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Front Psychiatry. 2019 Feb 21;10:78. doi: 10.3389/fpsyt.2019.00078. eCollection 2019.

Autistic Symptoms in Schizophrenia Spectrum Disorders: A Systematic Review and Meta-Analysis.

Author information

1
Department of Psychiatry, University of Oxford, Oxford, United Kingdom.
2
Pediatric University Hospital-Department, Bambino Gesù Children's Hospital, Rome, Italy.
3
Department of Epidemiology, Lazio Regional Health Service, Rome, Italy.
4
Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, JFK, Aurora, CO, United States.
5
Brain and Body Integration - Mental Health Clinic, Denver, CO, United States.
6
Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
7
Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
8
Child Neurology and Psychiatry Unit, System Medicine Department, University of Rome Tor Vergata, Rome, Italy.
9
Developmental Imaging and Psychopathology Lab, Department of Psychiatry, School of Medicine, University of Geneva, Geneva, Switzerland.

Abstract

Background: Recent studies have examined the association between autism spectrum disorder and schizophrenia spectrum disorders, describing a number of cognitive features common to both conditions (e.g., weak central coherence, difficulties in set-shifting, impairment in theory of mind). Several studies have reported high levels of autistic symptoms in population with schizophrenia spectrum disorders. Our study systematically reviews and quantitatively synthetizes the current evidence on the presence of autistic symptoms in individuals with schizophrenia spectrum disorders. Methods: A comprehensive literature search of the PubMed/MEDLINE, Cochrane Library, CINHAL, and Embase databases was performed from the date of their inceptions until March 2018. The primary outcome measure was the Autism Spectrum Quotient (AQ). As secondary outcome measures, we analyzed the AQ subscales. Data were extracted and analyzed by using a conservative model and expressed by standardized mean difference (SMD). Results: Thirteen studies comprising a total of 1,958 individuals were included in the analysis. Results showed that individuals with schizophrenia spectrum disorders have higher levels of autistic symptoms compared to healthy controls [SMD: 1.39, 95% confidence interval (CI): 1.11 to 1.68] and lower levels of autistic symptoms compared to individuals with autism (SMD: -1.27, 95% CI: -1.77 to -0.76). Conclusions: Current findings support that individuals with schizophrenia spectrum disorders have higher autistic symptoms than healthy controls. Therefore, further studies are needed in order to shed light on the association between these two conditions.

KEYWORDS:

autism; comorbidity; development; meta-analysis; schizophrenia

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