Prevalence and Clinical Correlates of Autistic Features in Patients with Initial-Treatment and Drug-Naive Schizophrenia

Overview

Journal Alpha Psychiatry

Publisher Aves

Specialty Psychiatry

Date 2024 Nov 18

PMID 39553488

Authors

Hong Zhang

Lin Zhang

Zhihua Liu

Jun Ma

Affiliations

Soon will be listed here.

Abstract

Objective: A distinct subtype of schizophrenia (SCZ) is the one accompanied with autistic features (AF). This study aimed to determine the prevalence of AF in initial-treatment and drug-naive (ITDN) patients with SCZ and investigate its influencing factors.

Methods: The study recruited 710 ITDN patients with SCZ. Their sociodemographic data and general clinical information were collected, and a clinical psychological assessment was performed to quantify their psychopathology and disease severity. The severity of AF was calculated based on psychopathology scores.

Results: Overall, 19.01% (135/710) patients with SCZ showed AF. Patients with AF exhibited higher levels of thyroid-stimulating hormone (TSH) ( = -4.54, < .001) and lower levels of free triiodothyronine (FT) and free tetraiodothyronine (FT) ( = 2.38, = .018; = 3.19, = .002) than those with AF. Binary logistic regression analysis revealed waist circumference ( = 0.03, = .022, odds ratio (OR) = 1.03) and TSH level ( = 0.54, < .001, OR = 1.71) as risk factors for AF, and deemed low-density lipoprotein cholesterol ( = -0.43, = .025, OR = 0.65), fasting blood glucose ( = -0.72, = .013, OR = 0.49), FT ( = -0.32, = .034, OR = 0.73), and FT ( = -0.08, = .025, OR = 0.93) levels as protective factors. Multiple linear regression analysis identified FT level ( = -0.85, = -2.22, = .028, 95%, Confidence Intervals (CI): -1.61- -0.09) as a protective factor influencing AF severity.

Conclusion: This study reports the prevalence of AF in the target SCZ population and identifies factors associated with its development and severity. The discernment of these distinctive clinical features may facilitate formulation of tailored prevention strategies and interventions for this precise subset of SCZ patients.

Citing Articles

Correlation Between Monocyte Count, Monocyte-Lymphocyte Ratio, and Other Inflammatory Cells With Sleep and Psychiatric Symptoms in First-Episode Schizophrenia Patients.

Hu C, Du N, Li J, Chen L, Meng X, Yao L Neuropsychiatr Dis Treat. 2025; 21:373-381.

PMID: 40034128 PMC: 11873015. DOI: 10.2147/NDT.S506074.

References

Andersen S, Laurberg P, Wu C, Olsen J . Attention deficit hyperactivity disorder and autism spectrum disorder in children born to mothers with thyroid dysfunction: a Danish nationwide cohort study. BJOG. 2014; 121(11):1365-74. DOI: 10.1111/1471-0528.12681. View

Nibbio G, Barlati S, Calzavara-Pinton I, Necchini N, Invernizzi E, DellOvo D . Assessment and correlates of autistic symptoms in Schizophrenia Spectrum Disorders measured with the PANSS Autism Severity Score: A systematic review. Front Psychiatry. 2022; 13:934005. PMC: 9468543. DOI: 10.3389/fpsyt.2022.934005. View

Driver D, Thomas S, Gogtay N, Rapoport J . Childhood-Onset Schizophrenia and Early-onset Schizophrenia Spectrum Disorders: An Update. Child Adolesc Psychiatr Clin N Am. 2019; 29(1):71-90. DOI: 10.1016/j.chc.2019.08.017. View

Telo S, Bilgic S, Karabulut N . Thyroid Hormone Levels in Chronic Schizophrenic Patients: Association with Psychopathology. West Indian Med J. 2017; 65(2):312-315. DOI: 10.7727/wimj.2015.186. View

Bechi M, Agostoni G, Buonocore M, Bosinelli F, Spangaro M, Bianchi L . The Influence of Premorbid Adjustment and Autistic Traits on Social Cognitive Dysfunction in Schizophrenia. J Int Neuropsychol Soc. 2019; 26(3):276-285. DOI: 10.1017/S1355617719000961. View

Singh S, Yazdani U, Gadad B, Zaman S, Hynan L, Roatch N . Serum thyroid-stimulating hormone and interleukin-8 levels in boys with autism spectrum disorder. J Neuroinflammation. 2017; 14(1):113. PMC: 5457729. DOI: 10.1186/s12974-017-0888-4. View

