Hostname: page-component-8448b6f56d-t5pn6 Total loading time: 0 Render date: 2024-04-17T23:29:46.871Z Has data issue: false hasContentIssue false
  • English
  • Français

Robust association between autistic traits and psychotic-like experiences in the adult general population: epidemiological study from the 2007 Adult Psychiatric Morbidity Survey and replication with the 2014 APMS

Published online by Cambridge University Press:  22 May 2020

Anton P. Martinez Open the ORCID record for Anton P. Martinez [Opens in a new window] ,
Sophie Wickham ,
Georgina Rowse ,
Elizabeth Milne  and
Richard P. Bentall
Anton P. Martinez*
Affiliation:
Psychology Department, The University of Sheffield, Cathedral Court, Sheffield S1 2LT, UK
Sophie Wickham
Affiliation:
Department of Public Health and Policy, University of Liverpool, Waterhouse Building Block F, Liverpool L69 3GL, UK
Georgina Rowse
Affiliation:
Psychology Department, The University of Sheffield, Cathedral Court, Sheffield S1 2LT, UK
Elizabeth Milne
Affiliation:
Psychology Department, The University of Sheffield, Cathedral Court, Sheffield S1 2LT, UK
Richard P. Bentall
Affiliation:
Psychology Department, The University of Sheffield, Cathedral Court, Sheffield S1 2LT, UK
*
Author for correspondence: Anton P. Martinez, E-mail: apmartinez1@sheffield.ac.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Studies have shown that there are overlapping traits and symptoms between autism and psychosis but no study to date has addressed this association from an epidemiological approach in the adult general population. Furthermore, it is not clear whether autistic traits are associated with specific symptoms of psychosis or with psychosis in general. We assess these associations for the first time by using the Adult Psychiatric Morbidity Survey (APMS) 2007 and the APMS 2014, predicting an association between autistic traits and probable psychosis, and specific associations between autistic traits and paranoia and strange experiences.

Methods

Participants (N = 7353 in 2007 and 7500 in 2014) completed the Psychosis Screening Questionnaire (PSQ) and a 20-item version of the Autism Quotient (AQ-20). Binomial logistic regressions were performed using AQ-20 as the independent variable and probable psychosis and specific symptoms as dependent variables.

Results

In the APMS 2007 dataset, significant associations were found between autism traits and probable psychosis, paranoia, thought insertion, and strange experiences. These results were replicated in APMS 2014 but with the additional significant association between autistic traits and hallucinations. Participants in the highest quartile of the AQ-20, compared with the lowest quartile, had an increased risk of probable psychosis of odds ratio (OR) = 15.5 [95% confidence interval (CI) 4.57–52.6] in APMS 2007 and OR = 22.5 (95% CI 7.64–66.3) in APMS 2014.

Conclusions

Autistic traits are strongly associated with probable psychosis and psychotic experiences with the exception of mania. Limitations such as the cross-sectional nature of the study are discussed.

