Comorbid Psychosis Research Articles

Complex PTSD symptoms predict positive symptoms of psychosis in the flow of daily life.

Post-traumatic stress disorder (PTSD) has been shown to predict psychotic symptomology. However, few studies have examined the relative contribution of PTSD compared to broader post-traumatic sequelae in maintaining psychosis. Complex PTSD (cPTSD), operationalized using ICD-11 criteria, includes core PTSD (intrusions, avoidance, hyperarousal) as well as additional "disturbances of self-organisation" (DSO; emotional dysregulation, interpersonal difficulties, negative self-concept) symptoms, more likely to be associated with complex trauma histories. It was hypothesized that DSOs would be associated with positive psychotic symptoms (paranoia, voices, and visions) in daily life, over and above core PTSD symptoms. This study (N = 153) employed a baseline subsample of the Study of Trauma And Recovery (STAR), a clinical sample of participants with comorbid post-traumatic stress and psychosis symptoms. Core PTSD, DSO and psychosis symptoms were assessed up to 10 times per day at quasi-random intervals over six consecutive days using Experience Sampling Methodology. DSOs within the preceding 90 min predicted paranoia, voices, and visions at subsequent moments. These relationships persisted when controlling for core PTSD symptoms within this timeframe, which were themselves significant. The associations between DSOs and paranoia but not voices or visions, were significantly stronger than those between psychosis and core PTSD symptoms. Consistent with an affective pathway to psychosis, the findings suggest that DSOs may be more important than core PTSD symptoms in maintaining psychotic experiences in daily life among people with comorbid psychosis and cPTSD, and indicate the potential importance of addressing broad post-traumatic sequelae in trauma-focused psychosis interventions.

Psychosis: Impaired perception of reality

The comorbidity of psychosis eliminates the patient’s chances of social interaction and adversely affects their ability to work. Objective: The purpose of this study is to diagnose disorders of neurocognitive functions in endogenous psychosis. Methods: The leading method for achieving the goal was the clinical-psychopathological method. An experiment and neurophysiological methods were used as additional methods.

A systematic review of the prevalence of psychosis in people with tuberculosis

IntroductionTuberculosis is a bacterial infectious disease caused by Mycobacterium tuberculosis. This disease predominately affects the lungs but also affects other parts of the body, including the central nervous system. According to the the World Health Organization (2023), tuberculosis has an incidence of 6.4 million people in 2022, with 1.5 million deaths attributed to this disease. Psychosis describes a group of disorders that affects a person’s thought process and perception. It is a serious disorder that can have a profound impact on a person’s mental and physical health. As a result, psychosis symptoms and its treatment can complicate the management of tuberculosis.Objectives The aim of this systematic review is to explore the association between tuberculosis and psychosis. It has been shown that up to 70% of patients with tuberculosis also have comorbid mental illness, this is likely to include psychosis. There are also shared risk factors between tuberculosis and psychosis, including poverty and homelessness, substance abuse, HIV positive serology and isolation. Tuberculosis medication, including isoniazid and rifampicin have been shown to have adverse psychiatric effects and we will examine if this includes psychosis.MethodsA systematic review was pre-registered with PROSPRO and performed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. MEDLINE, OVID and PsychINFO databases were searched from beginning of records to September 2023. This included hand-search of relevant reference lists. Observational and epidemiological studies were included along with population based registries.ResultsOver one thousand (1,154) articles were identified and screened. There was significant heterogenity in results and over half of studies were from Asia and Africa. Many studies reported cases of drug-induced psychosis from anti-tubercular agents. Studies also discussed the increased risk of TB incidence among patients with psychosis and other psychiatric disorders.ConclusionsThis study identifies the importance of training healthcare workers in rapid detection of co-morbid psychosis in patients with tuberculosis, along with neuropsychiatric side effects of antitubercular agents. Integration of psychiatric and medical care of these patients would be of benefit to improve outcomes in this patient population. More research is needed on co-morbidity of tuberculosis and psychosis.Disclosure of InterestNone Declared

Pediatric anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis: Exploring psychosis, related risk factors, and hospital outcomes in a nationwide inpatient sample: A cross-sectional study.