Deste G, Vita A, Nibbio G, Barlati S, Penn D, Pinkham A . Autistic symptoms in people with schizophrenia: Neurocognitive, socio-cognitive, clinical and real-world functional characteristics of individuals without autistic features. Schizophr Res. 2021; 236:12-18. DOI: 10.1016/j.schres.2021.07.037. View

DellOsso L, Carpita B, Cremone I, Gesi C, DErmo A, De Iorio G . Autism spectrum in patients with schizophrenia: correlations with real-life functioning, resilience, and coping styles. CNS Spectr. 2021; :1-11. DOI: 10.1017/S1092852921000353. View

Forsyth J, Nachun D, Gandal M, Geschwind D, Anderson A, Coppola G . Synaptic and Gene Regulatory Mechanisms in Schizophrenia, Autism, and 22q11.2 Copy Number Variant-Mediated Risk for Neuropsychiatric Disorders. Biol Psychiatry. 2019; 87(2):150-163. PMC: 6925326. DOI: 10.1016/j.biopsych.2019.06.029. View

10.

Levie D, Korevaar T, Bath S, Dalmau-Bueno A, Murcia M, Espada M . Thyroid Function in Early Pregnancy, Child IQ, and Autistic Traits: A Meta-Analysis of Individual Participant Data. J Clin Endocrinol Metab. 2018; 103(8):2967-2979. DOI: 10.1210/jc.2018-00224. View

11.

Rapoport J, Chavez A, Greenstein D, Addington A, Gogtay N . Autism spectrum disorders and childhood-onset schizophrenia: clinical and biological contributions to a relation revisited. J Am Acad Child Adolesc Psychiatry. 2009; 48(1):10-8. PMC: 2664646. DOI: 10.1097/CHI.0b013e31818b1c63. View

12.

Isvoranu A, Ziermans T, Schirmbeck F, Borsboom D, Geurts H, de Haan L . Autistic Symptoms and Social Functioning in Psychosis: A Network Approach. Schizophr Bull. 2021; 48(1):273-282. PMC: 8781349. DOI: 10.1093/schbul/sbab084. View

13.

Galderisi S, Rucci P, Kirkpatrick B, Mucci A, Gibertoni D, Rocca P . Interplay Among Psychopathologic Variables, Personal Resources, Context-Related Factors, and Real-life Functioning in Individuals With Schizophrenia: A Network Analysis. JAMA Psychiatry. 2018; 75(4):396-404. PMC: 5875306. DOI: 10.1001/jamapsychiatry.2017.4607. View

14.

Sullivan S, Rai D, Golding J, Zammit S, Steer C . The association between autism spectrum disorder and psychotic experiences in the Avon longitudinal study of parents and children (ALSPAC) birth cohort. J Am Acad Child Adolesc Psychiatry. 2013; 52(8):806-814.e2. DOI: 10.1016/j.jaac.2013.05.010. View

15.

Jutla A, Foss-Feig J, Veenstra-VanderWeele J . Autism spectrum disorder and schizophrenia: An updated conceptual review. Autism Res. 2021; 15(3):384-412. PMC: 8931527. DOI: 10.1002/aur.2659. View

16.

Pinkham A, Morrison K, Penn D, Harvey P, Kelsven S, Ludwig K . Comprehensive comparison of social cognitive performance in autism spectrum disorder and schizophrenia. Psychol Med. 2019; 50(15):2557-2565. DOI: 10.1017/S0033291719002708. View

17.

Peng P, Wang Q, Zhou Y, Hao Y, Chen S, Wu Q . Autistic features in Chinese patients with chronic schizophrenia: Prevalence, clinical characteristics, and relationship with cognitive impairment. Asian J Psychiatr. 2023; 87:103697. DOI: 10.1016/j.ajp.2023.103697. View

18.

Lyall K, Anderson M, Kharrazi M, Windham G . Neonatal thyroid hormone levels in association with autism spectrum disorder. Autism Res. 2016; 10(4):585-592. DOI: 10.1002/aur.1708. View

19.

Barbero J, Palacin A, Serra P, Sole M, Ortega L, Cabezas A . Association between anti-thyroid antibodies and negative symptoms in early psychosis. Early Interv Psychiatry. 2019; 14(4):470-475. DOI: 10.1111/eip.12873. View

20.

Vita A, Barlati S, Deste G, Rocca P, Rossi A, Bertolino A . The influence of autistic symptoms on social and non-social cognition and on real-life functioning in people with schizophrenia: Evidence from the Italian Network for Research on Psychoses multicenter study. Eur Psychiatry. 2020; 63(1):e98. PMC: 7737172. DOI: 10.1192/j.eurpsy.2020.99. View