Psychotic Spectrum Symptoms in Adults with Autism Spectrum Disorder and in Their First-Degree Relatives

Area of Science:

• Neurodevelopmental disorders
• Psychiatry
• Genetics

Background:

• Autism Spectrum Disorder (ASD) and psychotic disorders are increasingly recognized for shared neurodevelopmental mechanisms and symptom overlap.
• Psychotic-like experiences are common in ASD, and autistic traits may increase psychosis risk in relatives.

Purpose of the Study:

• Compare psychotic spectrum manifestations in adults with ASD, their first-degree relatives (BAP), and controls (HCs).
• Explore associations between psychotic symptoms and autistic traits.
• Determine if psychotic symptoms predict diagnostic group membership.

Main Methods:

• Cross-sectional study involving 22 adults with ASD, 22 BAP, and 24 HCs.
• Utilized the Psychotic Spectrum-Self Report (PSY-SR) and Adult Autism Subthreshold Spectrum (AdAS Spectrum).

Main Results:

• ASD participants reported significantly higher PSY-SR scores than BAP and HCs.
• BAP individuals showed higher PSY-SR scores than HCs, indicating elevated psychotic experiences.
• All PSY-SR domains positively correlated with autistic traits (AdAS Spectrum domains).
• Higher PSY-SR scores predicted ASD and BAP membership; paranoid symptoms specifically predicted both groups versus HCs.

Conclusions:

• Psychotic spectrum symptoms are elevated in both ASD individuals and their first-degree relatives, supporting a continuum of vulnerability.
• The strong association between paranoid symptoms and autistic traits is clinically relevant for early identification.
• Findings support shared neurodevelopmental pathways between autism and psychosis spectra, emphasizing dimensional approaches.