Autism and Psychosis

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So I was just wondering, is it true that a very low percentage of anyone with autism can have severe psychosis? If so, is it incurable or untreatable? I came across this while in the hospital. A patient there told me that the doctors didn't know what to diagnose him as. He then brought up autism as a possible diagnosis. I found this interesting because I started to get bad psychosis (unindentified) and that was why I was hospitalized. I also happen to have high functioning autism, so I really wanted to know if this could be me oe not.

ANYONE can have psychotic episodes. Some episodes are permanent, some are temporary, and some re-occur only under certain conditions.

Nothing is incurable

I've been diagnosed with both (Autism & Schizophrenia/Schizoaffective Disorder). I still have experiences that would fit as symptoms of psychosis, except for the fact that I don't take medication for them and I am no longer distressed or disabled by them. They are experiences that have been negative/distressing in the past, but which have changed over time, with therapy and self-help work.

So now I view these experiences in the same way I view being autistic - a difference in the way I exist in the world, that can be difficult or disabling at times, but that doesn't necessarily need to be gotten rid of/cured, and that has the potential to be a gift.

I suspect that presentations of psychosis are as variable as presentations of autism. I probably wouldn't have counted as having "severe psychosis". On the other hand, I have been hospitalised for it in the past. I'm not sure what "severe" means in this context. Do you mean that the symptoms are chronic? Or that they are significant enough to cause disability and/or require hospitalisation?

Anyway, if you're interested in talking with another person who has both experiences/diagnoses, you're welcome to PM me.

as far as i know, there are 2 broad categories of psychiatric illnesses which are psychopathy and psychosis.
they are mutually exclusive.

psychopathy is characterized by "self absorption", and psychosis is characterized by "external (from self) absorption".

psychopaths are primarily cognizant of their own needs and desires, and they are immutable and psychopaths do not feel a connection to validity of external reference.

psychotics are primarily cognizant of external reference (depersonalized ones) which are highly mutable.

psychopaths do not act on the basis of delusion, and so they are fully accountable for criminal behaviour (they are not assessed as insane). they usually have a complete understanding of what is right or wrong, but they simply do not care about which one they choose other than with consideration as to their action's likelihood of providing them with what they desire.

psychotic people imagine the outside world is governing their actions, and as such are deluded into thinking that they are commissioned by some external force to act as they do. they are not aware of right or wrong in the context of what they are being compelled to do. they are considered to be insane and therefore not responsible for their actions.

i think that autism is more closely related to psychopathy than psychosis.

my doctor once told me that autistic people are extremely unlikely to ever have a psychotic episode excepting for in the event of intoxication by mind altering substances, or by the result of organic brain damage for what ever reason.

I have Aspergers & I fell into a psychotic depression when I was 21. My OCD & anxiety contributed to it. I wouldn't say my psychosis was sever but my depression was. I spent the next 5 years seeing psychs & taking psych meds including an antidepressant & an antipsychotic. My psychoses gradually lifted as my depression gradually improved.

well you are an exception to the rule that i believe is the rule. psychotic depression is devastating and you should have been keenly aware that it was intolerable (severe that is). i have heard that psychotic depression crushes one into an immobile resignation as to the bleakness of even attempting to react to anything, and so often results in a kind of catatonic immobility.
how interesting.

I've not seen the new DSM, but in the DSM IV, a diagnosis of schizophrenia disqualified one from a diagnosis of autism or Asperger's Syndrome. The reason for this was not organic, but because juvenile onset Schizophrenia has a prodromal phase which can mimic Asperger's Syndrome/Autism in some respects. For example, social difficulties.

The question is, is there an organic reason as to why a person can't have both autism/AS/ASD and schizophrenia?

Possibly yes. During certain parts of one's life, the brain grows or prunes synapses. The brain undergoes at least two large synaptic pruning events around the age of 3 or 4, which is why most people, as adults can't recall memories before these ages, and also during the teen/young adult years.

Recent studies have found that those with autism have synaptic overgrowth and under pruning of the synapses. They have increased local connectivity as compared to global connectivity. I believe Temple Grandin once explained this as having a very fast internet connection between adjacent brain cells.

