Autistic Spectrum Disorders and Schizophrenia

Abstract: Autism spectrum disorders are a group of complex neurodevelopmental disorders that primarily present with deficits in social interactions, communication, and repetitive behaviors. With a progressive evolution in understanding this unique group of disorders, a variety of phenotypes have been postulated, with variability in both biological features and response to treatment. Etiologically, autism is believed to involve a genetic predisposition that may be triggered by environmental factors. While there is no known cure for autism, many treatment approaches are available that potentially improve certain core and associated symptoms. In the past decade, research in the etiology and treatment of these disorders has grown tremendously, as evident by the increasing number of publications in this area. This chapter will review some of the recent advances in the current understanding of these disorders. In addition, a historical background regarding the clinical diagnosis of autism spectrum disorders, including the development of diagnostic concepts and definitions, will be reviewed. Clinical features of autism, its course, prognosis, interventions, including psychosocial and educational interventions, and pharmacological treatments, will also be highlighted. This will be followed by an outline of standard clinical assessment of individuals with a suspected diagnosis of autism. Furthermore, epidemiological data along with recent advances in the understanding of autism’s etiology and pathogenesis, including genetic influences, neuropsychological research, and neurobiological mechanisms, will also be briefly discussed. Finally, although autism can be separated from early onset psychosis and recent data suggest that individuals with autism are probably not at higher risk for developing schizophrenia, it is striking that children with childhood onset schizophrenia show high rates of early social, language and motor developmental abnormalities, with premorbid social impairment being the most common feature. Beginning with Kanner’s use of the term autism that suggested a similarity to schizophrenia, the question of comorbid association or phenotypic variations between autism and schizophrenia has been frequently asked. This chapter will also aim to clarify the similarities and differences in presentation between autism and childhood onset schizophrenia