How do Aspergeans get misdiagnosed with Schizophrenia?

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When I think of a person with Asperger's, I think of a person with social and communicational problems, who has average to above average intelligence, and who has at least one uncommon hobby or obsession.

When I think of a person with schizophrenia, I think of a person who is detached from reality, who suffers from delusions and hallucinations, and who is emotionally unstable.

How is it then, that so many aspies get misdiagnosed with schizophrenia? Do psychologists tend to assume that most people who report having so many different problems, as is often the case for people with Asperger's, must be seriously delusional?

I was 10 years old, and I read stuff about schizo, and I went home and I said I had schizo. It didn't occur to me what the big picture was. I just read the symptoms and I thought it sounded like me. So maybe that will give you an idea.

I think it is because both aspies and schizophrenics can present as cold and detached with lack of affect.

I had no idea so many did. Schizophrenia doesn't mean emotional instability. Schizophrenia means having a flat affect, no emotions. Schizo-affective Disorder means emotional instability. In order to be diagnosed with Schizophrenia someone must have hallucinations, delusions, or thought disorder for, at least, six months. Many Psychiatrists will not Dx Schizophrenia without auditory hallucinations and a delusional system in place around these hallucinations...ie:"I hear the voice of Satan all around me"
AS isn't anything like this.

Schizophrenia symptoms include disorganized speech and thinking. A coupling of a low intellect with autism could look like that (you wouldn't necessarily even need the low intellect if the communication was poor enough). Remember that part of what is identified as autism now was called childhood schizophrenia because of these similarities, so it isn't so much a "misdiagnosis" as it is a changing in labels as it came to be understood as two different sets of conditions.

EDIT: BTW childhood onset schizophrenia is quite rare.

For one: Aspies might take this question literal, "Do you hear voices?" So the doctor is going to think they hallucinate. They don't even ask "What voices do you hear?" "Are you hearing any now?" "How often do you hear them?" "Where are the voices coming from?"

And aspies can hear sounds other people can't hear and smell things others can't smell, etc. so the doctor might think they are smelling things that aren't there and hearing things that aren't there, feeling things that's aren't there, etc.

Also schizos and aspies share the same signs such as routines and not liking change.

I also read that schizos also struggle in social skills.

BTW I could see really strong/odd synaesthesia being confused for hallucinations and/or delusions. Especially if you coupled that with poor communication of them. Synaesthesia isn't exactly foreign to the spectrum.

Well, in my own case it was because AS wasn't a diagnosis in 1989, and the psych thought my flatness of affect was a lack of affect - one of the signs of schizophrenia. He also thought that I seemed angry. Sounds odd, because at the time I wasn't terribly angry about anything - a little stressed, because my job was to plan World War III, but not angry...

My mother's friend has schizophrenia- started hearing voices when she was a kid. Knowing her at first glance I can see why the uninformed might mistake an ASD for that.

Some people with ASDs have verbal stims and both me and my cousin 'think out loud', and cannot always help it. Both individuals with an ASD and individuals with schizophrenia may talk to themselves and have disorganised speech but for very different reasons.

It might not also be apparent to an NT what sensory input a person with an ASD may be reacting to. Sometimes my mother's friend imagines that things are touching her, and sometimes I appear to flinch away from mid air- but I am reacting to, say, a piece of hair or fluff that has fallen on me etc.

She often has inappropriate emotional responses to situations, for example, laughing at funeral cars. People with ASDs often have difficulty expressing emotional reactions or may even have a /slightly/ different (but understandable given our perception or our tendency to focus on small detail that are sometimes easily missed by NTs) reaction to NTs in certain situations.

I've also heard that some adults with ASDs can be paranoid because of their deficits in understanding the motives of others in social situations that NTs might easily gather via reading social cues- due to their negative experiences they may feel safe presuming the worst and thus may in some circumstances appear delusional to others.

So, in my opinion the causes are different but an ignorant individual may perceive apparent similarities in symptoms.

Well, that's my opinion anyway. I'm making a bit of a generalisation- the subtypes and variability of both disorders need to be taken into account.

Edit:

The two disorders are very similar in many respects in outward traits and even the professionals sometimes have a hard time distinguishing between the two.
(SPD/AS that is)

I've been diagnosed with both schizoaffective disorder and autism, so yes, they both can co-exist. Mine was mainly about my "delusions" even though I think it is real. You can read about my so called "delusions" and "hallucinations" in the Haven in either "Am I losing my mind?" or "hallucinations increasing oh no!" In that one (the hallucination one) I had the disorganized speech in the beginning of the thread, sometimes I speak really random words and that can be a part of autism or schizophrenia. That is probably why Dr. Evil that graduated from Evil Medical School (my pdoc) diagnosed me with Evil Schizoaffective Disorder. How evil! I'm totally sane, I swear!

I think it mostly boils down to doctors at least in the US being quick to label something a "delusion". I've read that the doctors in the US diagnose people as schizophrenic significantly more often than doctors in the UK. Why? Well, likely because doctors in the UK are less apt to think that a given statement is delusional and more apt to view it as either "an opinion" or "a misunderstanding". I don't think that being an American actually makes you more likely to be schizophrenic. Couple that with SPD, which is a difficulty explaining ideas to people, and the docs just hear something they don't understand and jot down "delusion # 4 - great gazooka in the sky". Of course not all docs do that -- Firebird's doc seemed to have done it though, and apparently there are enough docs in the US who do it to constitute a statistically increased number of diagnosis here versus in the UK.