People with schizophrenia have over pruning of the synapses, and also hyperactivity of the frontal lobe. Their brain cells can't communicate well with each other, and are hyper active on top of that.

So it seems like autism and schizophrenia are at opposite ends of the neurological spectrum, and that a person, may not actually be able to have both. However there is still a lot to learn about these disorders.

There are other brain abnormalities associated with schizophrenia and autism. For example, people with schizophrenia tend to have elongated brains and enlarged ventricles as can be deduced by twin studies where one twin remains unaffected. Another study found that people with autism have "holes" in certain layers of their brain. I should point out though, that I believe there is significant variability in what we call "autism" that should be better addressed. A person with Asperger's Syndrome or HFA is clearly not the same as a person with low functioning autism, and likely has a different neurology.

Perhaps, even though they might not be able to coexist in the same person, they could, in some instances, be caused by the same gene...for example a mutation on some gene may cause over pruning, while a different mutation on the same gene may cause under pruning.

Hello. In the DSM-V, one can have schizophrenia and autism as long as one of the two symptoms shown (two or three) is a delusion and/or hallucination. The other symptoms are said to be caused or related to autism. So now it can coexist. Also, AD/HD and autism can now coexist too.

Thankyou for the update on the DSM.

Let us remember though, the DSM criteria is not based on that which is organic, but on psychological theories and politics, with a pinch of science. The committee can make a disorder at the snap of their fingers, or take one away.

It is the personality disorders which cannot share the autism diagnosis

Hello. The only personality disorders that can't be diagnosed if you have an autism diagnosis is schzoid personality disorder and schizotypal personality disorder. Just looked it up the DSM-V right now. They find the symptoms relate too much to autism for there to be a difference between them.

that does not compute.
schizoid personality disorder is a definite diagnosis in it's own right.
schizotypal personality disorder is also a diagnosis in it's own right.
you say they can not be diagnosed in conjunction with autism because they are essentially the same and can not be differentiated, so inferring that autism inherently is inclusive of both schizoid and schizotypal disorder.
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anyway, schizoid personality disorder is characterized by disinterested aloofness and lack of joy. due to the lack of pleasure, they have few interests, and as well, a lack of concern about the world in any way. it is not a psychotic condition. personality disorders are not psychotic in nature.

schizotypal personality disorder is, in my opinion, more of a "thought disorder" than a personality disorder, but anyway, it is a sub acute form of schizophrenic development. it is characterized by magical thinking (superstition, obsession by "vibes" and other intangible elements of consideration, ideas of reference (signs and symbols that somehow are divinely placed to attract their attention)) and it is not, in my opinion, a compatible state of mind with autism, but that is my opinion. schizotypal is a prepsychotic condition i think.
literal thinking is not very compatible with mystical associations drawn from superstitious thinking.

there are many groups of disorder definitions.
some are:
developmental disorders (eg:autism)
personality disorders (eg:narcisissm)
behavioural disorders (eg: antisocial personality disorder)
thought disorders (eg:schizophrenia)
mood disorders (eg: bipolar disorder)

It is possible (based on my own experience) to experience auditory hallucinations (voices) as a response to severe anxiety without becoming so severely psychotic that one completely loses touch with reality. Personally I usually retain enough insight to know I am experiencing voices without necessarily always being sure which are hallucinations and which are real (I tend to hear context-specific voices of people talking about me). This has never been attributed by any psychiatrist I have met to true psychosis but rather a severe reaction to anxiety, although depending on how you describe and react to your experiences and the 'fashion' among psychiatric professionals in your area I can fully see how it could be seen differently.

Furthermore, having been through some very severe depressive episodes, some of my beliefs could easily be described as delusional and/or paranoid according to strict psychiatric definitions, but would not really fit the profile of the types of beliefs typically found in schizophrenia (e.g. a firmly held belief that my family would be better off if I were dead, or the mental health team hated me vs the CID conspiring against someone at a national level). Again, having spent time around people with various forms of mental disorder a lot comes down to not just the bare psychiatric definitions in DSM V or the ICD, but the overall 'flavour' of the person's difficulties.