Are autism and psychosis related

Autism and Schizophrenia: Common Roots of the Disorders

The children and siblings of patients with schizophrenia are at increased risk of developing autism spectrum disorder. This is shown by three case control studies in the Archives of General Psychiatry. It could also be linked to bipolar disorder.

Autism and schizophrenia have only been separate diseases since the 1980s. Historically, autism was seen as the childish variant of schizophrenia, and Eugen Bleuler, who coined the term schizophrenia, viewed autism as a possible manifestation of psychosis. In fact, with all the differences (in the age of onset and in the symptoms) there could be more similarities than today's strictly separate classification suggests.

In their first study, Patrick Sullivan et al. evaluated the data from the National Patient Register of Sweden. It includes all discharge diagnoses from the clinics since 1973, and since 2001 also all outpatient psychiatric treatments. Results: The children of schizophrenia patients are 2.9 times more likely than others to develop an autism spectrum disorder. The risk for the siblings was 2.6 times higher. The diagnosis of bipolar disorder also increased the risk of autism for first-degree relatives. A second case-control study in Stockholm County, which includes all children and adolescents between 1984 and 2007, essentially confirmed the finding. In this study, it was also possible to differentiate between autistic children with and without mental retardation - this is a hallmark of severe early childhood autism. Both variants are more common if the parents had schizophrenia. The relationship to bipolar disorder was weaker here than in the first study and not significant for children with mental retardation.

The association was particularly clear in the third cohort of recruits from the Israeli army: Here, the siblings of schizophrenia patients were no less than twelve times more likely to develop an autism spectrum disorder. Sullivan attributes this to the good record of early forms of schizophrenia in Israel and sees the association as an indication of common etiological roots of schizophrenia and autism spectrum disorder. He refers to the latest results in genome research, which have found the same rare “copy number variants” in both diseases. Many psychiatrists interpret autism and schizophrenia as genetically determined developmental disorders of the brain that occur at different ages. rme

Sullivan PF, Magnusson, C, Reichenberg A, et al .: Family History of Schizophrenia and Bipolar Disorder as Risk Factors for Autism. Arch Gen Psychiatry. 2012; 1-5. doi: 10.1001 / archgenpsychiatry.2012.730