People with autism are 3.5 times more likely to also have schizophrenia than the general population.
Both disorders have some similar symptoms and therefore can be misdiagnosed as the other disorder. When schizophrenia and autism occur together, the co-occurrence can create more health problems and difficulties functioning in daily life.
It is important to accurately diagnose both disorders in order to treat them simultaneously and effectively.
Treatment for autism and schizophrenia needs to be specialized and personalized. Medications, therapies, and support groups are often all part of a comprehensive treatment plan for these comorbid disorders.
The History of the Connection Between Autism & Schizophrenia
The link between schizophrenia and autism goes back many years. Historically, autism was considered a feature or symptom of schizophrenia. It was not until 1943 that it was even considered to possibly be its own disorder.
The “negative” symptoms of schizophrenia, such as flat affect, social withdrawal and detachment, communication difficulties, little interest in other people and preference instead for objects, and rigid and repetitive behaviors were actually autistic traits.
Research in the 1970s showed that hallucinations, which are a common psychotic symptom of schizophrenia, were not common in children with autistic traits that manifested prior to age 3. Instead, these children often turned out to have difficulties with social relationships and language delays.
Finally, in 1980, autism and schizophrenia were recognized as two separate diagnoses with a big distinction — age of onset. Children presenting with symptoms around age 4 or earlier were considered to have autism, while those with symptoms that began between the ages of 16 and 30 had schizophrenia.
In the 1990s, research began to shift the landscape again, indicating a potentially greater connection between the two disorders. It is now recognized that it is possible to have both schizophrenia and autism at the same time. This situation is called comorbid disorders.
Research is ongoing regarding the link between the two disorders. Studies indicate a gene overlap, intersecting regions of the brain and atypical brain function, and a genetic connection between the two disorders.
The Commonality of Schizophrenia & Autism
People with autism are more likely to also have schizophrenia, and vice versa.
Rates of comorbidity are highly variable, but they range from 3.5% to just over 50%. This large range can be related to the fact that one disorder is commonly mistaken as the other. Since the symptoms can be so similar, it is also common for both disorders to be present but only one is diagnosed.
Typically, schizophrenia does not manifest until late adolescence to early adulthood. A severe form of the disorder that is also more rare, called child-onset schizophrenia (COS), shows up prior to age 13. This form regularly co-occurs with autism spectrum disorder (ASD) as well. When schizophrenia occurs earlier in life, it is more likely that the person already has autism as well.
Overlapping symptoms for schizophrenia and autism can include:
- Trouble relating socially.
- Motor function difficulties.
- Concentration issues.
- Difficulties processing information.
- Problems with social communication and relationships.
- Unusual thinking patterns.
Treatments for Schizophrenia & Autism
Schizophrenia and autism need to be managed through a specialized and complete treatment plan. The plan should include input from:
- Mental health providers.
- Parents and/or caregivers.
- Occupational therapy practitioners.
- Speech-language pathologists.
A treatment plan will often include a combination of both medication and therapy. Treatment should be based on the specific symptoms of a person and not solely on the diagnosis of one or both disorders. Individual cases can be best managed by treating each person with a specialized care plan that focuses on the direct symptoms.
Usually, medications will be used to manage psychosis, and therapy will be used to regulate moods, emotions, and social communication deficits.
Treatments can include:
- Medications. One of the first things to address in comorbid schizophrenia and autism is the potential for psychosis, self-harm, and aggression. These symptoms are managed through the aid of medications. There are no specific medications approved for the treatment of autism directly, but there are several antipsychotics that are used to address schizophrenia. Talk to your doctor about the risks and benefits of medications.
- Behavioral therapies. Interventions like cognitive behavioral therapy (CBT) and applied behavior analysis (ABA) are both helpful when treating autism. CBT is also used for schizophrenia and can help a person identify how they feel and what their stressors are. A person can determine how these thoughts and emotions impact their actions. They can then develop coping mechanisms for stressors as well as methods to regulate themselves. ABA can be used in conjunction with other therapies. It is very flexible and adaptable to suit an individual’s needs. ABA focuses on positive reinforcement techniques to encourage positive actions and behaviors. The opposite happens with unwanted behaviors, so the person does not receive any positive attention. The negative behaviors therefore lessen over time.
