| 1. |
- Lugnegård, Tove, et al.
(författare)
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Asperger syndrome and schizophrenia: Overlap of self-reported autistic traits using the Autism-spectrum Quotient (AQ).
- 2015
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Ingår i: Nordic journal of psychiatry. - : Informa UK Limited. - 1502-4725 .- 0803-9488. ; 69:4, s. 268-274
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Tidskriftsartikel (refereegranskat)abstract
- Background: In clinical practice, the differential diagnosis of Asperger syndrome (AS) versus schizophrenia can be a challenge. Some self-report instruments-such as the Autism-spectrum Quotient (AQ)-have been portrayed as proxies for the diagnosis of AS. However, it has not been demonstrated to what extent autistic traits-as measured by the AQ-separate AS from schizophrenia. Aim: To examine the AS-schizophrenia discriminating ability of the AQ. Method: The AQ is a 50-item self-administered questionnaire (with score range 0-50) for measuring "autistic traits" in adults. Here, it was completed by 136 individuals: 36 with schizophrenic psychosis, 51 with AS and 49 non-clinical comparison cases. A receiver operating characteristic (ROC) analysis for the total AQ score was performed to examine the discriminating power of the instrument. Result: Both individuals with schizophrenia and individuals with AS scored significantly higher on AQ than the non-clinical group. The mean total AQ score (± standard deviation) of the AS group (26.7 ± 8.9; range 9-44) was significantly higher than that of the schizophrenia group (22.7 ± 6.2; range 10-35) (P = 0.041). However, when using the full Likert scale for scoring, the difference did not reach significance. In the ROC analysis of total AQ scores for AS versus schizophrenia, the area under the curve (AUC) was 0.65 (P = 0.02). Conclusion: Although mean AQ scores separated AS and schizophrenia at a group comparison level, significant overlap of AQ scores across the two diagnostic groups clearly reduces the discriminating power of the AQ in the separation of schizophrenia from AS.
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| 2. |
- Lugnegård, Tove
(författare)
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Asperger syndrome and schizophrenia. Psychiatric and social cognitive aspects
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Asperger syndrome (AS) and schizophrenia are psychiatric disorders often implying low global social functioning and a life-long course. Both disorders are of neurodevelopmental origin and genetic factors are prominent. Diagnostic criteria concerning age of onset, life course and the presence of psychotic symptoms differ markedly across the two disorders. However, considerable similarities regarding social cognitive and neurocognitive deficits as well as developmental delays have been noted. The boundaries between AS and schizophrenia are still not clear, and particularly not between the broader concepts of autism spectrum and schizophrenia spectrum. This thesis aims to explore similarities and differences between AS and schizophrenia by using a cross-sectional approach. Psychiatric comorbidity in young adults with AS was studied, as well as occurrence of personality disorders according to DSM-IV. Social cognitive ability and self-report of autistic traits were compared across a group with AS, a group with schizophrenia and a non-clinical comparison group. Method: Fifty-four individuals (26 men, 28 women) with a clinical diagnosis of AS were given the Structured Clinical Interview for DSM-IV Axis I Disorders and the Structured Clinical Interview for DSM-IV Axis II Disorders. The clinical AS diagnosis was confirmed by performing the Diagnostic Interview for Social and Communication Disorders with a parent. The same AS study group, another group of 36 individuals (22 men, 14 women) with schizophrenic psychosis (schizophrenia, schizoaffective disorder, schizofreniform psychosis, psychotic disorder NOS) and a non-clinical comparison group (19 men, 30 women) were compared regarding self-report of autistic traits measured by the Autism-Spectrum Quotient (AQ) and as regards social cognition, as indexed by the Animations Task and the Reading the Mind in the Eyes Test. Results: Of the individuals with AS, 70% had experienced at least one episode of major depression and 50% had suffered from recurrent depressive episodes. Anxiety disorders were present in about 50%. No one fulfilled criteria for schizophrenia, and other psychotic disorders and substance-induced disorders were uncommon. Approximately half of the group fulfilled diagnostic criteria for a personality disorder, all within cluster A or cluster C according to the DSM-IV. Comparison on social cognitive ability across AS, schizophrenic psychosis and the non-clinical sample, demonstrated significant impairments in the two clinical groups, the schizophrenia group being the most impaired. Both clinical groups demonstrated significantly higher total AQ scores than the non-clinical group. The difference across the AS and schizophrenia groups was small, but significant, with the AS group demonstrating higher scores. Conclusions: The phenotypes of AS and schizophrenia show considerable overlap regarding both social cognitive impairments and self-report of autistic traits. Nevertheless, among young adults with a clinical diagnosis of AS, schizophrenia does not appear to be overrepresented. However, other psychiatric disorders, particularly related to mood and anxiety, are common in AS, and about half meet criteria for personality disorders. Future research on genetic susceptibility and the etiology of neurodevelopmental disorders will benefit from approaches based on more refined endophenotypes as well as including several diagnostic domains, rather than being based solely on established diagnostic criteria.
