Joined: 29 Nov 2008
Location: North Carolina, USA
My AS son, 19, was recently hospitalized with auditory hallucinations and has been diagnosed with schizophrenia along with a reconfirmation of his Asperger's Syndrome. Are there any other Aspies out there who are living and coping with schizophrenia? I've read there may be a link between the two. My aunt was a schizophrenic adult, but other than that no one in either family was either schizophrenic or autistic.
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Before AS was recognised as a condition in its own right, many people on the autistic spectrum were misdiagnosed with childhood schizophrenia in youth. Some of the outward behaviours can display similarly. But there is no proven link between psychotic illness and AS. While they may be comorbid, they're unrelated.
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Joined: 20 Oct 2008
I was make a post about this paper:
http://www.era.lib.ed.ac.uk/bitstream/1 ... hil+AS.pdf
The authors studied adolescents with autistic symptoms, with schizotypical symptoms and with both.
They (by brain scans and other tests) concluded that the subjects with "moderate autism symptoms+schizotypical symptoms" are much more similar to the subjects with "schizotypical symptoms without autistic symptoms" than to the subjects with "moderate autistic symptoms without schizotypical symptoms".
They also noted that first-degree relatives of people with AS have a high incidence of schiziophrenia but that this not occur with the relatives of classical autistics.
Between other things, they concluded that it is possible that people with schiziophrenia spectrum disorders could be mis-diagnosed as having PDD, because of the similiarities in the symptoms.
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Joined: 19 Jun 2007
Location: somewhere over the rainbow
i saw on wikipedia there is condition that some doctors believe is a cross between autism spectrum disorders and schizophrenia
Its not currently in the DSM and i dont know whether or not they are planning to put in in DSM5 or not but here is the article on wikipedia ( oh and by the way i looked it up and theres info on other sites too so its not just Wikipedia which i know can be messed up sometimes)
Multiple-complex Developmental Disorder
Multiple-complex Developmental Disorder (McDD) represents a distinct group within the autism spectrum based on symptomatology.
Ever since autism was first recognized, its continuity with schizophrenia has been a matter of debate. In fact, until the late 1970s, children with autism were often labeled as having "childhood schizophrenia." In the last thirty years, however, the term "childhood schizophrenia" has been displaced. Diagnostic criteria for autism have been established that rely solely on social, communicative and sensorimotor symptoms, without reference to the thought disorders typical of schizophrenia.
Nevertheless, there are some children who display the severe, early-appearing social and communicative deficits characteristic of autism who ALSO display some of the emotional instability and disordered thought processes that resemble schizophrenic symptoms. Cohen, et al. (1986), coined the term Multiplex Developmental Disorder (MDD) to describe these children, although they are often given a diagnosis of PDD-NOS by clinicians who may be unfamiliar with this terminology. Unlike schizophrenia, MDD symptoms emerge in childhood, sometimes in the first years of life, and persist throughout development.
Multiplex developmental disorder is diagnosed in people who are on both the autism and schizophrenia spectrums. Their intelligence and emotional range run the gamut. There is a high rate of co-morbidity with learning disorders, AD/HD, obsessive-compulsive disorder, depression, bipolar disorder, social anxiety disorder, Tourette's syndrome, personality disorders, epilepsy, and phobias.
McDD is a developmental disorder with symptoms that can be divided into three groups.
A. Regulation of emotion. (Affective symptoms) – two or more of the following.
1. Depressive symptoms such as consistent depressed mood, feelings of sadness or emptiness, thoughts of death, little interest or pleasure in activities, chronic fatigue, feelings of worthlessness or guilt.
2. Manic symptoms such as racing thoughts, irritability, distractibility, psychomotor agitation, impulsivity, sleep disturbances, feelings of grandiosity or extreme self worth, risky behavior.
3. Anxious symptoms such as recurrent panic, intense inappropriate anxiety, dissociation, diffuse tension, paranoia, unusual fears and phobias that are peculiar in content or in intensity.
4. Severely impaired regulation of feelings.
5. Significant and wide emotional variability with or without environmental precipitants.
B. Consistent impairments in social behavior and development (Autistic symptoms) - at least two from (A) and one from (B) or (C).
(A) Qualitative impairment in social interaction.
1. Marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction
2. Failure to develop peer relationships appropriate to developmental level
3. A lack of spontaneous seeking to share enjoyment, interests, or achievements with other people
4. Lack of social or emotional reciprocity
(B) Qualitative impairments in communication.
1. Delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)
2. In individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
3. Stereotyped and repetitive use of language or idiosyncratic language
4. Lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level
(C) Restricted repetitive and stereotyped patterns of behavior, interests and activities.
1. Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
2. Apparently inflexible adherence to specific, nonfunctional routines or rituals
3. Stereotyped and repetitive motor mannerisms
4. Persistent preoccupation with parts of objects
C. Impaired cognitive processing (psychotic symptoms) – two or more of the following.
1. Delusions, including fantasies of personal omnipotence, thought insertion, paranoid preoccupations, overengagement with fantasy figures, grandiose fantasies of special powers, referential ideation, and confusion between fantasy and real life.
2. Hallucinations and/or unusual perceptual experiences.
3. Negative symptoms (anhedonia, affective flattening, alogia, or avolition)
4. Disorganized or catatonic behavior such as thought disorder symptoms, easy confusability, inappropriate emotions/facial expressions, uncontrollable laughter, etc.
5. Disorganized speech.
Other possible symptoms. (Does not count for diagnosis)
-Poor sensory integration/moter skills.
-Compulsive behavior and tics.
-Poor judgement/difficulty making decisions.
-Difficulty expressing self.
-Literal concrete thinking.
Joined: 10 Oct 2006
There has been many studies linking autism and schizophrenia, at least in that they share a lot of common factors. I have always personally believed they are 2 sides of the same coin, and my family history indicates strong genetic components for both. There's a reason professional autism screenings also screen for schizophrenia.
A study published in Genome Biology last summer indicated there might be a link between large brains and autism/schizophrenia/bipolar and other similar disorders.
Oxytocin has been linked in studies as a possible treatment for both autism and schizophrenia.
I especially like this study, which I posted last March:
http://www.newscientist.com/article/mg1 ... tml?page=3
A common symptom of both schizophrenia and autism is sensory overload, where the person affected reports feeling bombarded with an overwhelming mixture of sensory information. Could a lack of pruning, due to underactive MHC1 be behind a confused and over-connected brain? In an effort to find out, Boulanger is now looking for behaviours analogous to autism or schizophrenia in mice whose mothers had challenges to their immune system during pregnancy, and in mice with genetically altered levels of MHC1. Initial tests show that MHC1-deficient mice do indeed exhibit symptoms of sensory overload in a diagnostic test called "prepulse inhibition".
This test is also used in humans as a measure of the brain's ability to filter out overwhelming sensory information. In the test, a loud tone causes people to startle and flinch, but playing a soft tone 50 milliseconds before the loud one reduces the startle response. This is a sign that the brain is filtering out information coming in too fast to process - a normal brain can't handle it so the second tone is filtered out and not heard. But some people with schizophrenia and autism lack the ability to filter, so startle just as much on hearing two tones as one. In Boulanger's tests, mice without MHC1 startle in much the same way as people with schizophrenia and autism. They also have a similar imbalance in the levels of excitatory neurotransmitters.
She admits that so far "all of these things are just correlated in a very interesting way" and more experiments are required to discover whether there really are changes in the MHC in the brains of people who develop schizophrenia. To do this she is using tissue samples from brain banks and is collaborating with local physicians to test whether levels of secreted MHC might be altered in the blood or urine. That could potentially pave the way for a diagnostic test for autism or schizophrenia. "It's a long shot," she admits. Schizophrenia symptoms may not manifest themselves until 20 years after an initial insult, perhaps during gestation. "It is like if someone tripped and then 20 years later you tried to figure out why their nose was broken... the clues just might not be there any more."
Joined: 2 Apr 2007
Psychotic episodes can actually occur in individuals with Asperger's in early adult life, but they don't persist or recur like they do in schizophrenia.
Something to think about if the positive symptoms of schizophrenia are only experienced once or for a short duration of time.
Joined: 3 Feb 2006
Location: Ohio, USA
I've seen it co-occurring, but not often. there are a couple of people around here with schizophrenia, schizotypal, and schizoaffective...
I think personally that the link between Asperger's and schizophrenia is completely explained by the tendency to misdiagnose and the overall increased risk of mental illness among autistics (which can probably be explained by our increased stress level). Actually, I wonder if somebody has tested that--it would be easy to do so; just gather a bunch of NTs and a bunch of autistics, control for stress level, and see whether the rate of mental illness is similar. Not that there aren't other factors--there almost guaranteed are, like an increased tendency to diagnose a mental illness if you already are in treatment for something else and a decreased ability to hide a mental illness you already have if you're autistic vs. NT; but I'm betting stress is responsible for a lot of the difference. Schizophrenia is highly heritable--not nearly so much as autism, but enough that you pretty much have to have the wrong genetics to get it, even though you could dodge it if you had a lot of protective factors.
But here's a question: Auditory hallucinations--are they sure that he isn't just hearing things that most people don't notice? With poor communication, describing hyperacusis to a psychiatrist who's not looking for that possibility could sound a lot like auditory hallucinations. Additionally, a lot of people who have auditory hallucinations aren't actually impaired by them to a great degree; I wouldn't call that schizophrenia, any more than shyness is the same as autism... Either that, or schizophrenia has a long spectrum that fades into the typical, just like autism does. It may, at that. Problem is, we still don't understand it properly... the usual response seems to be to act like the patient is incapable of doing anything for himself, stuff him full of drugs, either send him home or lock him up, and hope the drugs magically make everything the way it was before. There's a total underemphasis on counseling and teaching, IMO; and it hasn't been long since the majority of psychologists believed schizophrenics couldn't even benefit from therapy. I mean, HELLO... getting schizophrenia is a major life change, and people get counseling for comparatively petty things like divorce and teenage rebellion!
