Study Design And Setting
A case-control study was performed from May 2020 to October 2020 in the Psychiatric Department of Zagazig University Hospitals, Zagazig City, Sharkia Governorate, Egypt. The sample was selected randomly from the offspring of schizophrenic patients attending the outpatient clinic or admitted to the psychiatric department and from offspring of the normal populations . All participants were screened according to the defined inclusion and exclusion criteria to determine eligibility for participation in the research.
The sample size was calculated by open Epi according to the following: percent of autistic symptoms among the normal population was 2.7% and among schizophrenic parents was 55.6% so at the power of study 99% and CI 99%, the sample size was calculated to be 72 .
What It Feels Like To Live With Undiagnosed Autism
At 41, Anne Gingras learned she had autism, a neurological condition that can be detected in children as young as two. Now she has a new understanding of herself and her past.
As told to Katie UnderwoodUpdatedMarch 4, 2016
I never really fit in. I was the type of kid who, on a summer day, could watch the sprinkler go for hoursI liked looking at the water flow and seeing the different colours. One summer, I read about 30 books a week, and I remembered every detail. I found out around the age of 12 that not everyone did that.
In school, I was a top performer in some ways, but I couldnt get basic math. Teachers would give me errands to run, so Id never be in class. It dawned on me later that this was to get me out of the class because I was being troublesome. Socially, I was always included in groups, but I felt like I was on the outside. In high school, when people talked about their weekends, I wasnt included. And not because I didnt want to join in. I didnt know how.
For all the relief, I felt frustrated because society isnt ready to handle adults with autismespecially not women. It is still diagnosed five times more often in men. A boy might lash out or throw things. But as a girl or a woman on the spectrum, you almost have to prove it so people take you seriously and make accommodations for you. You follow people around to blend in.
Anne Gingras, 46, believes that if she had known while growing up that she had autism, it would have impeded her success.
Family And Caregiver Schizophrenia Discussion Forum
Hello everyone, I am new heremy 24 year old son, who has dealt with HFA and OCD just graduated in May Magna Cum Laude with a Major in Psychology and a Minor in Philosophy, was accepted into three graduate schools online, and had two jobs lined up for the summer. 5 days after graduation, he spiraled into an acute psychotic break which seems to be more and more like Schizophrenia. I feel like I am losing him slowlylike his hold on reality is hanging by a threadjust hoping to find and offer support to others so we dont feel so alone
I am not a doctor though and that idea came to me just as a fellow mom thinking out loud. I do think your son probably should be evaluated professionally and that the professional you choose knows about how much your son takes on in any given, day, week or month. He or she may agree or disagree with my thoughts. I can say with either of my sons stress is the ultimate enemy of their mental wellness and stability. I think in many ways its the enemy for all of us. Just something to consider. Just because our kids can do certain things and do them well, doesnt mean that they necessarily should . Self awareness is key. Please know you are definitely not alone. I wish you and your son the very best going forward.
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Schizophrenia Autism May Be Linked In Families
By Genevra Pittman, Reuters Health
4 Min Read
NEW YORK – Families with a history of schizophrenia or bipolar disorder are also more likely to have a child with autism, new research from Sweden and Israel suggests.
Researchers found that kids whose parents or siblings had been diagnosed with schizophrenia were almost three times more likely to have an autism spectrum disorder, including autism and Asperger syndrome.
The link was weaker for bipolar disorder, but still consistent, according to findings published this week in the Archives of General Psychiatry.
Most people with a family history of one of these disorders actually get nothing – the vast majority in fact, said Dr. Patrick Sullivan, the studys lead author from the University of North Carolina at Chapel Hill.
Still, he told Reuters Health, Maybe there is something that is more fundamental but common to both, such as certain changes in gene patterns that are passed from parents to children.
The number of autism diagnoses in the United States has been rising, and the Centers for Disease Control and Prevention now estimates one in 88 kids has an autism spectrum disorder. Thats up from one in 150 a decade ago.
One of the questions in recent autism research has been how much genetics is involved in who gets the condition, versus the prenatal or early childhood environment.
All in all, Sullivans team had data on more than 30,000 young people with autism.
What The Research Says
Autistic people are more likely to exhibit signs and symptoms of bipolar disorder. Theyre also more likely to be diagnosed with bipolar disorder than the typical population. However, its not clear how many people have both conditions or why.
According to one 2008 study, as many as 27 percent of autistic children show symptoms of bipolar disorder. However, other estimates say the real number may be much lower.
A large 2020 study looked at the rates of mood disorders in autistic people in Minnesota. The study participants were between 17 and 43 years old during the months that the data analysis took place. The researchers found that autistic people were 9.34 times more likely to have clinically diagnosed bipolar disorder than nonautistic people.
Researchers know that bipolar disorder may be linked to your genes. If you have a close family member who has either bipolar disorder or depression, you have a greater chance of developing the condition. The same is true for autism. Specific genes or gene errors may increase your chances of developing autism.