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| 3. |
- Lugnegård, Tove, et al.
(författare)
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Personality disorders and autism spectrum disorders: what are the connections?
- 2012
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Ingår i: Comprehensive Psychiatry. - : Elsevier BV. - 0010-440X .- 1532-8384. ; 53:4, s. 333-340
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The relationship between autism spectrum disorders/pervasive developmental disorders and personality disorders is not completely clear, although both concepts imply lifelong impairment. The purpose of the present study was to investigate the presence of possible personality disorders in a group of young adults with Asperger syndrome. METHOD: Fifty-four young adults with a clinical diagnosis of Asperger syndrome were assessed with Structured Clinical Interview for DSM-IV Axis II disorders to evaluate the presence of a concomitant personality disorder and completed the Autism Spectrum Quotient to measure level of autistic features. Autism spectrum diagnosis was confirmed by Diagnostic Interview for Social and Communication Disorders with a collateral informant. RESULTS: Approximately half of the study group fulfilled criteria for a personality disorder, all belonging to cluster A or C. There was a significant difference across sex: men with Asperger syndrome meeting personality disorder criteria much more often than women with Asperger syndrome (65% vs 32%). Participants fulfilling criteria for a personality disorder showed more marked autistic features according to the Autism Spectrum Quotient. CONCLUSIONS: There is a considerable overlap in symptoms between Asperger syndrome and certain personality disorders. Similarities and differences of the two concepts are discussed in the framework of the Diagnostic and Statistical Manual of Mental Disorders classification system.
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| 4. |
- Lugnegård, Tove, et al.
(författare)
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Psychiatric comorbidity in young adults with a clinical diagnosis of Asperger syndrome.
- 2011
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Ingår i: Research in Developmental Disabilities. - : Elsevier BV. - 0891-4222 .- 1873-3379. ; 32:5, s. 1910-1917
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Tidskriftsartikel (refereegranskat)abstract
- In children with autism spectrum disorders, previous studies have shown high rates of psychiatric comorbidity. To date, studies on adults have been scarce. The aim of the present study was to investigate psychiatric comorbidity in young adults with Asperger syndrome. Participants were 26 men and 28 women (mean age 27 years) with a clinical diagnosis of Asperger syndrome. Psychiatric comorbidity was assessed by the Structured Clinical Interview for DSM-IV Axis I Disorders. IQ was measured using the Wechsler Adult Intelligence Scale, Third Edition. Autism spectrum diagnoses were confirmed using the DIagnostic Interview for Social and Communication Disorders. In our study group, 70% had experienced at least one episode of major depression, and 50% had suffered from recurrent depressive episodes. Anxiety disorders were seen in about 50%. Psychotic disorders and substance-induced disorders were uncommon. In conclusion, young adults with autism spectrum disorders are at high risk for mood and anxiety disorders. To identify these conditions and offer treatment, elevated vigilance is needed in clinical practice.
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| 5. |
- Lugnegård, Tove, et al.