- Life skills training. Group therapy sessions and individual interventions, such as occupational therapy and speech therapy, teach self-care and other skills that can be helpful with everyday life. Social interactions, communication, and cognitive skills can all be improved through these sessions.
- Support groups. Groups are made up of peers in similar circumstances to promote structured interactions in a safe and monitored space. This can help people with autism improve social communication abilities and help them to feel less isolated.
- Family interventions. Parents and other family members play a big role in the life of a loved one with autism, schizophrenia, or both. There are varying severities of these disorders, and some people will need a higher level of support in daily life than others. Parents, caregivers, and family members should all be on the same page when it comes to treatment. They can learn how best to help their family member and manage the disorder collectively.
Can Schizophrenia Be Prevented in Autistic Children?
In short, there is no way to prevent schizophrenia.
People with autism do have a greater risk for developing the disorder. There is likely an environmental link for schizophrenia, however. As a result, there are some things that parents can do for autistic children to potentially decrease the odds for the second disorder occurring.
Early intervention for autism is vital to managing the symptoms of the disorder, improving functionality and quality of life, and minimizing the risk of a co-occurring mood or anxiety disorder, such as schizophrenia. It’s important to keep stress levels low and emotions regulated.
Early intervention techniques teach children how to cope with stressors and keep themselves calm. This can prevent increased stress from becoming a risk factor for schizophrenia. If a child has undiagnosed autism, their symptoms may worsen, and they may experience added stress from not seeing a reason behind their symptoms.
The best thing to do is to be aware of your child’s moods and habits. Alert your child’s pediatrician immediately if you notice changes and suspect an issue.
Continue to be an advocate for your child to ensure the right diagnosis is made and treatments are provided. Remember that the earlier you get an accurate diagnosis, the better the long-term prognosis for your child.
Managing Schizophrenia & Autism for Adults
Many times, adults are diagnosed with a psychosis, such as schizophrenia, and put on antipsychotic medications when a diagnosis of autism would have better fit. It can be even more confusing when both disorders are present.
Medications often impact someone with autism differently than they would someone with schizophrenia alone. Sometimes, medications can actually be detrimental. This is part of the reason why accurate diagnosis and treatment are so important for people of any age.
Adults with high-functioning autism can benefit from social skills and support groups. These groups can aid their ability to hold down a job, communicate more effectively, and regulate emotions.
These groups also provide education and information as well as a safe space to socialize. Through peer support groups, people with autism often experience healthy peer interactions, helping them to make lasting friends.
It can be helpful to connect with others impacted by autism, schizophrenia, or both.
Again, support groups can be a great outlet. Educational resources are also beneficial for learning more about the disorders and how to best advocate for those with them. A robust support network can make a big difference for someone with autism and schizophrenia.
Below are some resources for schizophrenia and autism:
- SARDAA: The Schizophrenia and Related Disorders Alliance of America is committed to helping people who are affected by schizophrenia-related mental health issues. They offer many resources to those in need, including events and links to local support groups.
- Autism Speaks: This national organization is dedicated to helping individuals and families who are affected by autism. They provide numerous online resources as well as information on in-person local support groups.
- SAMHSA: The Substance Abuse and Mental Health Services Administration offers 24/7 support and information on mental health concerns as well as referrals to treatment services. SAMHSA addresses all areas of mental health concerns, including schizophrenia.
- NAMI Family Support Groups: NAMI provides a host of online resources and also hosts local chapters for additional support for people affected by mental illness, including schizophrenia.
- Autism Resource Center: Hosted by the American Academy of Child & Adolescent Psychiatry, this site offers educational information and resources for those affected by autism.
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