Central Connecticut State University, Department of Psychological Science, New Britain, CT, USA.
Yale University, School of Medicine, Department of Psychiatry, New Haven, CT, USA.
Schizophr Res. 2024 Sep;271:1-8. doi: 10.1016/j.schres.2024.07.002. Epub 2024 Jul 14.
Autism spectrum disorder (ASD) and schizophrenia (SZ) share traits, especially in social skills and negative symptoms, and to a lesser degree positive symptoms. Differential diagnosis can be challenging and discerning expressive and experiential negative symptoms may provide knowledge with potential diagnostic and functional relevance that can guide treatment. Two exploratory factor analyses (EFA) were conducted to reveal the underlying dimensions of negative and positive symptoms using the Positive and Negative Syndrome Scale (PANSS), the Scale for the Assessment of Positive Symptoms & Negative Symptoms (SAPS/SANS) and the Autism Diagnostic Observation Schedule-Generic (ADOS-G). Three factors emerged from the negative symptom EFA (70.5 % variance): NF1) Expressive Negative; NF2) Experiential Negative; and NF3) Preoccupation, Absorption & Expressive Affective Flattening. Three positive factors emerged (68.6 % variance): PF1) Hallucinations-Delusions; PF2) Grandiosity; and PF3) Thought Disorder-ADOS positive Symptoms. SZ showed higher PF1 scores, and ASD had higher PF3 scores. No differences between groups were observed in the negative factors. Across groups, all negative factors were inversely associated with quality of life. Only NF1 and NF2 and PF1 were detrimentally related to social functioning. A discriminant function analysis using all factors classified correctly 84.4 % of participants, with PF1, NF1 followed by NF2 being the best predictors of diagnosis. Expressive negative followed by Experiential negative symptoms are of diagnostic value independent of and beyond SZ-related positive symptoms and are related with detrimental functioning. Findings confirm the need to distinctively target negative symptoms, and specific SZ-related and ASD-related positive symptoms, and especially the use of several assessment tools for diagnostic classification.
自闭症谱系障碍 (ASD) 和精神分裂症 (SZ) 具有共同特征，尤其是在社交技能和阴性症状方面，阳性症状的程度则较低。鉴别诊断可能具有挑战性，辨别表达性和体验性阴性症状可能提供具有潜在诊断和功能相关性的知识，从而指导治疗。使用阳性和阴性症状量表 (PANSS)、阳性症状和阴性症状评定量表 (SAPS/SANS) 和自闭症诊断观察量表-通用 (ADOS-G) 进行了两次探索性因素分析 (EFA)，以揭示阴性和阳性症状的潜在维度。阴性症状 EFA 中出现了三个因素（70.5%的方差）：NF1）表达性阴性；NF2）体验性阴性；NF3）专注、吸收和表达性情感平坦。三个阳性因素出现（68.6%的方差）：PF1）幻觉-妄想；PF2）夸大；PF3）思维障碍-ADOS 阳性症状。SZ 组 PF1 得分较高，ASD 组 PF3 得分较高。两组在阴性因素方面无差异。在所有组中，所有阴性因素均与生活质量呈负相关。只有 NF1 和 NF2 以及 PF1 与社会功能呈负相关。使用所有因素的判别函数分析正确分类了 84.4%的参与者，PF1、NF1 随后是 NF2 是诊断的最佳预测指标。表达性阴性随后是体验性阴性症状具有独立于且超越 SZ 相关阳性症状的诊断价值，并且与功能受损有关。研究结果证实，有必要明确针对阴性症状，以及特定的 SZ 相关和 ASD 相关阳性症状，特别是使用几种评估工具进行诊断分类。
