Esterberg Michelle L, Trotman Hanan D, Brasfield Joy L, Compton Michael T, Walker Elaine F
Emory University Graduate School of Arts and Sciences, Department of Psychology, United States, 1462 Clifton Road, Suite 235, Atlanta, GA 30322, United States.
Schizophr Res. 2008 Sep;104(1-3):265-73. doi: 10.1016/j.schres.2008.04.029. Epub 2008 Jun 13.
The diagnostic boundaries between autistic- and schizophrenia-spectrum disorders have varied over the years, and some overlap in diagnostic criteria persists. The present study examined childhood and current signs of autistic disorder (AD) in adolescents with schizotypal personality disorder (SPD) or other personality disorders, as well as healthy controls. A structured interview was administered to rate participants' current symptoms. Participants' guardians were interviewed with the Autism Diagnostic Inventory-Revised (ADI-R), a clinical assessment of childhood and current autistic signs. Compared to both the other personality-disordered and healthy groups, adolescents with SPD were rated as having significantly more impairment on childhood and current social functioning, and having more unusual interests and behaviors. For the entire sample, impaired childhood social functioning and unusual interests and behaviors were associated with higher negative symptom scores. Current impairments in social functioning, unusual interests and behaviors, and communication were also linked with greater negative symptoms. However, neither childhood nor current autistic features significantly predicted later conversion to an Axis I psychotic disorder over the course of three years of follow-up. The findings indicate that past and current autistic signs are more common in adolescents with SPD, but neither current nor childhood autistic features are linked with conversion to psychosis.
多年来，自闭症谱系障碍和精神分裂症谱系障碍之间的诊断界限一直在变化，并且在诊断标准上仍存在一些重叠。本研究调查了患有分裂型人格障碍（SPD）或其他人格障碍的青少年以及健康对照组中自闭症谱系障碍（AD）的童年期和当前症状。采用结构化访谈对参与者当前的症状进行评分。使用修订版自闭症诊断访谈量表（ADI-R）对参与者的监护人进行访谈，这是一项对童年期和当前自闭症症状的临床评估。与其他患有人格障碍的组和健康组相比，患有SPD的青少年在童年期和当前社会功能方面的受损程度被评定为显著更高，并且有更多异常的兴趣和行为。对于整个样本，童年期社会功能受损以及异常的兴趣和行为与更高的阴性症状评分相关。当前社会功能、异常兴趣和行为以及沟通方面的受损也与更严重的阴性症状相关。然而，在三年的随访过程中，无论是童年期还是当前的自闭症特征都不能显著预测后来是否会转变为轴I型精神障碍。研究结果表明，过去和当前的自闭症症状在患有SPD的青少年中更为常见，但当前和童年期的自闭症特征均与转变为精神病无关。