Keywords

Autism spectrum disorderco-occurrenceepidemiologypositive symptomsschizophrenia spectrum disorder
Type
Original Article
Information
Psychological Medicine , Volume 51 , Issue 15 , November 2021 , pp. 2707 - 2713
Check for updates
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC: American Psychiatric Pub.Google Scholar
Baron-Cohen, S., Wheelwright, S., Skinner, R., Martin, J., & Clubley, E. (2001). The Autism-Spectrum Quotient (AQ): Evidence from Asperger syndrome/high-functioning autism, males and females, scientists and mathematicians. Journal of Autism and Developmental Disorders, 31(1), 5–17. doi:10.1023/A:1005653411471.CrossRefGoogle ScholarPubMed
Bebbington, P., & Nayani, T. (1995). The Psychosis Screening Questionnaire. International Journal of Methods in Psychiatric Research, 5, 11–19.Google Scholar
Bell, V., Halligan, P. W., & Ellis, H. D. (2006). The Cardiff Anomalous Perceptions Scale (CAPS): A new validated measure of anomalous perceptual experience. Schizophrenia Bulletin, 32(2), 366–377. doi:10.1093/schbul/sbj014.CrossRefGoogle ScholarPubMed
Bentall, R. P., Wickham, S., Shevlin, M., & Varese, F. (2012). Do specific early-life adversities lead to specific symptoms of psychosis? A study from the 2007 the adult psychiatric morbidity survey. Schizophrenia Bulletin, 38(4), 734–740. doi:10.1093/schbul/sbs049.CrossRefGoogle ScholarPubMed
Bevan Jones, R., Thapar, A., Lewis, G., & Zammit, S. (2012). The association between early autistic traits and psychotic experiences in adolescence. Schizophrenia Research, 135(1–3), 164–169. doi:10.1016/j.schres.2011.11.037.CrossRefGoogle ScholarPubMed
Brugha, T., McManus, S., & Meltzer, H. (2009). Autism spectrum disorders in adults living in households throughout England: Report from the adult psychiatric morbidity survey 2007. Leeds: The NHS Information Centre for Health and Social Care.Google Scholar
Cederlöf, M., Pettersson, E., Sariaslan, A., Larsson, H., Östberg, P., Kelleher, I., … Gumpert, C. H. (2015). The association between childhood autistic traits and adolescent psychotic experiences is explained by general neuropsychiatric problems. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics, 171(B), 153–159. doi:10.1002/ajmg.b.32386.CrossRefGoogle Scholar
Chisholm, K., Lin, A., Abu-Akel, A., & Wood, S. J. (2015). The association between autism and schizophrenia spectrum disorders: A review of eight alternate models of co-occurrence. Neuroscience and Biobehavioral Reviews, 55, 173–183. doi:10.1016/j.neubiorev.2015.04.012.CrossRefGoogle ScholarPubMed
Constantino, J. N., & Todd, R. D. (2003). Autistic traits in the general population. Archives of General Psychiatry, 60(5), 524. doi:10.1001/archpsyc.60.5.524.CrossRefGoogle ScholarPubMed
Craig, J. S., Hatton, C., Craig, F. B., & Bentall, R. P. (2004). Persecutory beliefs, attributions and theory of mind: Comparison of patients with paranoid delusions, Asperger's syndrome and healthy controls. Schizophrenia Research, 69(1), 29–33. doi:10.1016/S0920-9964(03)00154-3.CrossRefGoogle ScholarPubMed
Esterberg, M. L., Trotman, H. D., Brasfield, J. L., Compton, M. T., & Walker, E. F. (2008). Childhood and current autistic features in adolescents with schizotypal personality disorder. Schizophrenia Research, 104(0), 265–273. doi:10.1016/j.schres.2008.04.029.Childhood.CrossRefGoogle ScholarPubMed
Freeman, D. (2007). Suspicious minds: The psychology of persecutory delusions. Clinical Psychology Review, 27(4), 425–457. doi:10.1016/j.cpr.2006.10.004.CrossRefGoogle ScholarPubMed
Haddock, G., & Lewis, S. (2005). Psychological interventions in early psychosis. Schizophrenia Bulletin, 31(3), 697–704. doi:10.1093/schbul/sbi029.CrossRefGoogle ScholarPubMed
Hanel, P. H. P., & Vione, K. C. (2016). Do student samples provide an accurate estimate of the general public? PLoS ONE, 11(12), 1–10. doi:10.1371/journal.pone.0168354.CrossRefGoogle ScholarPubMed
Hommer, R. E., & Swedo, S. E. (2015). Schizophrenia and autism-related disorders. Schizophrenia Bulletin, 41(2), 313–314. doi:10.1093/schbul/sbu188.CrossRefGoogle ScholarPubMed
Horder, J., Wilson, C. E., Mendez, M. A., & Murphy, D. G. (2014). Autistic traits and abnormal sensory experiences in adults. Journal of Autism and Developmental Disorders, 44(6), 1461–1469. doi:10.1007/s10803-013-2012-7.CrossRefGoogle ScholarPubMed
Hurst, R. M., Nelson-Gray, R. O., Mitchell, J. T., & Kwapil, T. R. (2007). The relationship of Asperger's characteristics and schizotypal personality traits in a non-clinical adult sample. Journal of Autism and Developmental Disorders, 37(9), 1711–1720. doi: 10.1007/s10803-006-0302-z.CrossRefGoogle Scholar
