Is autism related to schizophrenia?

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In the 60-s doctors related autism to schizophrenia. That was probably because they didn't bother to understand autistics, so they just labeled them as "crazy". Later, the doctors realized autistics are not "crazy". Quite the opposite in fact: at least on the high functioning end of a spectrum, a lot of them are "very logical". They simply lack the understanding of "illogical" social rules which is why they don't fit in. This pretty much disproved the connection between autism and schizphrenia.

Now, here comes a big surprise: an article came in 2007 that have shown that schizphrenics are ALSO "overly logical"! In particular, schizophrenics are MORE logical than normal controls while, at the same time, they lack common sense. Both would describe autistics! This, ironically, brings back the old school thought that autism and schizophrenia might be related. This time, instead of both conditions being on a "crazy" camp, both of them are in a "sane but different" camp.

Autism simply made the "move" few decades before schizophrenia did, which is why they were "unrelated". But now that both conditions made the exact same move (from "crazy" to "different") we can, again, think of them as related.

Anyway, here is the article: http://www.schizophrenia.com/sznews/archives/005699.html

I have seen schizotypal traits co-exist with autistic traits in quite a few individuals I have known..

Given the rush by mental health professionals and the general public to label any mental health condition they don't understand as 'schizophrenia', I question the adequacy of the diagnostic assessment of the individuals involved. Do we in fact know that they were schizophrenic or just labeled that for lack of a better diagnosis? How many studies have been performed like this, that show schizophrenics being 'more logical'?

I am inclined to believe that the individuals that participated in the referenced test may have been mis-diagnosed. Please, before you become outraged at such a suggestion let me state two things:

A) Such mistakes can and have happened in the application of the schizophrenia diagnosis. Don't ask me to prove this claim, you can find the evidence yourself quite easily.

B) Recent theories on autism, such as Baron-Cohen's theory, describe autism as an "extreme male brain" disorder or, if you'd prefer, condition. Another theory, the Crespi/Badcock hypothesis, has built on B-C's theory and I believe their theory can be summarized as arguing that autism is hyper rational-brain orientation and schizophrenia is hyper intuitive-brain orientation.

The study the OP has mentioned does raise some interesting questions but it doesn't prove anything yet. More studies need to be done to make the article's hypothesis a realistic possibility. For starters, I'd like to see a study that includes more than 17 diagnosed schizophrenics, such a small sampling is far from conclusive.

Just a quick note: I suspect autistics have more common sense, based on my personal experience. I'm curious about what makes this difference, to me, common sense always existed even when I was in the wildest period of my life. I was more confused than ignorant, while schizoid people seem to be more ignorant. Just a thought.

Schizophrenics have hallucinations. An autistic can tell the difference between real and imagined, even if their perception is atypical.

I can believe that autistic individuals might be commonly produced by families with schizophrenic members. My grandmother was obviously impaired by schizophrenia, and some other people I'm related to are diagnosed schizophrenics. I'm unofficially diagnosed as AS and I lack certain traits of schizophrenia such as auditory hallucinations. I've had dreams with an auditory component but I never hear these when I'm fully awake.

Negative and positive symptoms refer to things that are missing but are supposed to be there, and things that are there that aren't supposed to be there, respectively. There is a large overlap of the negative symptoms in autism and schizophrenia, hence one may easily be mistaken for the other. The two may be differentiated by the presence/absence of positive symptoms.

Last edited by sgrannel on 07 Apr 2011, 5:17 pm, edited 1 time in total.

it's related in that they share some characteristics, at least superficially.

Ask an schizo "do you hear voices?"
Schizo:" yes"

Ask an aspie "do you hear voices?"
Aspie: "yes"

of course the aspie hears voice, people talk to him all the time!

And that's how one girl got misdiagnosed with schizophrenia.

Isn't that really one of the biggest needs in differentiating autism from other mental health diagnoses? Many autistics are arguably NOT CRAZY. In fact, they can be VERY LOGICAL (and therefore many can function in the 'real world' just fine).

