Whats with people claiming psychiatic lables cannot co-occur

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I've seen several posts over the years of people saying if you have for example aspergers (or other condition of topic) you cannot have another said condition (schizophrenia, adhd, psychopathy, schizoid pd, bipolar, or another condition mentioned)
Being that I've been diagnosed with overlapping conditions I have noticed these statements. However this does not make sence to me. I wonder if people think that certain types of people just simply cannot exist in this world. That wouldn't make sence however. Of course anyone could exist displaying any assortment of symptomology. The only time this makes sence would be where the symptoms are obviously part of another condition or of something on the same spectrum such as why a doctor wouldnt diagnose someone with aspergers and autistic disorder on the same evaluation.

It's not so much that Asperger's cannot be comorbid with psychiatric or other neurobiological disorders, it's that AS often makes it more difficult for mental health professionals to see them. For example, AS and schizophrenia have almost identical negative symptoms (isolation, flat afffect) and many of the same indicators of ADHD (impulsivity, inattentiveness). Asperger's also has much in common with obsessive-compulsive disorder and schizotypal personality disorder. However, if an individual is very open with his/her doctor and is clear and persistent about disturbing symptoms beyond the AS, then they certainly can get another diagnosis and get helpful treatment and medication.

Last edited by dyingofpoetry on 07 Sep 2012, 11:47 pm, edited 1 time in total.

I see it much more pragmatic.
Of course every constelation is possible BUT:
a) a lot of autistic behaviour CAN look like ADHD, BPD, SPD and so on, but doesn't have to be a comorbidity
b) a lot of disorders are "too close" to each other that it's a matter of interpretation if you diagnose them together or not

I personally find it a bit strange if some people have maybe 10 disorders diagnosed (I've heared about a case like that and in the end ALL disorders got removed and just Asperger-Syndrome stayed), because a lot of symptoms just overlap. Let's take autism and sensory processing disorder for example. In the new DSM-V problems with the sensory processing will be part of of the ASD-diagnosis.
Also I find it a bit difficult in most cases to diagnose autism and SPD together. Of course you can be autistic and schizoid but in most cases this is just part of autism and autistic people are fiewed as being more for themself. Some even claim that in most cases ppl with SPD are on the autistic spectrum. I don't know if this is true.

So of course in the end you can have every disorder combined with autism but the psychiatrist have to asked themself if this behaviour is not really just part of autism.
Some comorbidities are considered really controversal and we know not enought about the brain to be sure if certain disorders are really comorbid in a lot of cases or if they just look simmilar.

I once read a study where autism experts looked for comorbidities in autistic people and found that normal psychiatrists diagnosed on average one comorbidity too much and that the rate of comorbidities is much lower than normal psychiatrists would diagnose their patients in addition to autism. Most wrong comorbidities were OCD and Bipolar.

I feel the same way with my Autism and Bipolar II suspicioun. I'm not 100% sure if those symptoms in my case are just part of autism or really Bipolar II. So far I know this comorbidity is very contriversial, even in the sientific world.
So even after years I'm still not sure if I have it or if it's just looking simmilar because of my autism.

So I heared a lot of opinions on this matter and read a lot of literature about autism and comorbidities and so on, because I'm very interessted in this topic and in the end I've to say that they all are a bit right and that time will show how it really is with autism and the possible comorbidities.

Last edited by Raziel on 06 Sep 2012, 11:19 am, edited 1 time in total.

In the realm of neuropsychiatry, comorbidity is the NORM, not the EXCEPTION...

Well yes, everyone can agree on that I guess.
I also have the feeling that some people have trouble just with certain disorders like the combination of ASD and schizophrenia for example. What I personally can't understand at all in this case. Because in my opinion they even cooccour together more often.

But still, the question is, if some psychiatrists, knowing hardly anything about autism, diagnosing in average "too many" comorbidities?
And I think this is really very often the case.

While comorbidity is a common occurrence, yes, there is overuse of "too many labels" nowadays, and we have the spotty, ambiguous criteria of the DSM to thank for that. "Textbook" cases of a particular neuropsychiatric disorder still are easily recognized and properly diagnosed, but it is the atypical cases or cases that present with general psychiatric symptoms that lead to too many diagnoses.

Another problem is also that psychiatrists think a lot of times to be able to diagnose a patient correctly after maybe 5 minutes or something and this has also happen to me.
I've toled my old shrink a messed up story, me running away from a hospital and suddenly standing on an airport. I have never done something like this befor or afterwards and today I strongly believe that this was agitated depression. But after that, together with my trauma symptoms I had at this time which followed this incidence for here it was clear that I have BPD-tendencies. But what she didn't realiced (even after telling her) that I just behaved like this in this hospital where they locked me away after the ocation on the airport and not in private live.
The problem at the locked up section in the hospital for 14 days was, that I had clautrophobia and didn't know that I could have left after 72 hours legally, because noone toled me that at that time.

Well there is just no section in the ICD or DSM who says:
"Just behaving SPD/BPD or whatever-like symptoms towards certain ppl./in certain situations."

She got even more confuced because I had to go to an expert who is in another citiy and is working with ppl with gender dysphoria since around 25 years, because I'm getting my name changed and so on and of course he wrote that I behaved totally normal and described me totally different (how I behave in normal live) what messed up my shrink even more and so I was toled I could leave, because in here opinion I would just manipulate everyone and just she is right no matter what other experts say (I even believe that she knew, that something is wrong with her theory).
Now I think it is better like this, because it was an unhealthy situation anyway to stay in the hospital where my trauma occoured. But on the other hand it was helpfull, because I realiced how this could happen and so on and even learned a lot about behaviour, diagnostic systems, missdiagnosis (every shrink in that hospital I met thought I would have something else, and that's propably because of the trauma symptoms towards that hospital). Now I can understand better, what happend and how it happend. But I'm still ambivalent towards that hospital, but even don't see it as that unhealthy, so I allways kept my own opinion about myself. (And in the end, accourding to that expert I'm even right with that ).

