Prevalence of Non-Affective Psychoses in Individuals with Autism Spectrum Disorders: A Systematic Review

Riccardo De Giorgi, Franco De Crescenzo, Gian Loreto D'Alò, Nicola Rizzo Pesci, Valeria Di Franco, Corrado Sandini, Marco Armando

Research output: Contribution to journalReview article

Abstract

Autism spectrum disorders (ASD) and non-affective psychoses such as schizophrenia are commonly acknowledged as discrete entities. Previous research has revealed evidence of high comorbidity between these conditions, but their differential diagnosis proves difficult in routine clinical practice due to the similarities between core symptoms of each disorder. The prevalence of comorbid non-affective psychoses in individuals with ASD is uncertain, with studies reporting rates ranging from 0% to 61.5%. We therefore performed a systematic review and pooled analysis of the available studies reporting the prevalence of non-affective psychosis in ASD. Fourteen studies, including a total of 1708 participants, were included, with a weighted pooled prevalence assessed at 9.5% (95% CI 2.6 to 16.0). In view of significant heterogeneity amongst the studies, subgroup analyses were conducted. We observed higher prevalence of non-affective psychoses among ASD inpatients versus outpatients, when operationalised criteria were used, and in studies with smaller sample sizes, whereas the figures were comparable between children and adults with ASD. Our results suggest that future studies involving larger samples should implement both operationalized criteria and specific scales for the assessment of psychotic symptoms in individuals with ASD. A deeper understanding of both differential and comorbid features of ASD and non-affective psychosis will be required for the development of optimized clinical management protocols.

Original languageEnglish
JournalJournal of Clinical Medicine
Volume8
Issue number9
DOIs
Publication statusPublished - Aug 24 2019

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Psychotic Disorders
Symptom Assessment
Clinical Protocols
Autism Spectrum Disorder
Sample Size
Comorbidity
Inpatients
Schizophrenia
Differential Diagnosis
Outpatients
Cross-Sectional Studies
Research

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Prevalence of Non-Affective Psychoses in Individuals with Autism Spectrum Disorders : A Systematic Review. / De Giorgi, Riccardo; De Crescenzo, Franco; D'Alò, Gian Loreto; Rizzo Pesci, Nicola; Di Franco, Valeria; Sandini, Corrado; Armando, Marco.

In: Journal of Clinical Medicine, Vol. 8, No. 9, 24.08.2019.

Research output: Contribution to journalReview article

De Giorgi, Riccardo ; De Crescenzo, Franco ; D'Alò, Gian Loreto ; Rizzo Pesci, Nicola ; Di Franco, Valeria ; Sandini, Corrado ; Armando, Marco. / Prevalence of Non-Affective Psychoses in Individuals with Autism Spectrum Disorders : A Systematic Review. In: Journal of Clinical Medicine. 2019 ; Vol. 8, No. 9.
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AU - De Giorgi, Riccardo

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AU - Rizzo Pesci, Nicola

AU - Di Franco, Valeria

AU - Sandini, Corrado

AU - Armando, Marco

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AB - Autism spectrum disorders (ASD) and non-affective psychoses such as schizophrenia are commonly acknowledged as discrete entities. Previous research has revealed evidence of high comorbidity between these conditions, but their differential diagnosis proves difficult in routine clinical practice due to the similarities between core symptoms of each disorder. The prevalence of comorbid non-affective psychoses in individuals with ASD is uncertain, with studies reporting rates ranging from 0% to 61.5%. We therefore performed a systematic review and pooled analysis of the available studies reporting the prevalence of non-affective psychosis in ASD. Fourteen studies, including a total of 1708 participants, were included, with a weighted pooled prevalence assessed at 9.5% (95% CI 2.6 to 16.0). In view of significant heterogeneity amongst the studies, subgroup analyses were conducted. We observed higher prevalence of non-affective psychoses among ASD inpatients versus outpatients, when operationalised criteria were used, and in studies with smaller sample sizes, whereas the figures were comparable between children and adults with ASD. Our results suggest that future studies involving larger samples should implement both operationalized criteria and specific scales for the assessment of psychotic symptoms in individuals with ASD. A deeper understanding of both differential and comorbid features of ASD and non-affective psychosis will be required for the development of optimized clinical management protocols.

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