Look at the theories that I referenced, you can easily find them on the internet. Autistic Spectrum Disorders are a condition and very different from classic definitions of mental illness. With each new theory scientists come closer to understanding, or at least annunciating, reality as experienced by many individuals so effected.

No they aren't related. They are both two different things. They share the same characteristics though.

Not all schizophrenics are "crazy" (having psychosis) either, though. Like, if you check out catatonic schizophrenia, all that's disorganized for those people are their voluntary movements. And most people even with the really obvious sorts of schizophrenia will have periods of much more efficient thought in between--schizophrenia is episodic just like recurrent depression.

There could be some relationship, I guess. Autism does sometimes involve catatonia and movement issues. Perceptions can get pretty weird, though it's not the same kind of weird as you would get with hallucinations.

There are most likely connections between all the major categories of mental and neurological conditions, because they all affect the same organ--the brain (and nervous system). Schizophrenia and autism may affect some of the same things, or cause some of the same effects, or be associated with some of the same groups of genes... but you might say that about any two things, really.

The reason schizophrenia can involve catatonia or psychosis or any number of other things is because schizophrenia doesn't exist. It's an outdated guess by Bleuler as to people with wildly differing and totally unrelated symptoms, had those symptoms. The guess is now known to be false. Why we continue calling them "schizophrenia" or even "the schizophrenias" is beyond me, it's just one of those examples of how bad psychiatry is at science.

I can't answer the question "Is autism related to schizophrenia?" because that translates to me as "Is autism related to a meaningless word that unfortunately makes it sound like several different conditions are even remotely related?" Is autism related to some of those conditions? Absolutely. The only reason autism is not schizophrenia now, is because it's been removed from the category. Not because it's special unlike all other things that got called schizophrenia. Just because they decided to remove it. They could have removed any of the other ones too (and have removed other things from it in the past). Most autistic people would meet criteria for schizophrenia (which are really, really broad) if it weren't for the part that says that you can't have both unless you have delusions or hallucinations. Which is just a way of saying "We removed autism from this category, therefore we don't want to consider it part of this category anymore."

And I'm saying all this after having read many, many historical documents on autism, schizophrenia, dementia praecox, etc. It just doesn't add up. Autism could be part of schizophrenia or not part of schizophrenia and neither of those would mean a thing about the nature of autism.

Have you by any chance read the latest edition of the DSM? The diagnosis has been streamlined quite a bit over the past few years. Where did you get the idea that schizophrenia does not exist? Do you have a source? Besides, it isn't that schizophrenia can involve psychosis so much as schizophrenia is a particular type of psychosis.



The delusions and hallucinations, along with disorganized speech, are precisely the very things that define schizophrenia. The reason why the diagnosis mentions the autism spectrum is a safety net: of the three things that define schizophrenia, disorganized speech is the most likely to be misunderstood. That is psychiatry's way of saying that while they don't understand the organization of some autistic speech, they recognize that it is organized somehow.

The people I know who have been diagnosed with schizophrenia all seem to have excellent logic for the most part, but cannot separate good logic from petitio principii. That is, their "logical" arguments are supported by their delusions and they believe their delusions are supported by their hallucinations (or, in one case, a lack thereof).

Yep.



This isn't the kind of thing you can have "sources" about. I think it doesn't exist because I think it is one of the most useless of the psychiatric categories. Meaning, that it describes several unrelated conditions. That's what I mean by "doesn't exist" -- not "the symptoms don't exist", but rather, "this is a word that doesn't have a true meaning and is a holdover from Bleuler's guesses decades ago". Saying "schizophrenia" is like taking about half of all pears, a large percentage of carrots, a tiny number of spaghetti squashes, and pretty much all bacon, and then claiming that these all form a unique category of food. I'm certain there are plenty of other people (including mental health professionals) who have said similar things, but I don't have sources (and don't think I need to cite sources in a casual conversation). But I can say I didn't reach this conclusion randomly, but only after following the history of the diagnosis (and views on it) from Kraepelin's days to the present. Honestly it doesn't take that much research to notice the problems, but I have done the research (having personal interest in it after being misdiagnosed with it in the past).



