Autism spectrum disorder and schizophrenia: An updated conceptual review.
Amandeep Jutla, Jennifer Foss-Feig, Jeremy Veenstra-VanderWeele
PMID 34967130WHAT IT FOUND
Autism and schizophrenia share symptoms, genetic risks, and brain connectivity patterns, but direct comparisons are sparse and often inconsistent.
Clinicians must differentiate them using developmental history and specific signs like restricted behaviors, as standard autism tests do not reliably separate the two in adults.
Key findings
01Standard autism diagnostic measures like the ADOS do not consistently separate autism from schizophrenia in adults, requiring clinicians to rely on developmental history and disorder-specific features.
02People with autism and schizophrenia show similar impairments in social cognition, such as theory of mind, but the underlying brain connectivity patterns and sensory processing differences are distinct.
03Co-occurring autism in young people with first-episode psychosis is associated with poorer response to initial medication and a greater likelihood of treatment failure.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The search was not exhaustive and relied on a conceptual approach rather than a comprehensive systematic review, introducing subjectivity. The included studies were highly heterogeneous in design, age range, and methodology, making direct comparisons difficult. Few studies directly compared ASD and SCZ in the same participants, and even fewer examined those with co-occurring diagnoses. Many studies excluded individuals with intellectual disability, limiting generalizability to that population. The review did not assess the quality of evidence or risk of bias in the included studies.
Declared interests
The authors declared no conflicts of interest. The work was supported by grants from the National Institutes of Health (N.I.H.) and non-U.S. government sources.
The easy way to misread this
Do not assume that similar social cognitive impairments in autism and schizophrenia mean the same underlying treatment approach will work for both. The review found that while the deficits look similar on the surface, the brain connectivity and sensory processing patterns are distinct, and standard autism measures do not reliably diagnose autism in adults with schizophrenia.