Schozophrenia Spectrum Traits and Mental Health In Children with ASD

Background: Autism spectrum disorder (ASD) and schizophrenia spectrum disorder are widely recognized as discrete clinical entities; nevertheless, recent developments in molecular biology and nosology suggest interesting etiological and phenomenological interrelations.

Objectives: Prepubertal children with ASD with and without co-occurring schizophrenia spectrum traits (SST), both positive and negative (anhedonic feelings, apathy) were examined for differences in co-occurring psychiatric symptoms, background characteristics, and mental health risk factors such as symptoms of depression and anxiety.

Methods: Parents and teachers completed a DSM-IV-referenced rating scale with established psychometric properties for a relatively large sample (N=147) of 6-12 year old children with ASD. Mothers also completed a background information questionnaire.

Results: There was a clear pattern of group differences in emotion dysregulation symptom severity (+SST>SST-) and background characteristics, but results varied as a function of informant who served as the basis for group classification. Children with impairing SST had more mental health risk factors. Girls were more likely to be classified SST (mothers' ratings), whereas non-SST youth were more likely to be born in spring-summer (teachers' ratings). ASD and SST symptoms were moderately correlated.

Conclusions: Findings provide tentative evidence for a phenomenologically unique SST syndrome within the ASD clinical phenotype, which may ultimately prove helpful in future research for examining pathogenic processes, developmental trajectory, and response to intervention. The results will be discussed with a special emphasis on the role of emotion dysregulation in this developmental trajectory.