor in the violence in both schizophrenia and Autism/ Aspergers Syndrome.
Andreasen points out that occasionally patients may perform violent acts such as injuring or tormenting animals, or attempting to injure or kill human beings. These features are observed in schizophrenia and Autism/Aspergers Syndrome . Persons with Autism/Aspergers Syndrome sometimes wave their arms and come to the attention of the police . Their behaviour and levels of distress in interpersonal situations can come across as appearing aggressive in both schizophrenia and Autism/Aspergers Syndrome.
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Do Schizophrenia And Autism Share The Same Root
New research suggests the two conditions may be de different outcomes of one genetic syndrome
In children with a deletion on chromosome 22, having autism does not boost the risk of developing schizophrenia later in life, according to a new study1.
The children in the study have 22q11.2 deletion syndrome, which is linked to a 25-fold increase in the risk of developing a psychotic condition such as schizophrenia. A deletion in the region is also associated with an increased risk of autism.
Some researchers have suggested that the relatively high autism prevalence in this population is the result of misdiagnoses of early signs of schizophrenia.
The new findings, published 21 January in Schizophrenia Research, support an alternate theory: Autism and schizophrenia are independent outcomes of the same genetic syndrome.
If there is a relationship between the two conditions, that can only be a very small, probably negligible effect, says lead investigator Jacob Vorstman, assistant professor of child psychiatry and genetics at the University Medical Center Utrecht in the Netherlands.
The new findings could help guide clinical care, says Opal Ousley, assistant professor of psychiatry at the Emory Autism Center in Atlanta. If prenatal testing picks up the 22q11.2 deletion, for instance, clinicians could discuss the risk of both autism and schizophrenia with parents.
Concerned Your Child May Have Schizophrenia
Take our 2-minute Schizophrenia quiz to see if he or she may benefit from further diagnosis and treatment.
Naturally, there is typically a high level of parental distress and confusion when a young child demonstrates what appear to be the symptoms of schizophrenia, says Peter L. Klinger, MD, assistant professor in the Departments of Psychiatry and Pediatrics at the University of Arizona in Tucson and psychiatrist for the Early Psychosis Intervention Center at Banner University Medical Group.
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Symptoms Of Bipolar Disorder
People with bipolar disorder experience episodes of intense emotions. These include three main types of episodes:
- Manic episodes are times of increased activity and energy. A manic episode can make you feel extremely happy or elated.
- Hypomanic episodes are similar to manic episodes, but theyre less intense.
- Depressive episodes are similar to those of people with major depression. A person having a depressive episode will feel severely depressed and lose interest in activities that they used to enjoy.
To be diagnosed with bipolar disorder, you have to have at least one episode of depression that meets the criteria for a major depressive episode. You must also have at least one episode that meets the criteria for a manic or hypomanic episode.
Other behavioral changes that may be symptoms of bipolar disorder include:
- extreme self-confidence and impulsivity, in the case of a manic episode
- suicidal thoughts, in the case of a depressive episode
People with bipolar disorder can also experience psychotic symptoms during a manic or depressive episode. These can include hallucinations or delusions. Because of this, people may mistake their symptoms of bipolar disorder for those of schizophrenia.
Family And Caregiver Schizophrenia Discussion Forum
Hello everyone, I am new heremy 24 year old son, who has dealt with HFA and OCD just graduated in May Magna Cum Laude with a Major in Psychology and a Minor in Philosophy, was accepted into three graduate schools online, and had two jobs lined up for the summer. 5 days after graduation, he spiraled into an acute psychotic break which seems to be more and more like Schizophrenia. I feel like I am losing him slowlylike his hold on reality is hanging by a threadjust hoping to find and offer support to others so we dont feel so alone
I am not a doctor though and that idea came to me just as a fellow mom thinking out loud. I do think your son probably should be evaluated professionally and that the professional you choose knows about how much your son takes on in any given, day, week or month. He or she may agree or disagree with my thoughts. I can say with either of my sons stress is the ultimate enemy of their mental wellness and stability. I think in many ways its the enemy for all of us. Just something to consider. Just because our kids can do certain things and do them well, doesnt mean that they necessarily should . Self awareness is key. Please know you are definitely not alone. I wish you and your son the very best going forward.
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Autism And Bipolar Disorder
People with bipolar disorder tend to alternate between a frenzied state known as mania and episodes of depression.
It is important to understand the symptoms of true bipolar disorder from those of autism by looking at when the symptoms appeared and how long they lasted. For example, a child with autism may be consistently high-energy and socially intrusive through childhood. As such, her tendency to talk to strangers and make inappropriate comments are likely part of her autism, and not a symptom of a manic mood swing.
Treatments: Some of the medications used to treat bipolar disorder can be problematic for some with autism who has difficulty recognizing and expressing feelings. A psychiatrist can provide additional medications that may be safer.