Autism Spectrum Disorder and Clinical High Risk for Psychosis: A Systematic Review and Meta-analysis.
Julio Vaquerizo-Serrano, Gonzalo Salazar de Pablo, Jatinder Singh and 1 others
PMID 33993403WHAT IT FOUND
Autism is found in 11.6% of people at clinical high risk for psychosis, though estimates vary widely.
These individuals have poorer social functioning than those without autism, but their risk of converting to psychosis is not higher. Clinicians must distinguish new-onset symptoms from lifelong autistic traits.
Key findings
01Approximately 11.6% of individuals at clinical high risk for psychosis meet criteria for Autism Spectrum Disorder, though study estimates ranged from 1.1% to 39.6%.
02Individuals with both conditions showed significantly greater impairment in structural and pragmatic language and social functioning compared to those with psychosis risk alone.
03The presence of Autism Spectrum Disorder was not associated with differential rates of conversion to psychosis compared to those without Autism.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
There was very high heterogeneity between studies (I² = 96.008%), and prevalence estimates ranged widely from 1.1% to 39.6%. Most CHR-P studies specifically exclude individuals with ASD, leading to a small number of available studies for the meta-analysis (only four). There is no gold-standard measure to define CHR-P status, and diagnostic criteria varied across studies. The review could not meta-analyse the presence of CHR-P in ASD populations due to lack of data. Response to treatment was not reported in the included studies.
Declared interests
The study was funded by Fundación Alicia Koplowitz. No other specific conflicts of interest were declared in the provided text.
The easy way to misread this
Do not assume that the presence of 'formal thought disorder' or odd communication in a patient with ASD indicates a high risk of psychosis or a worse prognosis for conversion. In this review, these symptoms were linked to pragmatic language abnormalities inherent in autism and did not predict conversion to psychosis.