College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
Institute of Clinical Sciences, University of Birmingham, Birmingham, UK.
Psychol Med. 2021 Jun;51(8):1364-1372. doi: 10.1017/S0033291720000124. Epub 2020 Feb 21.
There is increasing interest in the clinical and aetiological overlap between autism spectrum disorders and schizophrenia spectrum disorders, reported to co-occur at both diagnostic and trait levels. Individually, sub-clinical autistic and psychotic traits are associated with poor clinical outcomes, including increased depressive symptomatology, self-harming behaviour and suicidality. However, the implications when both traits co-occur remain poorly understood. The study aimed to (1) examine the relationship between autistic and psychotic traits and (2) determine if their co-occurrence increases depressive symptomatology, self-harm and suicidality.
Cross-sectional data from a self-selecting (online and poster advertising) sample of the adult UK population ( = 653) were collected using an online survey. Validated self-report measures were used to assess sub-clinical autistic and psychotic traits, depressive symptomatology, self-harming behaviour and suicidality. Correlation and regression analyses were performed.
A positive correlation between sub-clinical autistic and positive psychotic traits was confirmed ( = 0.509, < 0.001). Overall, autistic traits and psychotic traits were, independently, significant predictors of depression, self-harm and suicidality. Intriguingly, however, depression was associated with a negative interaction between the autistic domain attention to detail and psychotic traits.
This study supports previous findings that sub-clinical autistic and psychotic traits are largely independently associated with depression, self-harm and suicidality, and is novel in finding that their combined presence has no additional effect on depression, self-harm or suicidality. These findings highlight the importance of considering both autistic and psychotic traits and their symptom domains in research and when developing population-based depression prevention and intervention strategies.
自闭症谱系障碍和精神分裂症谱系障碍在临床和病因学上存在重叠，这一现象在诊断和特征层面均有报道，因此人们对其越来越感兴趣。单独来看，亚临床自闭症和精神病特征与较差的临床结局相关，包括抑郁症状加重、自残行为和自杀意念。然而，当这两种特征同时存在时，其影响仍知之甚少。本研究旨在：(1) 研究自闭症和精神病特征之间的关系；(2) 确定它们的同时存在是否会增加抑郁症状、自残和自杀意念。
本研究采用横断面研究，从英国成年人（年龄范围 18-65 岁）中通过在线调查和海报广告招募参与者，使用在线问卷调查收集数据。采用经过验证的自陈式量表评估亚临床自闭症和精神病特征、抑郁症状、自残行为和自杀意念。本研究进行了相关性和回归分析。
本研究证实了亚临床自闭症和阳性精神病特征之间存在正相关（ = 0.509， < 0.001）。总体而言，自闭症特征和精神病特征均独立预测抑郁、自残和自杀意念。然而，有趣的是，抑郁与自闭症特征中的注意细节与精神病特征之间存在负向交互作用。
本研究支持了之前的研究结果，即亚临床自闭症和精神病特征与抑郁、自残和自杀意念存在较大的独立性关联，且本研究的创新性发现为，它们的共同存在对抑郁、自残或自杀意念并无额外影响。这些发现强调了在研究和制定基于人群的抑郁预防和干预策略时，考虑自闭症和精神病特征及其症状维度的重要性。