And yet schizophrenia, as currently diagnosed, doesn't require psychosis (loss of reality contact) at all for some forms of it (although it's often implied that such people must be psychotic because it's schizophrenia... very circular).



And yet they're not necessary for a diagnosis of schizophrenia. You can be diagnosed by having disorganized or catatonic behavior, plus negative symptoms. (And disorganized behavior doesn't have to imply loss of reality contact, it can actually be very similar to that seen in dementia, to give one example. Or some forms of autism for that matter. It's just assumed people are doing these bizarre things because they're psychotic.)



I've known a lot of people diagnosed with it, and I can't generalize about such a diverse group of people (which is part of my point when I say this is not a single condition, nor are the conditions involved necessarily even related to each other or divided at the logical division points).

Many of them had no delusions or hallucinations, at least no obvious ones.

One person I knew, for instance, simply moved extremely slowly, repeated everything that was said to him, and had little ability to care for himself. It seemed to me that his problem was more that he had trouble relating to his body and organizing his actions with his thoughts well enough to move, speak, and plan for himself. He seemed aware, but trapped inside a body that wasn't functioning well.

Similarly trapped was a woman I knew who appeared at least superficially very different from this guy. She seemed bound to her impulses to the point that she just kept doing all kinds of random things all over the place, never sitting still. Rather than a lack of emotional expression, she just had strange emotional expressions, seemingly inappropriate to the situation. She would sometimes take off her clothes in situations where most people wouldn't, and at other times she'd simply fail to put enough clothes on for the weather and circumstances. She could speak, but most of what she said didn't make any sense.

Then there was another woman, who spent all day switching from one odd position to another, holding them for extensive lengths of time, and bursting out laughing for reasons that nobody outside her could explain. She had no speech at all.

What I noticed was that people simply assumed that none of these people understood what they were doing, and that this was the reason behind their behavior. Also, it was assumed that they had hallucinations or delusions simply because they had all these other traits normally associated with schizophrenia. And yet none of them seemed to be attending to anything that wasn't there at the time. None of them seemed to be acting on unusual beliefs about the world either. And from my perspective, each of them actually had a strong sense of "I am perfectly aware of what is going on around me but my connection to my body/ability to plan actions/etc. is malfunctioning terribly." The same sense I get around many autistic people, actually, and the same sense I have about myself at times. (In fact, the first two people behaved a whole lot like autistic people I've known, to the point where if I hadn't known they were originally "perfectly normal", I'd never have been able to differentiate them from autistic people.)

On the other hand I've met people who really do seem to have various problems with reality, or logic, or something. The whole "the logic is sound but the premises are messed up" thing is something I've seen in some people. Other people, though, seem to have a subtle twist in their thinking, it's very hard for me to describe, but it's definitely a flaw in logic itself. It strikes me as a kind of thing where it's something very tiny, but a very tiny thing placed in such a location that the effect it has on rational thought is huge. But, as I said, I've also met plenty of people with no proof of delusions or hallucinations at all (and whose "disorganized speech", if present, was so similar to autistic speech (immediate and delayed echolalia, very odd-sounding phrases and sentences, etc.) that it's indistinguishable... think of Kanner's patient Elaine C. for instance).)

Anyway, as I said, too diverse to generalize about anyone's logic. Some people had seemingly perfect logic and others had nothing even resembling logic with all sorts of twists and turns that made no sense at all. (And still others seemed to be totally devoid of logic but were in reality simply devoid of the ability to use speech in typical ways. A huge problem in the diagnosis of psychosis is the assumption that speech represents a window to people's thoughts. It doesn't always.) Some people had delusions or hallucinations, other people had nothing close. (And I'm not even getting into the fact that there are perfectly ordinary delusions that are considered acceptable and that people would never be thought psychotic for believing...). It's way more complicated than most people make it sound.

