Ünver Buket, Öner Özgür, Yurtbaşı Pınar
Turk Psikiyatri Derg. 2015 Spring;26(1):65-70.
Schizotypal personality disorder is characterized by social and interpersonal deficits marked by discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior. Inappropriate or constricted affect, reduced capacity for relationships, lack of close friends and reduced capacity for social life are the symptoms that overlap both schizotypal personality disorder and autism spectrum disorders. The making of differential diagnosis may be difficult since several symptoms are similar between these disorders. In this study, we discussed the differential diagnosis issues on the basis of an adolescent case. Odd appearance, magical thoughts, reference thoughts suggests Schizotypal Personality Disorder whereas lack of eye contact at 2 years old, a preference to be isolated and play alone and referral to a child psychiatrist at 4 years old suggest Autism Spectrum Disorders. Based on the results of psychological assessment, Wechsler Intelligence Scale for Children-Revised (WISC-R) profile is compatible with autistic children's profiles. Based on Schizotypal Personality Questionnaire, the patient's anxiety, lack of close friends, constricted affect symptoms which take place in the category of interpersonal schizotypy seems to overlap with lack of communication of Autism Spectrum Disorders. This case report indicates that, separation of autism and schizophrenia, a very important historical breakthrough in autism research, may be blurred in cases with less typical clinical pictures representing autistic and schizophrenic "spectrum" diagnosis.
分裂型人格障碍的特征是社交和人际关系缺陷,表现为对亲密关系感到不适且建立亲密关系的能力下降,同时伴有认知或感知扭曲以及行为怪异。情感不适当或受限、建立关系的能力下降、缺乏亲密朋友以及社交生活能力下降,这些症状在分裂型人格障碍和自闭症谱系障碍中都存在。由于这些障碍之间有几种症状相似,因此进行鉴别诊断可能会很困难。在本研究中,我们基于一个青少年病例讨论了鉴别诊断问题。奇特的外表、奇幻思维、牵连观念提示分裂型人格障碍,而2岁时缺乏眼神交流、偏好独处和独自玩耍以及4岁时转诊至儿童精神科医生提示自闭症谱系障碍。根据心理评估结果,儿童韦氏智力量表修订版(WISC-R)的剖面图与自闭症儿童的剖面图相符。根据分裂型人格问卷,患者在人际分裂型类别中出现的焦虑、缺乏亲密朋友、情感受限症状似乎与自闭症谱系障碍的沟通障碍相重叠。本病例报告表明,自闭症研究中一个非常重要的历史突破——自闭症与精神分裂症的区分,在代表自闭症和精神分裂症“谱系”诊断的不太典型临床表现的病例中可能会变得模糊。