(författare)
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Retrospective parental assessment of childhood neurodevelopmental problems : the use of the Five to Fifteen questionnaire in adults
- 2019
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Ingår i: BJPsych Open. - : Royal College of Psychiatrists. - 2056-4724. ; 5:3
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Attention-deficit hyperactivity disorder and autism are increasingly recognised in adults. For a diagnostic evaluation, parental information on childhood development is needed. However, no instruments that retrospectively describe neurodevelopmental problems in childhood are validated for evaluating adults. The 181-item parent-report questionnaire Five to Fifteen (FTF) is nevertheless frequently used for assessments in adulthood.AIMS: To examine if FTF is reliable for obtaining retrospective neurodevelopmental history among young adults.METHOD: Details of parents who had assessed their children with the FTF for neuropsychiatric evaluation were retrieved and they were asked to complete the FTF again 10-19 years later. Agreements between original and retrospective scorings were analysed.RESULTS: Long-term reliability for FTF varies considerably between individual items. Several difficulties are reported as more severe at the retrospective scoring than at the original scoring. A selection of 24 items (FTF-Brief) with good agreement over time, is presented for use in adult psychiatry settings.CONCLUSION: Neuropsychiatric symptoms may fluctuate over time and become more prominent when demands increase. Informants' recollections of their child's neurodevelopmental symptoms may be a selection of symptoms that are longstanding rather than present at a specific age in childhood.
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| 6. |
- Lugnegård, Tove, et al.
(författare)
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Social cognition impairments in Asperger syndrome and schizophrenia.
- 2013
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Ingår i: Schizophrenia research. - Amsterdam : Elsevier BV. - 1573-2509 .- 0920-9964. ; 143:2-3, s. 277-284
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Tidskriftsartikel (refereegranskat)abstract
- Social cognition impairments are well described in both autism spectrum disorders, including Asperger syndrome (AS), and in schizophrenia spectrum disorders. However, little is known about whether there are differences between the two groups of disorders regarding this ability. The aim of this study was to compare social cognition abilities in AS and schizophrenia. Fifty-three individuals (26 men, 27 women) with a clinical diagnosis of AS, 36 (22 men, 14 women) with a clinical diagnosis of schizophrenic psychosis, and 50 non-clinical controls (19 men, 31 women) participated in the study. Clinical diagnoses were confirmed either by Structured Clinical Interview on DSM-IV diagnosis or the Diagnostic Interview for Social and Communication Disorders. Verbal ability was assessed using the Vocabulary subtest of the WAIS-III. Two social cognition instruments were used: Reading the Mind in the Eyes Test (Eyes Test) and the Animations Task. On the Eyes Test, patients with schizophrenia showed poorer results compared to non-clinical controls; however, no other group differences were seen. Both clinical groups scored significantly lower than the comparison group on the Animations Task. The AS group performed somewhat better than the schizophrenia group. Some differences were accounted for by gender effects. Implicit social cognition impairments appear to be at least as severe in schizophrenia as they are in AS. Possible gender differences have to be taken into account in future research on this topic.
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| 7. |
- Marinopoulou, Maria, et al.
(författare)
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Asperger Syndrome and Schizophrenia : A Comparative Neuropsychological Study
- 2016
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Ingår i: Journal of autism and developmental disorders. - New York : Springer. - 0162-3257 .- 1573-3432. ; 46:7, s. 2292-2304
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Tidskriftsartikel (refereegranskat)abstract
- There has been an increasing interest in possible connections between autism spectrum disorder (ASD) and schizophrenia in the last decade. Neuropsychological comparison studies have, however, been few. The present study examined similarities and differences in intellectual and executive functioning between adults with Asperger syndrome (AS) and adults with schizophrenic psychosis (SP). A group with AS and a group with SP were assessed neuropsychologically with WAIS-III and D-KEFS. Similarities were found between groups, as displayed by an uneven cognitive profile, limitations in working memory, processing speed and some aspects of executive functioning. Full Scale IQ was higher in the AS group. These results add to the current research illuminating similarities and differences between ASD and schizophrenia on a cognitive level.
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| 8. |
- Nylander, Lena, et al.