[http://www.nytimes.com/2007/03/25/magazine/25voices.t.html?_r=1&pagewanted=1]These people[/url] have an interesting viewpoint on auditory hallucinations... Don't know how right they are; nor how well it works; but they have a point when they say that there's a lot more to this than just taking drugs and pretending you're not hearing things.
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Last edited by Callista on 15 Dec 2008, 2:01 pm, edited 1 time in total.
Joined: 2 Mar 2007
Something to think about if the positive symptoms of schizophrenia are only experienced once or for a short duration of time.
Interesting. Like an adjustment reaction, maybe, to big social changes.
Joined: 15 Jul 2006
I find the McDD criteria absurd.
From section A.
Sensory issues could ping this criteria.
From section C.
And this one. So things expected in autism (sensory issues) would result in a person half meeting the criteria for each of these sections.
From section A.
The fact is, given how the world responds to them, many people with AS very reasonably end up depressed, combined with sensory difficulties, it is predictable that ASDs and their impact alone would result, independent of further disorder, in the meeting of criteria for section A.
From section C.
The first (in bold) item could be construed to be occurring simply because someone with an ASD believes that people exchange information around them that they themselves are left out of. It would also be an absolutely true belief in their case. The second is a highly likely predictable outcome whenever and wherever special interests coincide with some fantasy character or other. So that gives us the other half of criteria C.
Then there is;
Affective flattening is difficult to determine in AS because of impairment in the regulation of non-verbal communication to express and regulate expression of affect.
Then there is
Again all predictable outcomes of impairment in the regulation of non-verbal communication to regulate expression.
And then there is
Which seems likely to occur in a group known to have communication impairment, and often characterized by idiosyncratic communication, echolalia, and central coherence/executive function impairment.
Obviously no one diagnosable with an ASD would not meet criteria B.
To me, this criteria throws a net that it seems few ASDers (including those who have no thought disorder and have never had a hallucination) would escape.
Joined: 2 Apr 2007
Which is how it went in the old days where verbal autism was missed; most were pegged with schizophrenia. The negative symptoms of such are almost indistinguishable to that of ASDs, especially in verbal/higher-functioning individuals with autism. Add in social withdrawal, an odd response to questions due to having atypical thought processes [and communication difficulties], and bang, someone with autism has a schizophrenia label.
Joined: 15 Jan 2010
Yes this discussion of schizophrenia and asperger is funny and controverial. There are those with asperger who very strongly want to exclude the schizophrenics from the spectrum. I think there are in a sense two kinds of schizophrenia, that is schizophrenia among neurotypicals and schizophrenia among the neurodiverse.
Anyway I myself am a bit of a strange person. I dont know what possible diagnosis I would have. But I have traits similar to MCDD in my personality. I am not psychotic. But if you go to a psychiatrist in the political psychiatry of sweden you might like I did, end up on first generation anti psychotics anyway. Autism is often even today here in sweden mistaken for schizophrenia och semi psychotic symptoms. I wouldnt say that it is mistaken. I would say they simply give them the anti psychotics, period.
When you look into psychiatry you find out that they dont have that many medications to chose from and many different so called diseases are treated with the same drugs.
Anyway I am not diagnosed with anything really. But in my case , well I have autistic traits as I said and .....
There are definately those with asperger who also have schizophrenia. I have talked to a few. Nice people.
But high funktioning autism or MCDD is easily seen as schizophrenia.
Aspergers are often kind of full of themselves about how funktioning and non schizophrenic they are and in fact in the diagnosis I think it says that schizophrenia has to be excluded för a diagnoses of asperger, but as I said here in sweden there are many people with the double diagnoses of asperger and schizophrenia.
I dont have any diagnosis. I am going to talk to psychiatry in the end of september concerning autism spectrum diagnosis. But anyway I dont care.
What was strange with me is that I kind of started to become like this more when I was like 15. So it started more as I grow up. This should be a sign of schizophrenia. I am not schizophrenic though. And I do have autistic traits. So I dont know what to think of these diagnosis that they make up and follow to the letter as if people were made by old men and not by creation itself.
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I do not even know what all those words mean, yet I believe one of my brothers and I are at least very similar and he has been on medication and disability as a "paranoid schizophrenic" for many years. In contrast, and especially now that AS/HFA makes much more sense to me, I am willing to do absolutely anything necessary to avoid any and all psychiatric medication.
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