Department of Psychiatry, Columbia University, New York, NY, USA.
Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
Eur Child Adolesc Psychiatry. 2022 Jul;31(7):1-10. doi: 10.1007/s00787-021-01738-1. Epub 2021 Mar 1.
Although the schizophrenia (SCZ) rate is increased in autism spectrum disorder (ASD), it is difficult to identify which ASD youth will develop psychosis. We explored the relationship between ASD and emerging psychotic-like experiences (PLS) in a sample of 9127 youth aged 9-11 from the Adolescent Brain Cognitive Development (ABCD) cohort. We predicted that parent-reported ASD would be associated with PLS severity, and that ASD youth with PLS (ASD+/PLS+) would differ from ASD youth without PLS (ASD+/PLS-) and youth with PLS but not ASD (ASD-/PLS+) in cognitive function. We fit regression models that included parent-reported ASD, family history of psychosis, lifetime trauma, executive function, processing speed, working memory, age, sex, race, ethnicity, and income-to-needs ratio as predictors of Prodromal Questionnaire-Brief Child (PQ-BC) distress score, a continuous index of PLS severity. We assessed cognitive differences using regression models with ASD/PLS status and relevant covariates as predictors of NIH Toolbox measures. ASD increased raw PQ-BC distress scores by 2.47 points (95% CI 1.33-3.61), an effect at least as large as Black race (1.27 points, 95% CI 0.75-1.78), family history of psychosis (1.05 points, 95% CI 0.56-1.54), and Latinx ethnicity (0.99 points, 95% CI 0.53-1.45. We did not identify differences in cognition for ASD+/PLS+ youth relative to other groups. Our finding of association between ASD and PLS in youth is consistent with previous literature and adds new information in suggesting that ASD may be a strong risk factor for PLS even compared to established SCZ risk factors.
虽然精神分裂症（SCZ）在自闭症谱系障碍（ASD）中的发病率增加，但很难确定哪些 ASD 青少年会发展为精神病。我们在一项 9127 名 9-11 岁青少年大脑认知发育（ABCD）队列的样本中探索了 ASD 与新兴精神病样体验（PLS）之间的关系。我们预测，父母报告的 ASD 与 PLS 严重程度相关，并且具有 PLS 的 ASD 青少年（ASD+/PLS+）在认知功能方面与没有 PLS 的 ASD 青少年（ASD+/PLS-）和有 PLS 但没有 ASD 的青少年（ASD-/PLS+）不同。我们拟合了回归模型，其中包括父母报告的 ASD、精神病家族史、终生创伤、执行功能、处理速度、工作记忆、年龄、性别、种族、族裔和收入需求比作为预测 Prodromal Questionnaire-Brief Child（PQ-BC）困扰评分的指标，这是 PLS 严重程度的连续指数。我们使用回归模型，以 ASD/PLS 状态和相关协变量作为 NIH 工具包测量的预测因子，评估认知差异。ASD 使 PQ-BC 困扰评分增加了 2.47 分（95%CI 1.33-3.61），这一效应至少与黑人种族（1.27 分，95%CI 0.75-1.78）、精神病家族史（1.05 分，95%CI 0.56-1.54）和拉丁裔种族（0.99 分，95%CI 0.53-1.45）相当。我们没有发现 ASD+/PLS+青少年与其他群体在认知方面的差异。我们在青少年中发现 ASD 与 PLS 之间的关联与先前的文献一致，并提供了新的信息，表明 ASD 即使与已确立的 SCZ 风险因素相比，也可能是 PLS 的一个强烈风险因素。