In the ICD and DSM you just have criterias to every disorder, but how I showed in my case it just don't allways function that well.
Today I belive, I had (and still have slightly) atypical trauma.
Well, at least it's mostly gone now...!
(I don't fullfil the criterias for an PTSD anymore, but still have some symptoms left, I'm working on).

I was diagnosed with AS a couple of years ago and recently was diagnosed with bipolar II. It's very common to have comorbidities.

~Kate

I have adhd and schizo-affective which means really just a cluster of issues. I dont know what I'd personally call it. but to me schizophrenia seems like the combination of Autism and Sensory Processing problems. For instance if someone cannot process sensory information they would hallucinate because theyre confusing two different sounds or thoughts, and also depersonalization.

They told me I wasn't AS even when I scored it on the test because I have the schizo label, so I see where you are coming from. and It kind of annoys me they won't consider Autisms role in genetics and why certain issues in gene expression occur due to evolution.

Thank you for posting this thread
i recently posted about my schizophrenia and Asperger's diagnosis and was shot down by about 5 people
it was pretty amazing!! !
they can't co occur it's like extreme male brain and extreme female brain they said or overlapping symptoms!!
sorry but please give me a break



It has been made clear to me that my new Aspie diagnosis does not negate my schizophrenia or schizoaffective - i am not clear which of these two i am - in hospital in london the doc thought Sza but where i live i am still diagnosed Paranoid Sz

i mean yes i would agree to the one disorder too many because i have now got Asperger's and the misdiagnosis absolutely years ago of borderline personality disorder which sort of fit but not really at the time - actually think this is a rubbish diagnosis that is a catch all anyway

I am not sure you can call a disorder like schizophrenia as co morbid to Asperger's - Asperger's is not an illness

I'd like to see this thread grow - i have a lot to say just don't feel like writing pages of all about me right now

I don't really believe in the male and female brain theory and believe that those are just tendencies in very specific areas of the brain. A friend of mine has Asperger-Syndrome and is also male-to-female-Transsexual. Accourding to this theory this would hardly be possible.
So there might be some parts of the brain who are "hypermasculiniced" but others don't.

My brother who was schizophrenic actually had a lot of parallels to me and I think he could have also been schizophrenic and autistic. But I don't know for sure and I will propably never know, because he commited suicide years ago.

I even believe that ASD and Schizophrenia occour together slightly more often than in the general population, because both are genetically related to each other. They also share a lot of symptoms. The negative symptoms of schizophrenia and ASD are nearly the same. Actually in most cases ASD is more sever than the negative symptoms of schizophrenia.
Also accourding to Fitzgerald autistic people show more often stress related paranoid symptoms.

Hi - i was in my post suggesting what i feel are pretty stupid reasons why schizophrenia and Asperger's can't co occur - which is i believe a load of rubbish as i have schizoaffective or phrenia and Asperger's myself

I also believe it is likely that these illnesses can co occur more frequently than in general although it would not upset me if Asperger's is not a factor in Schizophrenia in a + or - way

I'm sorry to hear about your brother - my sister made very very serious attempts and then one day got hit by a car - she was Schizophrenic too with about one lucid afternoon in 12 years

sorry to read back = i don't know if you thought i was saying that i believe it can't co occur - you may not have meant that

To be clear
i have schizophrenia and Asperger's
i may have Schizoaffective due to a more recently (last 10 years) more vivid mood disorder while psychotic than in my earlier psychotic episodes - although it was not absent even in the first few years
i went from very paranoid to hypermanic in my psychotic episodes - over a number of episodes i mean over time i have had more of a mood element in recent years and at the start of my illness it was mostly paranoid

i was trying to say - some people have bizzare opinions: that there are reasons why you can't have schizoprhenia and aspergers
which is a load of rubbish

No, I didn't meant that.
I just wanted to share my own experience with this topic, because it also kind of anoyes me that some people think that.

I once had psychotic symptoms myself, but there were part of PTSD and didn't occour again, after my trauma got better (but I still can get slightly paranoyed thinking about the trauma and so on. )

I've been wondering about this too. I am fairly certain that someone I am very close to has both AS and Narcissistic Personality Disorder. So many people claim that these two conditions, while they share many traits, cannot exist together because people with NPD are capable of manipulating, controlling, lying, and are generally self serving attention seekers, which isn't exactly typical of AS - yet I witness the two conditions working in perfect harmony with one another constantly. I actually believe that this person developed NPD as a means for compensating for her inability to form lasting friendships. The attention that she gets from the narcissistic behaviors keeps her surrounded by lots of acquaintances, keeping her from feeling lonely. I think that she took her ability to mimic behavior to an extreme and not only gained acceptance in social circles, but gained admiration. Of course, the minute a person get's to know the "real" her (the side of her that has AS) the friendship falls apart.

Isn't autism per definition found in schizophrenia as autism originally was defined as a symptom in schizophrenia, by which I do not want to say that every autistic person has schizophrenia, but - and I am not sure with this guess - that every schizophrenic person has autistic traits, which might lead to not diagnosing the autism seperately if there is a case of schizophrenia.
I have also read that if you are diagnosed with autism, a comorbid AD(H)D leaves undiagnosed as being a part of the autism. It maybe different if first the AD(H)D is diagnosed and the autism later?
Maybe sometimes it depends on what is found and diagnosed first if you get some particular comorbidities or added conditions diagnosed as well or elsewise they are just been recognized as a part of the autism?