Why can't you have both ASD *and* a schizoid disorder?

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Why is there a general belief that if you have one then you can't have the other? And why the the sympthoms say the basically the same?

I don't see why someone couldn't have all the sympthoms of both, someone could have all the sympthoms of aspergers and be a paranoid schizophrenic and I don't see any inherent contradiction.

I ask because I see so much of myself in disorganised schizophrenia lately, and autism doesn't explain some of my episodes of extreme confusion.

I've wondered about this for several years. Can AS and Schizoid Personality Disorder co-exist, or are they mutually exclusive? Wouldn't the communications issues associated with AS cause SPD symptoms to develop, as the person with AS tries for years or decades to establish normal social ties and then just gives up? Not everyone would develop SPD, but for those who are more acutely unable to communicate with others, wouldn't that lead directly to SPD? I've never found anything much about this topic, and would appreciate any points to any resources that discuss these two conditions.

The DSM-IV excludes a lot of diagnoses if you're diagnosed with an ASD, but in the time since, researchers and professionals have found that these conditions can in fact coexist. I seem to recall coming across a video on youtube of a guy diagnosed with schizoid personality disorder and AS.

I also think there have been findings that a lot of teens or children diagnosed with ASDs meet or come close to the criteria for schizotypal personality disorder.

I also think it's possible to be diagnosed with schizophrenia and an ASD although since ASDs tend to have the negative symptoms of schizophrenia that you need to have enough positive symptoms (hallucinations and delusions, for example) to meet the criteria.

I believe there are people here who are diagnosed with or suspect they have both an ASD and schizoaffective disorder.

Incidentally, the connection between schizoid personality disorder and schizophrenia is tenuous at best. I think it is mostly defined by having very similar negative symptoms - and SPD is defined entirely by negative symptoms.

on schizophrenia: you are speaking of paranoid schizophrenia alone, other forms do not necessarily have delusions.

There is a connection not only because they share negative sympthoms but also because they tend to co occur in family, if one has shizotypal then another is more likely to have SPD or schizoaffective.

I hope this whole exclusivisty thing ends, because thinking back: off all the things I said to my first therapist that lead her to say after 3 hours talking "do you know what aspergers is?" she could have just as easilly said "Do you know what sciziod personality disorder is?"< it was probably my stimming and interests that tipped it over the edge.

No, I picked two positive symptoms that indicate schizophrenia. There's obviously more possibilities, but I didn't want to look up the DSM-IV criteria. Throw in disorganized speech and grossly disorganized behavior as well.



Yes, but the chances of someone with SPD developing schizophrenia is something like 1% higher than the general population, which is what I meant by tenuous. I didn't take heredity into account.



Yeah, I think a lot of it is going away entirely in the DSM-V.

I seem to have characteristics of both. Socializing is not something I'm good at, and it's not something I've ever really enjoyed either.

Here is a link detailing a study that uncovered such an overlap (between ASD and schizotypal PD, though it confusingly describes schizotypal as being 'the mildest illness' on the schizophrenia spectrum, which is what I thought schizoid was considered being).

http://pn.psychiatryonline.org/content/43/19/20.2.full

You can have both, under these circumstances:
1. The ASD was known to exist in childhood.
2. The schizotypal PD has an obvious onset after about the age of 15.
3. The schizotypal PD adds symptoms that were not present with the ASD.

It's a difficult dual diagnosis to make, just like ASD and schizophrenia, but it is possible. Thankfully many of the things that both people with ASD and SPD benefit from are the same things, such as social skills training; so a misdiagnosis isn't particularly dangerous.

I am not sure, but I think that, according to WHO/ICD-10 (who supposedly covers 95% of world population) the two can coexist.



Posts, Internet articles, etc.:

http://www.bautforum.com/archive/index.php/t-62542.html
http://www.theapricity.com/forum/showthread.php?t=16614
http://chaoticidealism.livejournal.com/50666.html (from "our" Callista)

Studies:

http://onlinelibrary.wiley.com/doi/10.1 ... x/abstract (that is about SPD vs. HFA, before the recognition of AS as a distinct condition)
http://bjp.rcpsych.org/cgi/content/abstract/153/6/783

Articles from Sula Wolff, probably the better expert on the issue (at least, until her death last year):

http://4np.net/~sum1/psyforum/swolff-beyond_as.pdf
http://books.google.pt/books?id=ovvD0ZuH0GMC&pg=PA278

Schizoid is not the same as schizophrenia. Schizoid is more of a personality type where a person is so indifferent to other people that they don't desire any social interaction. It's not that they're afraid of or hostile to others, they just feel no need to be around others for any reason.

Thank you Callista and TPE2 for the links and the help with understanding Schizoid a bit better.

A lot of the symptoms in both are common, so it is generally seen that you have one or the other. Symptoms are usually accounted for under one diagnosis. There has been cases of people with autism being diagnosed with schizophrenia; however, the dsm says that those people, in order to get the schizophrenia diagnosis, must have severe hallucinations, not just mild symptoms. The dsm says schizoid personality disorder cannot occur with a PDD. They must have their reasons, and I am guessing it is because the similar symptoms are either for one reason or another and not both.

It does seem quite possible though, that in response to distress, abuse, etc., that one can develop schizoid like behaviors due to abuse encountered due to an ASD. When bullied for being different, and when one is unable to understand the reason for such, developing schizoid traits almost seems like a requirement. Flat affect, reclusion, suppression of sexual desires, emotional detachment, etc., all seem like justifiable, and almost desirable, responses to torment at the hands of others. How would these developed negative behaviors be defined if not as schizoid personality disorder?

A lot of people with just plain ol' autism have these traits as well. It seems to me, that the schizophrenia spectrum always seems to have at least some kind of hallucinations or other types of delusions attached to them, rather than just isolation, etc.

Because psychiatrists like to put everyone in nice, neat little boxes. If you have ________________ you can't possibly have __________________....my question is, how would they know and what makes them the ultimate authority on what we can and cannot have? Are they infallible? Not likely since no one is.


In the case of the schizophrenias, I can see their point because of the positive symptoms. They aren't present in autism, they are in schizophrenia and since there are so many different diagnoses, imo you should have positive symptoms to be diagnosed with schizophrenia. No positive symptoms? It must be something else. What I get confused on is ASDs and personality disorders. Why must one preclude the other? It seems, definitely, both could exist in the same person without any friction whatsoever.

That's my point exactly. The ASD is the underlying condition and it is NOT a personality disordering. However, if one has an ASD and one grows up without any support, especially in an abusive environment, it stands to reason that one's personality would get all screwed up trying to deal with both the ASD and the abuse at the same time.