Dossetor David R
Department of Psychological Medicine, Children's Hospital at Westmead, University of Sydney, NSW, Australia.
Clin Child Psychol Psychiatry. 2007 Oct;12(4):537-48. doi: 10.1177/1359104507078476.
The early literature established the validity of the distinction between early onset schizophrenia and autism. In the modern context of increasing recognition of pervasive developmental disorders (PDD) and a growing interest in very early onset schizophrenia and other childhood onset psychoses, this clinical distinction is often difficult to make. This article looks at problems arising from overdiagnosing psychosis in those with PDD. Four case examples of misattributed diagnosis of psychosis are described. The features that were mistaken for psychotic phenomena are described and explained and successfully treated in the context of a diagnosis of PDD. The article describes problems of reliability of ascertaining subjective mental phenomena and the range of mental phenomena that need to be recognized in PDD. The overlap of abnormal perceptions and cognitions in both these conditions is described with reference to the literature. It is evident that more needs to be done to improve diagnostic reliability of psychosis in PDD, by improving clinical awareness and research tools.
早期文献确立了早发性精神分裂症与自闭症之间区别的有效性。在如今对广泛性发育障碍（PDD）认识不断增加以及对极早发性精神分裂症和其他儿童期起病的精神病兴趣日益浓厚的背景下，这种临床区别往往很难做出。本文探讨了在PDD患者中过度诊断精神病所产生的问题。描述了四个精神病误诊的病例实例。对被误认为是精神病现象的特征进行了描述、解释，并在PDD诊断的背景下成功进行了治疗。本文描述了确定主观心理现象的可靠性问题以及PDD中需要识别的心理现象范围。参考相关文献描述了这两种情况中异常感知和认知的重叠。显然，需要通过提高临床意识和研究工具来进一步提高PDD中精神病诊断的可靠性。