Researchers have identified some of the genes that may be connected to bipolar disorder, and several of those genes may be linked to autism, too. While this research is preliminary, experts believe it may help them understand why some people develop both bipolar disorder and autism.
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How Is Schizophrenia Treated In A Child
Antipsychotic medications are the treatment of choice, Dr. Fornari says. If a child were to be diagnosed with COS, second-generation antipsychotic medications would be used, he says. But early identification of the disorder is important, as are psychosocial treatment such as social support groups. For a child with schizophrenia, both academic and social support is key.
Finding ways to keep the person motivated and engaged is important, too, Dr. Houston says. Now people are really recognizing the value of these psychosocial interventions, he says.
Autism And Schizophrenia: A Tale Of Two Disorders
Split the difference: New evidence suggests autism and schizophrenia may be closely related.
For much of the twentieth century, autism was considered childhood schizophrenia.
But, in 1943, Leo Kanner, a psychiatrist at Johns Hopkins University, suggested that children who have an innate inability to form relationships with people have a distinct disorder that he dubbed early infantile autism1.
Thus began a passionate psychological debate over the next 30 years: should autism be considered a separate entity, or part of the schizophrenic syndrome complex?
Clinical differences between the two disorders led to diverging research, but new evidence that suggests they are related diseases may spark the debate anew.
On 5 May, Swedish researchers revealed that, based on health records from more than 1,200 families, parents of children diagnosed with autism are twice as likely to have been diagnosed with schizophrenia as controls2. The mothers of those children with autism are also 1.7 times as likely to have been diagnosed with depression or personality disorders.
Using cutting-edge genetic technologies, researchers are also finding the same random genetic variants particularly in genes involved in neurodevelopmental pathways in both autism and schizophrenia.
The epidemiology didnt teach us there could be a common basis to distinguish between disorders, says Jonathan Sebat, a geneticist at Cold Spring Harbor Laboratory in New York. Genetics is teaching us that.
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Comparisons Of Positive And Negative Symptoms
ADOS
For both analyses, tests for homogeneity of variances were violated. Therefore, we ran BrownForsythe tests to examine equality of means and GamesHowell post hoc comparisons, which are more robust to homogeneity of variance violations. Diagnosis had a statistically significant effect on both positive symptoms, F = 57.69; p< .001 and negative symptoms, F = 11.83; p< .001. For positive symptoms, post hoc comparisons revealed that the ASD group displayed more positive symptoms than both the SZ and TD groups , and the SZ group scored marginally higher on this scale than the TD group . For negative symptoms, the ASD group scored significantly higher than the TD group , and group differences between the SZ and TD groups approached significance as the SZ group scored marginally higher . However, there were no statistically significant differences between the ASD and SZ groups for negative ASD symptoms .
We next examined ROC curves to see if ADOS-2 positive symptoms better discriminate ASD and SZ than ADOS-2 negative symptoms. By Metzs standards, negative items poorly discriminated ASD and SZ , AUC = .64, p = .03. In contrast, positive items did a good job discriminating the ASD and SZ samples, AUC = .81, p< .001.
PANSS
Figure 2*p< .05, ***p< .001 . Error bars represent standard error of the means. + and symbols refer to positive and negative symptoms, respectively. ASD, Autism Spectrum Disorder; SZ. Schizophrenia; TD, Typical Development.
Older Dads: Possible Links To Autism Schizophrenia In Offspring
- Date:
- American College of Neuropsychopharmacology
- Summary:
- Advanced paternal age has been associated with greater risk for psychiatric disorders, such as schizophrenia and autism. With an increase in paternal age, there is a greater frequency of certain types of mutations that contribute to these disorders in offspring. Recent research, however, looks beyond the genetic code to “epigenetic effects,” which do not involve changes in the genes themselves, but rather in how they are expressed to determine one’s characteristics.
Advanced paternal age has been associated with greater risk for psychiatric disorders, such as schizophrenia and autism. With an increase in paternal age, there is a greater frequency of certain types of mutations that contribute to these disorders in offspring. Mutations are changes in the genetic code. Recent research, however, looks beyond the genetic code to “epigenetic effects,” which do not involve changes in the genes themselves, but rather in how they are expressed to determine one’s characteristics. Such epigenetic changes in sperm, related to aging, have been linked with psychiatric disorders in offspring.
Offspring of old fathers showed the same deficit in DNA methylation, and they differed in their behavior from the offspring of the young fathers. They showed less exploratory activity and differed in the startle response and in habituation.
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Regarding Education And Occupation Of The Parents
In this study, there was no significant statistical difference regarding the relationship between the severity of autistic traits in the children and the education and the occupation of their parents in the case and control group.
In agreement with our study, Salah El-Deen and Mahdy reported that there was no statistical difference relation between the severity of autistic traits in the children and the education and the occupation of schizophrenic parents. Other studies that carried on ASD children of non-psychiatric parents revealed that the risk of ASD was not associated with education or occupation of the parents or maternal education .
On the other hand, Rai et al. mentioned in their study that children of parents with manual occupations were at higher risk of ASD. This is inconsistent with the results of our study maybe because of the cultural differences and this study was applied in Sweden, a country that has routine screening for developmental problems, free universal healthcare, and thorough protocols for diagnoses of autism.
