Recognizing Psychosis in Autism Spectrum Disorder

Michele Ribolsi; Federico Fiori Nastro; Martina Pelle; Caterina Medici; Silvia Sacchetto; Giulia Lisi; Assia Riccioni; Martina Siracusano; Luigi Mazzone; Giorgio Di Lorenzo

doi:10.3389/fpsyt.2022.768586

Recognizing Psychosis in Autism Spectrum Disorder

Front Psychiatry. 2022 Feb 28:13:768586. doi: 10.3389/fpsyt.2022.768586. eCollection 2022.

Authors

Michele Ribolsi¹, Federico Fiori Nastro^{2

3}, Martina Pelle^{2

3}, Caterina Medici^{2

3}, Silvia Sacchetto^{2

3}, Giulia Lisi⁴, Assia Riccioni⁵, Martina Siracusano⁶, Luigi Mazzone⁵, Giorgio Di Lorenzo^{2

3

7}

Affiliations

¹ Unit of Neurology, Neurophysiology, Neurobiology and Psychiatry, Department of Medicine, University Campus Bio-Medico of Rome, Rome, Italy.
² Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
³ Psychiatry and Clinical Psychology Unit, Fondazione Policlinico Tor Vergata, Rome, Italy.
⁴ Department of Mental Health, Azienda Sanitaria Locale (ASL) Roma 1, Rome, Italy.
⁵ Child Neurology and Psychiatry Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
⁶ Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
⁷ IRCCS-Fondazione Santa Lucia, Rome, Italy.

Abstract

There is strong evidence for the existence of a high comorbidity between autism and psychosis with percentages reaching up to 34. 8% and several significant implications for treatment and prognosis of these patients. However, the identification of comorbid psychosis in patients with Autism Spectrum Disorder represents a complex challenge from a psychopathological point of view, in particular in patients with greater deficits in verbal communication. Intercepting the onset of a psychotic breakdown in autism may be very difficult, both disorders in fact occur along a phenotypic continuum of clinical severity and in many cases, psychotic symptoms are present in an attenuated form. In this paper, we reviewed the available scientific literature about comorbidity between psychosis and autism, focusing our attention on four specific dimensions: delusions, hallucinations, negative symptoms, and clinical course. The aim of this paper is to provide clinical tools to identify these psychotic phenomena in autistic patients, even when they occur in their attenuated form.

Keywords: autism; delusions; hallucinations; negative symptoms; psychosis.

Publication types

Review