University of Birmingham, School of Psychology, Edgbaston, Birmingham B15 2TT, United Kingdom; University of Birmingham, Institute of Clinical Sciences, College of Medical and Dental Science, Edgbaston, Birmingham B15 2TT, United Kingdom; Forward Thinking Birmingham and Birmingham and Solihull Mental Health Foundation Trust, 1 Printing House Street, Birmingham B4 6DF, United Kingdom.
University of Lausanne, Institute of Psychology, UNIL - Mouline, Géopolis - office 4129, CH-1015 Lausanne, Switzerland.
Schizophr Res. 2018 May;195:80-85. doi: 10.1016/j.schres.2017.08.028. Epub 2017 Aug 18.
There is increasing recognition of the co-occurrence of autism and schizophrenia spectrum disorders. However, the clinical significance of this on outcomes such as depression and suicidal thinking has not been explored. This study examines the association of autism spectrum traits, depressive symptoms and suicidal behaviour in individuals with psychotic experiences. In two cross sectional studies, individuals from a non-help seeking university student sample and patients with first episode psychosis (FEP) service completed standardized measures of autism spectrum traits, psychotic experiences, depressive symptoms and suicidal thinking. In healthy non-help seeking students, increased autism traits and increased subclinical psychotic experiences were significantly associated with depressive symptoms; a significant interaction effect suggests their combined presence has a greater impact on depression. In FEP, high autism traits and positive symptoms were associated with increased depression, hopelessness and suicidality, however there was no significant interaction effect. In FEP a multiple mediation model revealed that the relationship between autism traits and risk for suicidality was mediated through hopelessness. Young people with subclinical psychotic experiences and all patients with FEP should be screened for autism spectrum traits, which may have significant impact on clinical outcomes. Tailored interventions for patients with high levels of autistic spectrum co-morbidities in FEP should be a priority for future research.
人们越来越认识到自闭症和精神分裂症谱系障碍的共同发生。然而，这种情况对抑郁和自杀意念等结果的临床意义尚未得到探讨。本研究探讨了自闭症谱系特征、抑郁症状和有精神病体验个体的自杀行为之间的关系。在两项横断面研究中，来自非求助大学生样本和首发精神病（FEP）服务的患者完成了自闭症谱系特征、精神病体验、抑郁症状和自杀意念的标准化测量。在健康的非求助大学生中，自闭症特征增加和亚临床精神病体验增加与抑郁症状显著相关；显著的交互作用表明它们的共同存在对抑郁有更大的影响。在 FEP 中，高自闭症特征和阳性症状与抑郁、绝望和自杀意念增加有关，但交互作用不显著。在 FEP 中，一个多重中介模型表明，自闭症特征与自杀风险之间的关系是通过绝望来介导的。有亚临床精神病体验的年轻人和所有首发精神病患者都应该接受自闭症谱系特征的筛查，这可能对临床结果有重大影响。针对 FEP 中自闭症谱系共病程度较高的患者的针对性干预应该是未来研究的重点。