Kincaid, D. L., Doris, M., Shannon, C., & Mulholland, C. (2017). What is the prevalence of autism spectrum disorder and ASD traits in psychosis? A systematic review. Psychiatry Research, 250, 99–105. doi:10.1016/j.psychres.2017.01.017.CrossRefGoogle ScholarPubMed
McManus, S., Bebbington, P., Jenkins, R., Brugha, T., Appleby, L., Asherson, P., … Wessely, S. (2016). Mental health and wellbeing in England adult psychiatric morbidity survey 2014. Leeds: NHS Digital.Google Scholar
McManus, S., Meltzer, H., Brugha, T., Bebbington, P. E., & Jenkins, R. (2009). Adult psychiatric morbidity in England, 2007. Results of a household survey. Leeds: The NHS Information Centre for Health and Social Care.Google Scholar
Mealey, A., Abbott, G., Byrne, L. K., & McGillivray, J. (2014). Overlap between autistic and schizotypal personality traits is not accounted for by anxiety and depression. Psychiatry Research, 219(2), 380–385. doi:10.1016/j.psychres.2014.05.040.CrossRefGoogle Scholar
Milne, E., Dickinson, A., & Smith, R. (2017). Adults with autism spectrum conditions experience increased levels of anomalous perception. PLoS ONE, 12(5), 1–12. doi:10.1371/journal.pone.0177804.CrossRefGoogle ScholarPubMed
Nylander, L., Lugnegård, T., & Unenge Hallerbäck, M. (2008). Autism spectrum disorders and schizophrenia spectrum disorders in adults – is there a connection? A literature review and some suggestions for future clinical research. Clinical Neuropsychiatry: Journal of Treatment Evaluation, 5(1), 43–54.Google Scholar
Palmer, C. J., Paton, B., Enticott, P. G., & Hohwy, J. (2015). ‘Subtypes’ in the presentation of autistic traits in the general adult population. Journal of Autism and Developmental Disorders, 45(5), 1291–1301. doi:10.1007/s10803-014-2289-1.CrossRefGoogle ScholarPubMed
Peralta, V., & Cuesta, M. J. (2011). Eugen Bleuler and the schizophrenias: 100 years after. Schizophrenia Bulletin, 37(6), 1118–1120. doi:10.1093/schbul/sbr126.CrossRefGoogle Scholar
Raja, M., & Azzoni, A. (2010). Autistic spectrum disorders and schizophrenia in the adult psychiatric setting: Diagnosis and comorbidity. Psychiatria Danubina, 22(4), 514–521.Google ScholarPubMed
Schultze-Lutter, F. (2009). Subjective symptoms of schizophrenia in research and the clinic: The basic symptom concept. Schizophrenia Bulletin, 35(1), 5–8. doi:10.1093/schbul/sbn139.CrossRefGoogle ScholarPubMed
Skuse, D. H., Mandy, W., Steer, C., Miller, L. L., Goodman, R., Lawrence, K., … Golding, J. (2009). Social communication competence and functional adaptation in a general population of children: Preliminary evidence for sex-by-verbal IQ differential risk. Journal of the American Academy of Child and Adolescent Psychiatry, 48(2), 128–137. doi:10.1097/CHI.0b013e31819176b8.CrossRefGoogle Scholar
Spain, D., Sin, J., & Freeman, D. (2016). Conceptualising paranoia in ASD: A systematic review and development of a theoretical framework. Research in Autism Spectrum Disorders, 25, 97–111. doi:10.1016/j.rasd.2016.02.002.CrossRefGoogle Scholar
Sugranyes, G., Kyriakopoulos, M., Corrigall, R., Taylor, E., & Frangou, S. (2011). Autism spectrum disorders and schizophrenia: Meta-analysis of the neural correlates of social cognition. PLoS ONE, 6(10), e25322. doi:10.1371/journal.pone.0025322.CrossRefGoogle ScholarPubMed
van Os, J., Hanssen, M., Bijl, R. V., & Vollebergh, W. (2001). Prevalence of psychotic disorder and community level of psychotic symptoms. Archives of General Psychiatry, 58(7), 663. doi:10.1001/archpsyc.58.7.663.CrossRefGoogle ScholarPubMed
van Os, J., Linscott, R. J., Myin-Germeys, I., Delespaul, P., & Krabbendam, L. (2009). A systematic review and meta-analysis of the psychosis continuum: Evidence for a psychosis proneness–persistence–impairment model of psychotic disorder. Psychological Medicine, 39(2), 179–195. doi:10.1017/s0033291708003814.CrossRefGoogle ScholarPubMed
Wickham, S., Taylor, P., Shevlin, M., & Bentall, R. P. (2014). The impact of social deprivation on paranoia, hallucinations, mania and depression: The role of discrimination social support, stress and trust. PLoS ONE, 9(8), 1–9. doi:10.1371/journal.pone.0105140.CrossRefGoogle ScholarPubMed
Supplementary material: File

Martinez et al. supplementary material

Martinez et al. supplementary material

Download Martinez et al. supplementary material(File)
File 92.4 KB