Psychosis in Autism Spectrum Disorder

The relationship between autism and schizophrenia isn’t clear but findings from several studies imply that autistic people might be at higher risk of developing psychosis than the rest of the population.

Is Psychosis a Symptom of Autism?

Autism spectrum disorder (ASD) is defined as a neuro-developmental disorder that causes difficulties with social interaction, communication, sensory sensitivity and behaviour, while psychosis is a symptom of schizophrenia and describes a pattern of hallucinations (hearing or seeing things that don’t exist) and delusions (unusual beliefs).

Although psychosis isn’t a symptom of autism, even up to 34.8% of people with ASD might experience psychotic symptoms. [1] Interestingly, their experience differs from the experience of non-autistic people with psychosis.

Additionally, findings from recent studies show that traits of individuals diagnosed with autism who display symptoms of psychosis are different than traits of individuals who only have an autism diagnosis. For example, those who experience psychosis might not exhibit repetitive behaviours or have stereotypical interests. [2]

What is the Difference Between Psychosis in Autism and Psychosis in Schizophrenia?

Although the topic is still under-researched, it seems that psychosis in autistic people usually appears in early childhood, while psychosis in people with schizophrenia tends to develop in adolescence.

What Does Psychosis Look Like in Autistic People?

Autistic people might suffer from ‘anomalous perceptual experiences’ that might involve hearing sounds that don’t have a source. [3] New evidence also shows that a lot of autistic people might experience sensory hallucinations, such as thinking someone is touching them when there’s no one around. [4] Delusions commonly involve misinterpreting other people’s intentions, although many believe this might simply be due to poor social skills typical for autistic people. [5]

What Might Cause Psychosis in People with ASD?

Studies show that families with a history of schizophrenia or bipolar disorder are more likely to have autistic children. [2] It’s also speculated that psychosis shares genetic mechanisms with autism and that the distress associated with being autistic increases the likelihood of experiencing mood disorders in the future. Similarly, according to the vulnerability/stress model, individuals might be at risk of having a psychotic episode due to their personal limitations such as social incompetence or environmental stressors, which would mean autistic people are more likely to develop symptoms of schizophrenia than the rest of the population. [6]  


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References:

[1] https://www.sciencedirect.com/science/article/abs/pii/S0149763415001165
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5376719/
[3] https://www.frontiersin.org/articles/10.3389/fpsyt.2022.768586/full
[4] https://www.spectrumnews.org/opinion/hallucinations-unusually-common-adults-autism/
[5] https://academic.oup.com/schizbullopen/article/1/1/sgaa046/5899822
[6] https://psycnet.apa.org/record/2005-09718-011