I think that we have there some confusion (both in Roman's post and in some replys, like Dinosaw) motivated by the differences of the meaning of expression like "logical" or "rational" in common language and in "technical" language.

But, before I explain my reasoning, I will make reference to an old philosophical debate (at first, it will think unconnected to the issue, but I think that can be connected):



For a more complete description of the empiricism vs. rationalism debate, you can go there:

http://plato.stanford.edu/entries/ratio ... mpiricism/

Now, let's return to the "logical" and "rational". In common language, both expressions have the meaning of ideas that are "not crazy", nor "absurd"; however, the "technical" definition (or, at least, according to some definitions) of both "logical" or "rational" have more the meaning of "reasoning where the conclusions derive from the premises in a consistent way" - "cats spit fire, my Fluffy is a cat, than Fluffy spits fire" is a logical reasoning (even if crazy). Note that is the meaning of "logical" that was studied in that paper.

Now, the point is that schizophrenics never had been considered "illogical" in this sense, of having contradictory ideas, or of jumping from the premises to the conclusions without making a connection between then (or, at least, they are not supposed to be more "illogical" than the regular guy) - if anything, I have the idea that schizophrenics sometimes are too much consistent in his thinking, with a tendency to try to fit everything in a big theory, explaining simultaneously the murder of JFK and the lack of hot water when I was taking bath yesterday.

The crazyness of schizophrenics is more in the sense that their reasoning is completely disconnected from reality , not in the sense of their reasoning being internally inconsistent.

By the terms the old debate between "rationalists" and "empiricists" (this was the reason because I wrote about that in the beginning), we can say that the "crazyness" of schizophrenics has more to do with an extreme deficit in empiricism than with a deficit in "reason".

A point - during the 20th century, it was popular in some theoreticians the idea that schizophrenia and maniac-depression were a kind of opposites, and some had made researches proofing (or trying to proof) that schizophrenia was relatively common in the families of abstract scientists/thinkers (mathematicians, philosophers, theologians, etc.) while maniac-depression was common in the families of experimental scientists.

Don't matter much if this theories were right or wrong (probably they are wrong, because the current thinking is that schizophrenia and bipolar disorder are connected); what this "schizophrenia - abstract thinker; maniac depression - experimentalist" theory shows is that the "conventional wisdom" was not that schizophrenia was associated particularly with problems with logical thinking, but more with a state of disconnection from concrete and objective reality (btw, I think that this is the etymological root of "schizophrenia" - a mind split from the external world)

Making a tangent, perhaps could be interesting to compare the old stereotype of "schizophrenia - abstract sciences" with the modern stereotype "autism - hard sciences". If these stereotypes have any adherence to reality (and probably didn't) perhaps the conclusion could be that autism and schizophrenia are nor opposites neither related, but orthogonal (with the possibility of people as John Nash and the Einstein family being in both leagues)?

Ambuend probably is right when she says that schizophrenia is a collection of unrelated conditions; however I suspect that, with "schizophrenia" many people are thinking in "paranoid schizophrenia", who is a more restric condition.

The problem with talking about the nature of and relationship between diagnoses like autism and schizophrenia is that you really need to have a good "feel" for the history of the terminology, the nature of neuropsychological diagnoses, and "mental" health in general, in order to even know what you're discussing. In my experience, very few people on this forum have that "feel".

I think anbuend's assessment is "close, but no cigar"--I wish there was just a bit more understanding and not as much scornful dismissing in it. Bleuler's establishing the concept of schizophrenia was not merely some ill-conceived "guess" that didn't account for its own heterogeneity, but a true breakthrough in understanding, no matter how crude it might seem now.

From Leo Kanner's 1965 paper, Infantile Autism and the Schizophrenias: