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The diagnostic boundary between autism spectrum disorder, intellectual developmental disorder and schizophrenia spectrum disorders
- Authors:
- BERTELLI Marco O., et al
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 9(5), 2015, pp.243-264.
- Publisher:
- Emerald
Purpose: During the last few years the prevalence of autism and Autism Spectrum Disorder (ASD) has increased greatly. A recurring issue is the overlap and boundaries between Intellectual Developmental Disorder (IDD), ASD and Schizophrenia Spectrum Disorders (SSD). In clinical practice with people with IDD, the alternative or adjunctive diagnosis of ASD or SSD is particularly challenging. The purpose of this paper is to define the boundaries and overlapping clinical characteristics of IDD, ASD and SSD; highlight the most relevant differences in clinical presentation; and provide a clinical framework within which to recognize the impact of IDD and ASD in the diagnosis of SSD. Design/methodology/approach: A systematic mapping of the international literature was conducted on the basis of the following questions: first, what are considered to be core and overlapping aspects of IDD, ASD and SSD; second, what are the main issues in clinical practice; and third, can key diagnostic flags be identified to assist in differentiating between the three diagnostic categories? Findings: Crucial clinical aspects for the differentiation resulted to be age of onset, interest towards others, main positive symptoms, and anatomical anomalies of the central nervous system. More robust diagnostic criteria and semeiological references are desirable. Originality/value: The present literature mapping provides a comprehensive description of the most relevant differences in the clinical presentation of ASD and SSD in persons with IDD. (Publisher abstract)
Autism and mental health
- Author:
- GOULD Judith
- Journal article citation:
- Mental Health Today, Supplement, December 2009, pp.1-2.
- Publisher:
- Pavilion
- Place of publication:
- Hove
Asserting that autism is not a mental health disorder but it is sometimes misdiagnosed as one, and can bring its own mental health issues, the author explains how mental health problems may mask undiagnosed autistic spectrum disorders (ASDs) - for example, adults with Asperger syndrome may be misdiagnosed with a mental health disorder such as schizophrenia. ASDs are not in themselves a mental illness, but are lifelong developmental disabilities that affect the way a person communicates with, and relates in, the world around them. People with ASD are particularly vulnerable to mental health problems, such as anxiety, depression and other mood disorders. The author concludes that autism is a complex disorder and can be difficult to diagnose in the less obvious cases, that a detailed developmental history taking into account a person's early developmental and current behaviour is necessary, and that it is crucial that people receive the correct diagnosis in order that they can receive appropriate treatment and support for their condition.
Intellectual disability and other neuropsychiatric outcomes in high-risk children of mothers with schizophrenia, bipolar disorder and unipolar major depression
- Authors:
- MORGAN Vera A., et al
- Journal article citation:
- British Journal of Psychiatry, 200(4), April 2012, pp.282-289.
- Publisher:
- Cambridge University Press
Evidence is accumulating for partially shared genetics in neuropsychiatric disorders, including schizophrenia, learning disabilities, autism and epilepsy. The authors examined the risk of intellectual disability and other neuropsychiatric outcomes in 3174 children of mothers with schizophrenia, bipolar disorder or unipolar major depression compared with 3129 children of unaffected mothers. The study used record linkage across Western Australian population-based registers. The contribution of obstetric factors to risk of intellectual disability was also assessed. Children were at significantly increased risk of intellectual disability with odds ratios (ORs) of 3.2, 3.1 and 2.9 in the maternal schizophrenia, bipolar disorder and unipolar depression groups respectively. Multivariate analysis suggested familial and obstetric factors may contribute independently to the risk. Although collectively labour/delivery complications (OR = 1.4) just failed to reach significance, neonatal encephalopathy (OR = 7.7) and foetal distress (OR = 1.8) were independent significant predictors. Rates of rare syndromes in children of mothers with mental disorder were well above population rates. Risk of pervasive developmental disorders, including autism, was significantly elevated for children of mothers with bipolar disorder. Risk of epilepsy was doubled for children of mothers with unipolar depression. The authors believe that their findings provide epidemiological support for clustering in neuropsychiatric disorders, they suggest that larger epidemiological studies are warranted.
Latino mothers caring for a son or daughter with autism or schizophrenia: similarities, differences, and the relationship between co-residency and maternal well-being
- Authors:
- MAGANA Sandy, GHOSH Subharati
- Journal article citation:
- Journal of Family Social Work, 13(3), May 2010, pp.227-250.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
In this study, the authors examine similarities and differences in depressive symptoms and psychological well-being between a sample of 62 Latina maternal caregivers of people with autism and schizophrenia in Wisconsin, Los Angeles and Massachusetts. The results of regression analysis showed that mothers of adults with schizophrenia had lower levels of psychological well-being than mothers of young people or adults with autism and, overall, co-residing with a son or daughter was significantly related to lower levels of depressive symptoms in mothers. The article discusses caregiving in autism and mental illness, the unique cultural context within which Latina mothers of children with autism and schizophrenia provide care, and the implications of the study findings.