(författare)
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Autism spectrum disorders and schizophrenia spectrum disorders in adults - Is there a connection? : A literature review and some suggestions for future clinical research
- 2008
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Ingår i: Clinical Neuropsychiatry. - Rom : Giovanni Fioriti Editore. - 1724-4935. ; 5:1, s. 43-54
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Forskningsöversikt (refereegranskat)abstract
- Since autism was first described, there has been an ongoing discussion concerning the connections, if any, with schizophrenia. Once thought to be the same disorder, autistic disorder and childhood schizophrenia were in the 1970s shown to be distinguishable by symptomatology and age of onset. However, as the concept of autism spectrum disorders (ASD) as well as that of schizophrenia spectrum disorders have evolved, the distinction has become less clear. To begin with the increased frequency of ASD diagnosed in adults of normal intelligence has brought up the issue of possible comorbidily of ASD and psychoses. Second, in the schizophrenia research field, it has become clear that schizophrenia is a neurodevelopmental disorder, implying that a liability may be manifested by developmental delays or abnormalities appearing in early childhood. Thus, as neurodevelopmental markers for adult schizophrenia have become better known, it seems reasonable to speculate that ASD may be among several such vulnerability factors. Finally, autistic symptoms in adults and some non-psychotic symptoms of schizophrenia are not always easily distinguishable. Cognitive impairments, deficit symptoms and motor symptoms including catatonia may be features of ASD as well as of schizophrenia. Until we have reliable biological markers for psychiatric syndromes, differential diagnosis between ASD, particularly in patients of normal intelligence, and psychoses, particularly some variants within the schizophrenia spectrum, will remain difficult. A further confounding factor is the possibility of comorbidity. More studies are needed, preferably as collaborative efforts between adult psychiatry and child and adolescent psychiatry.
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| 9. |
- Unenge Hallerbäck, Maria, 1962, et al.
(författare)
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ADHD and Nicotine Use in Schizophrenia and Asperger Syndrome: A Controlled Study.
- 2014
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Ingår i: Journal of Attention Disorders. - : SAGE Publications. - 1087-0547 .- 1557-1246. ; 18:5, s. 425-433
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To examine ADHD prevalence, rating scales, and relationship to nicotine use in adults with schizophrenia or Asperger syndrome. Method: Ninety-five individuals, 41 with schizophrenia and 54 with Asperger syndrome, were included. Self-rating of adult ADHD symptoms with the Wender-Reimherr Adult Attention Deficit Diagnostic Rating Scale (WRAADDS), parent rating of proband's ADHD childhood and adult life symptoms using the Swanson, Nolan, and Pelham Questionnaire (SNAP), and report of clinical ADHD diagnosis were included as ADHD measures. Nicotine use data were compared with data from a population sample. Results: In all, 10% of the schizophrenia group and 30% of the Asperger syndrome group had a clinical ADHD diagnosis. Nicotine dependency in the whole sample was closely linked to ADHD. Conclusion: The prevalence of comorbid ADHD was high in schizophrenia and Asperger syndrome. The WRAADDS self-rating scale for ADHD can be one useful tool for assessing comorbid ADHD in these patient groups.
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| 10. |
- Unenge Hallerbäck, Maria, 1962, et al.
(författare)
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Is autism spectrum disorder common in schizophrenia?
- 2012
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Ingår i: Psychiatry Research. - : Elsevier BV. - 0165-1781 .- 1872-7123. ; 198:1, s. 12-17
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Tidskriftsartikel (refereegranskat)abstract
- A century ago, Kraepelin and Bleuler observed that schizophrenia is often antedated by "premorbid" abnormalities. In this study we explore how the childhood neurodevelopmental problems found in patients with schizophrenia relate to the current concept of autism spectrum disorder (ASD). Forty-six young adult individuals with clinical diagnoses of schizophrenic psychotic disorders were assessed. The Structured Clinical Interview for DSM Disorders (SCID-I) was used in face-to-face psychiatric examination of each individual. In 32 of the 46 cases (70%), collateral information was provided by one or both parents. The Diagnostic Interview for Social and Communication disorders - eleventh version (DISCO-11) was used when interviewing these relatives. This instrument covers, in considerable depth, childhood development, adaptive functioning, and symptoms of ASD - current and lifetime. There is a strict algorithm for ASD diagnosis. About half of the cases with schizophrenic psychosis had ASD according to the results of the parental interview. The rate of ASD was strikingly high (60%) in the group with a SCID-I diagnosis of schizophrenia paranoid type. The findings underscore the need to revisit the DSM the either or stance between ASD and schizophrenia.
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