How To Recognize Mania In An Autistic Person
If you think you or a loved one may have both bipolar disorder and autism, its important to understand how the conditions appear together. The symptoms of comorbid bipolar disorder and autism are different than if either condition appeared by itself.
Depression is often obvious and easy to identify, while mania is less clear. Thats why recognizing mania in an autistic person can be difficult.
If the behaviors have been a constant since symptoms associated with autism appeared, theyre unlikely to be the result of mania. However, if you noticed a sudden shift or change, these behaviors may be the result of mania.
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The Two Conditions Are Not Mutually Exclusive
Autism and schizophrenia have been considered separate disorders since 1980, with the publication of the third edition of the American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders . In fact, some researchers have described these conditions as diametrical disorders and thus oppose the idea of diagnosing schizophrenia in patients who have already been diagnosed with autism spectrum disorder .
Take Note
- A new study investigated the overlap of ASD and psychotic illness and what this means for ASD patients who experience subclinical psychotic episodes.
- Rates of conversion to concurrent psychosis were similar between high-risk patients with or without ASD.
- Clinicians need to monitor psychotic symptoms in their autism patients during regular appointments and refer, if necessary.
As a consequence, experts in the fields of ASD and schizophrenia have, to a large extent, remained isolated from one another. Plus, over the years, some clinicians may have been likely to downplay the occurrence of psychotic episodes in ASD patients.
Clinicians treating patients with ASD where concerns about psychosis are raised must be cautious about diagnostic overshadowing, or prematurely misattributing psychotic experiences to the core ASD phenotype, Jennifer H. Foss-Feig, PhD, and her fellow researchers wrote in a report published recently in the Journal of theAmerican Academy of Child & Adolescent Psychiatry.1
Risk is similar in both sets of patients
References
Frequency And Ages Affected
Bipolar disorder affects approximately 2.2 percent of people in the United States. Typically, it first appears between the late teen years and early adulthood. Children can also show signs of bipolar disorder.
Schizophrenia isnt as common as bipolar disorder. It affects 1.1 percent of the U.S. population. People usually learn they have it between the ages of 16 and 30. Schizophrenia isnt usually seen in children.
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Affect In Schizophrenia And Autism/aspergers Syndrome
Flattened affect is common in schizophrenia and Autism/Aspergers syndrome. Lewis et al. point out that avolition is similar to apathy, and these may be considered closely related, with avolition identifying a deficit in the ability to act, and apathy a loss of concern for an idea or task. This is very common in Autism/ Aspergers syndrome and schizophrenia. Lewis et al. point out that in schizophrenia the blunting of expression includes deficits in production, facial expression, gestures, and prosody, and understanding these social signals is similarly impaired. This is also typical of Autism/Aspergers syndrome. The DSM-IV- TR glossary points out that affective flattening is the persons face appearing immobile and unresponsive, with poor eye contact and reduced body language. This is typical of Aspergers syndrome. Thaker points out that in schizophrenia one observes a lack of facial expression even while describing the experience of an emotion, lack of tonal inflections of the patients voice, and reduced expression of feelings through gestures and body language which is also observed in Autism/ Aspergers syndrome.
Maternal Infection And The Cytokine Hypothesis Of Neurodevelopmental Disorders
Epidemiologic studies suggest that the risk of schizophrenia is increased after prenatal maternal viral infections such as influenza, rubella, measles, and polio, as well as infections with bacterial pathogens and genital and/or reproductive infections . Thus, the association between maternal infection during pregnancy and schizophrenia in the offspring does not seem to be pathogen specific. Similarly, prenatal/perinatal exposure to numerous pathogens including rubella, measles, and cytomegalovirus has been implicated in the etiology of autism , suggesting that the infection-associated risk of autism may also not be pathogen specific. This notion finds support from a recent nationwide study in Denmark on >20,000 children born to mothers who required hospitalization because of infection during pregnancy . Hospital admission due to maternal exposure to various viral or bacterial infections significantly increased the offspring’s risk of ASD, an effect that seemed unrelated to hospitalization per se .
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Modeling The Genetic Contribution To Asd And Schizophrenia
Both ASD and schizophrenia etiology have important genetic components, with high heritability. However, multiple sites in the genome appear to be associated with the development of these and other mental disorders. Currently, most genetic animal disease models are rodents, particularly mice, and focus on highly penetrant rare mutations.
Some inbred mouse strains that are sometimes used as background for genetic mouse models display behavior abnormalities akin to human mental disorders, and can be used as models of psychiatric diseases. Many were characterized as part of the Mouse Phenome Project , which resulted in the mouse phenome database , and two studies that followed it .
Meta-analysis have been performed to attempt to uncover the genes associated with schizophrenia, and many risk factor molecules, such as the NMDA receptor subunit 1 and 2A , disrupted in schizophrenia 1 , neuregulin 1 , dysbindin, and reelin have been proposed. Genetic models of schizophrenia have recently been reviewed .