Skip to main content
Log in

The relationship between Asperger’s syndrome and schizophrenia in adolescence

  • Original Contribution
  • Published:
European Child & Adolescent Psychiatry Aims and scope Submit manuscript

Abstract

Asperger’s syndrome (AS), a pervasive developmental disorder (PDD), has nowadays been widely advocated in media. Therefore, psychiatrists treating adolescents frequently meet patients as well as their families reporting of symptoms resembling those of Asperger’s syndrome. It is known that symptoms of Asperger’s syndrome have some overlap with those of schizophrenia, but less is known about comorbidity between these two syndromes. We describe a sample of 18 adolescents with early onset schizophrenia. Diagnosis of schizophrenia was based on assessment with Kiddie Schedule for Affective Disorders and Schizophrenia. The diagnostic interview for Social and Communication Disorders version 11 was used to assess autism spectrum disorders. Ten adolescents fulfilled symptom criteria of Asperger’s syndrome after the onset of schizophrenia, while only two persons had Asperger’s syndrome before the onset of schizophrenia, a prerequisite for diagnosis. 44 % of the adolescents fulfilled the diagnosis of some PDD in childhood. Most of them were, however, unrecognized before the onset of schizophrenia. On the other hand, all 18 patients had one or more symptoms of PDDS in adolescence. Adolescents with schizophrenia have often symptoms consistent with AS, although only few of them have fulfilled the diagnostic criteria in their childhood, a prerequisite for the diagnosis of AS. There is a risk for misdiagnosis of adolescents with autistic symptoms if detailed longitudinal anamnesis is not obtained.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Fernell E, Gillberg C (2010) Autism spectrum disorder diagnoses in Stockholm preschoolers. Res Dev Disabil 31(3):680–685

    Article  PubMed  Google Scholar 

  2. Lugnegård T, Hallerbäck MU, Gillberg C (2011) Psychiatric comorbidity in young adults with a clinical diagnosis of Asperger syndrome. Res Dev Disabil 32(5):1910–1917

    Article  PubMed  Google Scholar 

  3. The ICD-10 classification of mental and behavioural disorders: diagnostic criteria for research. World Health Organization, Geneva, 1993

  4. McClellan J, Werry J (2001) Practice parameter for the assessment and treatment of children and adolescents with schizophrenia. J Am Child Adolesc Psychiatry 40(suppl 7):4S–23S

    Google Scholar 

  5. McDonell M, McClellan J (2007) Early-onset schizophrenia. In: Mash E, Barkley R (eds) Assessment of childhood disorders, 4th edn. Guilford Press, New York, pp 526–550

    Google Scholar 

  6. Remschmidt H, Theisen FM (2005) Schizophrenia and related disorders in children and adolescents. J Neural Transm Suppl 69:121–141

    PubMed  Google Scholar 

  7. Patel V, Flischer AJ, Hetrick SA, McGorry PD (2007) Mental health of young people: a global public health challenge. Lancet 369:1302–1313

    Article  PubMed  Google Scholar 

  8. Kessler RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S, Wittchen HU, Kendler KS (1994) Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Arch Gen Psychiatry 5:8–19

    Article  Google Scholar 

  9. Ghaziuddin M (2005) Mental health aspects of autism and Asperger syndrome. Jessica Kingsley Publishers, London

    Google Scholar 

  10. Rapoport J, Chavez A, Greenstein D, Addington A, Gogtay N (2009) Autism spectrum disorders and childhood-onset schizophrenia: clinical and biological contributions to a relation revisited. J Am Acad Child Adolesc Psychiatry 48(1):10–18

    Article  PubMed  Google Scholar 

  11. Unenge Hallerbäck M, Lugnegård T, Gillberg C (2012) Is autism spectrum disorder common in schizophrenia? Psychiatry Res (Epub ahead)

  12. Mattila ML, Hurtig T, Haapsamo H, Jussila K, Kuusikko-Gauffin S, Kielinen M, Linna SL, Ebeling H, Bloigu R, Joskitt L, Pauls DL, Moilanen I (2010) Comorbid psychiatric disorders associated with Asperger syndrome/high-functioning autism: a community- and clinic-based study. J Autism Dev Disord 9:1080–1093

    Article  Google Scholar 

  13. Skokauskas N, Gallagher L (2010) Psychosis, affective disorders and anxiety in autistic spectrum disorder: prevalence and nosological considerations. Psychopathology 43(1):8–16

    Article  PubMed  Google Scholar 

  14. Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P, Williamson D, Ryan N (1997) Schedule for affective disorders and schizophrenia for school-age children—present and lifetime version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry 36:980–988

    Article  PubMed  CAS  Google Scholar 

  15. Wing L (2006) Diagnostic interview for social and communication disorders, 11th edn. Centre for Social and Communication Disorders, Bromley

    Google Scholar 

  16. Wing L, Leekam SR, Libby SJ, Gould J, Larcombe M (2002) The diagnostic interview for social and communication disorders: background, inter-rater reliability and clinical use. J Child Psychol Psychiatry 43(3):307–325

    Article  PubMed  Google Scholar 

  17. Nygren G, Hagberg B, Billstedt E, Skoglund A, Gillberg C, Johansson M (2009) The Swedish version of the diagnostic interview for social and communication disorders (DISCO-10). Psychometric properties. J Autism Dev Disord 39(5):730–741

    Article  PubMed  Google Scholar 

  18. Sprong M, Becker HE, Schothorst PF, Swaab H, Ziermans TB, Dingemans PM, Linszen D, van Engeland H (2008) Pathways to psychosis: a comparison of the pervasive developmental disorder subtype Multiple Complex Developmental Disorder and the “At Risk Mental State”. Schizophr Res 99(1–3):38–47

    Article  PubMed  CAS  Google Scholar 

  19. de Bruin EI, de Nijs PF, Verheij F, Hartman CA, Ferdinand RF (2007) Multiple complex developmental disorder delineated from PDD-NOS. J Autism Dev Disord 37(6):1181–1191

    Article  PubMed  Google Scholar 

  20. Raja M, Azzoni A (2010) Autistic spectrum disorders and schizophrenia in the adult psychiatric setting: diagnosis and comorbidity. Psychiatr Danub 22(4):514–521

    PubMed  Google Scholar 

  21. Tuisku K, Tani P, Nieminen-von Wendt T, von Wendt L, Holi MM, Porkka-Heiskanen T, Lauerma H, Lindberg N, Appelberg B, Wahlbeck K (2004) Lower limb motor restlessness in Asperger’s disorder, measured using actometry. Psychiatry Res 128(1):63–70

    Article  PubMed  Google Scholar 

  22. Raja M, Azzoni A (2009) Thought disorder in Asperger syndrome and schizophrenia: issues in the differential diagnosis. A series of case reports. World J Biol Psychiatry 10(4 Pt 3):944–952

    Google Scholar 

  23. Sporn AL, Addington AM, Gogtay N, Ordoñez AE, Gornick M, Clasen L, Greenstein D, Tossell JW, Gochman P, Lenane M, Sharp WS, Straub RE, Rapoport JL (2004) Pervasive developmental disorder and childhood-onset schizophrenia: comorbid disorder or a phenotypic variant of a very early onset illness? Biol Psychiatry 55(10):989–994

    Article  PubMed  Google Scholar 

  24. Gillberg C, Wahlström J, Forsman A, Hellgren L, Gillberg IC (1986) Teenage psychoses—epidemiology, classification and reduced optimality in the pre-, peri- and neonatal periods. J Child Psychol Psychiatry 27(1):87–98

    Article  PubMed  CAS  Google Scholar 

  25. American Psychiatric Association (2000) Diagnostic and Statistical Manual of Mental Disorders, 4th edn, Text Revision (DSM-IV-TR). American Psychiatric Publishing, Inc., Washington DC

  26. Asperger H (1944) Die ‘Autistischen Psychopathen’ im Kindesalter. Archiv fur Psychiatrie und Nervenkrankheiten 117:76–136. Translated by Uta Frith in: Frith U, ed. (1999) Autism and Asperger syndrome. Cambridge University Press

  27. Isohanni M, Mäkikyrö T, Moring J, Räsänen P, Hakko H, Partanen U et al (1997) A comparison of clinical and research DSM-III-R diagnoses of schizophrenia in a Finnish national birth cohort. Clinical and research diagnoses of schizophrenia. Soc Psychiatry Psychiatr Epidemiol 32:303–308

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Pekka Tani.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Waris, P., Lindberg, N., Kettunen, K. et al. The relationship between Asperger’s syndrome and schizophrenia in adolescence. Eur Child Adolesc Psychiatry 22, 217–223 (2013). https://doi.org/10.1007/s00787-012-0338-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00787-012-0338-x

Keywords

Navigation