Mental illness in adults with autistic spectrum disorders
- Author:
- CARPENTER Peter
- Journal article citation:
- Advances in Mental Health and Learning Disabilities, 1(4), December 2007, pp.3-9.
- Publisher:
- Emerald
This article discusses the functional mental health issues of people with autistic spectrum disorders (ASD). Anxiety and mood disorder are common as well as paranoia, but there are problems assessing the phenomenology of illness in people with ASD. Schizophrenia does not appear to be more common in people with ASD. Suggestions are made for the assessment and treatment of co-morbid mental illnesses. The article does not cover the role of epilepsy, ADHD, Tourette's Syndrome of sensory dysfunctions in the mental health of people with ASD.
Mental health aspects of autism and Asperger Syndrome
- Author:
- GHAZIUDDIN Mohammad
- Publisher:
- Jessica Kingsley
- Publication year:
- 2005
- Pagination:
- 252p.bibliog.
- Place of publication:
- London
This book addresses the increasingly urgent need for information about psychiatric problems in people with autism spectrum disorders (ASDs). It systematically explains the emotional and psychological difficulties that are often encountered with ASDs. The author describes each of the conditions that are commonly seen in autistic children and adults, including schizophrenia, depression, anxiety, and tic disorders, and gives guidance on their early detection and treatment.
Some considerations about personality structure in child psychosis
- Author:
- MORRA Mauro
- Journal article citation:
- Journal of Child Psychotherapy, 28(3), December 2002, pp.283-303.
- Publisher:
- Routledge
Some of the literature connected with child psychosis and autism is examined, together with different hypotheses about its psychological aetiology. Special attention is given to the problem of fixation/regression, which is quite controversial. An example is provided of a child, basically autistic, who can be seen as being in an intermediate state between a psychotic and an obsessional disorder. With this, another controversial problem arises: is there any similarity between the rituals of autism and those of obsessional neurosis? And what about the withdrawal of affects we find in both? A psychotherapy case is then presented. Further considerations are given in conclusion, dealing with the structure of childhood psychosis. Autism and confusional psychosis are considered as being basically one structure, with different pictures, easily interchangeable. Some features typical of the paranoid-schizoid position can be recognized: feelings of persecution, massive projective identification and fragmentation.
The Borderline psychotic child: a selective integration
- Editor:
- LUBBE Trevor
- Publisher:
- Routledge
- Publication year:
- 2000
- Pagination:
- 233p.,bibliog.
- Place of publication:
- London
Reviews the history and evolution of the borderline psychosis diagnosis for children, both in the USA and the UK, bringing the reader up to date with current clinical opinion on the subject. Uses a range of clinical case studies to attempt to harmonise US and UK views on borderline diagnosis in the light of new developments in theory at the Menninger Clinic, the Anna Freud Centre and the Tavistock Clinic.
Clinical evidence: mental health; the international source of the best available evidence for effective mental health care
- Editor:
- GODLEE Fiona
- Publisher:
- BMJ Publishing,|Gaskell
- Publication year:
- 2004
- Pagination:
- 264p.bibliog.
- Place of publication:
- London
This book is designed to make the best available evidence easily accessible to mental health practitioners, general practitioners and students. The content is maintains standards of rigorous quality control and ease of access to relevant evidence. For each of the following conditions the literature has been thoroughly searched, appraised and condensed into concise but comprehensive summaries: Alzheimer's disease, Anorexia nervosa, Attention deficit hyperactivity disorder in children, Bulimia nervosa, Chronic fatigue syndrome, Depression in children and adolescents, Depressive disorders, Generalised anxiety disorder, Obsessive compulsive disorder, Panic disorder, Post-traumatic stress disorder, and Schizophrenia.
Disintegration of the components of language as the path to a revision of Bleuler's and Schneider's concepts of schizophrenia: linguistic disturbances compared with first-rank symptoms in acute psychosis
- Authors:
- CECCHERINI-NELLI Alfonso, CROW Timothy J.
- Journal article citation:
- British Journal of Psychiatry, 182(3), March 2003, pp.233-240.
- Publisher:
- Cambridge University Press
The 20th century ended without a resolution of the debate about the supremacy of Schneider's psychopathological conceptualisation of schizophrenia (the first-rank symptoms) over Bleuler's 'four As' (disorders of association and affect, ambivalence and autism). The authors assessed language disturbances and first-rank symptoms with the Clinical Language Disorder Rating Scale (CLANG) in 30 consecutive patients with acute psychosis, selected for the presence of at least one active first-rank symptom, and 15 control participants with depression but no psychotic symptoms. Strong positive correlations were found between the CLANG factor 'poverty' (of speech) and first-rank delusions of control and ('delusional perceptions') between semantic/phonemic paraphasias and verbal auditory hallucinations. Language disturbances were superior to nuclear symptoms in discriminating ICD-10 schizophrenia from other psychoses.