Palumbo Davide, Stanghellini Giovanni, Mucci Armida, Ballerini Massimo, Giordano Giulia Maria, Lysaker Paul H, Galderisi Silvana
Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy.
Department of Psychological, Humanistic and Territorial Sciences, G. D'Annunzio University, Chieti, Italy.
Front Psychiatry. 2021 Jan 26;12:622359. doi: 10.3389/fpsyt.2021.622359. eCollection 2021.
Social dysfunctions (SD) are frequently observed in subjects with schizophrenia. Some of these dysfunctions are also observed in other neuropsychiatric disorders such as autism spectrum disorders (ASD), major depression, bipolar disorder, or Alzheimer disease. Recently, a characterization of a specific type of SD in schizophrenia has been proposed, with the concept of dis-sociality, which form the core aspect of "Schizophrenic Autism" (SA). The present study aimed to explore the presence in people with schizophrenia of SA, independent of other autistic traits, which can be often found in schizophrenia and other neurodevelopmental disorders. We used a structured interview-the Autism Rating Scale (ARS), an instrument devised to detect and measure SA. Fifty-one outpatients affected by schizophrenia (26 remitted, SCZ-r) and 28 affected by bipolar disorder type 1, with psychotic features, in the euthymic phase (BD-e) were recruited. Before assessing the specificity for schizophrenia of SA, we tested the internal consistency, the convergent and divergent validity of the ARS in the schizophrenia sample. Specificity was assessed by examining potential differences in ARS scores between SCZ-r and BD-e subjects. ARS showed good internal consistency, as well as convergent and divergent validity. ARS items were more frequently of moderate severity in SCZ-r than in BD-e subjects. This scale can contribute to establish more precise phenomenal boundaries between schizophrenia and bipolar disorder, and opens up the possibility of identifying a different type of SD in schizophrenia, independent of autistic traits and negative symptoms, which might benefit from different treatments.
社交功能障碍（SD）在精神分裂症患者中经常被观察到。其中一些功能障碍在其他神经精神疾病中也有发现，如自闭症谱系障碍（ASD）、重度抑郁症、双相情感障碍或阿尔茨海默病。最近，有人提出了精神分裂症中一种特定类型的SD的特征，即反社会性概念，它构成了“精神分裂症性自闭症”（SA）的核心方面。本研究旨在探讨精神分裂症患者中SA的存在情况，不考虑其他自闭症特征，这些特征在精神分裂症和其他神经发育障碍中经常出现。我们使用了一种结构化访谈——自闭症评定量表（ARS），这是一种旨在检测和测量SA的工具。招募了51名患有精神分裂症的门诊患者（26名缓解期患者，SCZ-r）和28名处于心境正常期（BD-e）、有精神病性特征的1型双相情感障碍患者。在评估SA对精神分裂症的特异性之前，我们测试了ARS在精神分裂症样本中的内部一致性、收敛效度和区分效度。通过检查SCZ-r和BD-e受试者之间ARS分数的潜在差异来评估特异性。ARS显示出良好的内部一致性以及收敛效度和区分效度。与BD-e受试者相比，SCZ-r受试者的ARS项目中度严重程度更为常见。该量表有助于在精神分裂症和双相情感障碍之间建立更精确的现象学界限，并为识别精神分裂症中一种不同类型的SD开辟了可能性，这种SD独立于自闭症特征和阴性症状，可能受益于不同的治疗方法。