Our study aims to examine the risk factors for comorbid psychosis in pediatric patients hospitalized for anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis and its impact on hospital outcomes. We conducted a cross-sectional study using the nationwide inpatient sample (NIS 2018-2019). We included 3,405 pediatric inpatients (age 6-17 years) with a primary discharge diagnosis of anti-NMDAR encephalitis. We used binomial logistic regression model to evaluate the odds ratio (OR) of variables (demographic and comorbidities) associated with comorbid psychosis. The prevalence of comorbid psychosis in anti-NMDAR encephalitis inpatients was 5.3%, and majorly constituted of adolescents (72.2%) and females (58.3%). In terms of race, Blacks (OR 2.41), and Hispanics (OR 1.80) had a higher risk of comorbid psychosis compared to Whites. Among comorbidities, encephalitis inpatients with depressive disorders (OR 4.60), sleep-wake disorders (OR 3.16), anxiety disorders (OR 2.11), neurodevelopmental disorders (OR 1.95), and disruptive behavior disorders (OR 2.15) had a higher risk of comorbid psychosis. Anti-NMDAR encephalitis inpatients with comorbid psychosis had a longer median length of stay at 24.6 days (vs. 9.8 days) and higher median charges at $262,796 (vs. $135,323) compared to those without psychotic presentation. Adolescents, females, and Blacks with encephalitis have a higher risk of psychotic presentation leading to hospitalization for anti-NMDAR encephalitis. Identification of demographic predictors and comorbidities can aid in early recognition and intervention to optimize care and potentially reduce the healthcare burden.

Racial and ethnic differences in comorbid psychosis: a population-based study.

Differences in the prevalence of psychiatric conditions such as psychosis as well as patterns of comorbidity for psychosis have been reported between racial and ethnic groups. It is unclear whether those differences are consistent for comorbid psychosis. Self-reported diagnostic data from American adults ages 18-99 participating in the Collaborative Psychiatric Epidemiology Surveys (CPES) (N ~ 11,844) were used to test the association between four racial and ethnic group categories (White, Asian, Hispanic, Black) and comorbid psychosis. Comorbid psychosis was measured as a 4-level categorical variable (No mental illness nor psychosis, Mental Illness, Psychosis only, comorbid psychosis (i.e., Psychosis + Mental Illness). Chi-square tests were used to determine significant differences in the prevalence of comorbid psychosis by race and ethnicity. A multinomial logistic regression was used to test the association between racial and ethnic classifications and comorbid psychosis after adjusting for common demographic characteristics (i.e., education, sex, income, and age). Relative to White participants, Hispanic and Asian participants were less likely to be affected with comorbid psychosis. (Adjusted Odds Ratio, AORAsian = 0.32, CI = 0.22 - 0.47, p <0.0001, AORHispanic = 0.66, CI = 0.48 - 0.92, p = 0.012). Relative to White participants there was not significant association for comorbid psychosis in Black participants (AORBlack = 0.91, CI = 0.70 - 1.20, p = 0.52) In contrast Hispanic and Black participants were more likely to report psychosis alone (AORHispanic = 1.94, CI = 1.27-2.98, p = 0.002, AORBlack = 1.86, 1.24-2.82, p = 0.003) compared to White participants. There were different patterns of associations by race and ethnicity for psychosis and comorbid psychosis. The lower prevalence of comorbid psychosis in non-White groups may be due to underdiagnosis or underreporting of other mental disorders.

B - 53 Effects of Personality on Response Speed.

The aim of the study is to measure how personality features reported on the MMPI-2 predicts response speed measured on a test of attention. Data was selected from a de-identified database of clinical adults. The sample chosen (N = 508) comprised of mixed psychiatric adults consisting of Caucasians (N = 224, M_edu =13,42% male & 58% female), African Americans (N = 103, M_edu = 12, 52.1% males & 47.8% females), Hispanics (N = 126, M_edu =13,53.5% male & 46.4% female), and Other (N-55, M_edu =13,38.4% male & 61.6% female). All participants were administered the CPT-II and MMPI-2. Multiple hierarchical regressions were run to test what personality factors predict significant incremental variance on a measure of attention when controlling for age and education. In the final model, the Depression scale was a significant predictor accounting for approximately 0.8% of the variance. The Schizophrenia scale was a significant predictor accounting for approximately 2.2% of the variance. The Paranoia scale was a significant predictor accounting for approximately 1.7% of the variance. The Social Introversion scale was a significant predictor accounting for approximately 1.3% of the variance. The study found that individuals reporting psychosis, paranoia, and depressive-like symptoms including social introversion on the MMPI-2 demonstrate inattention via slower response time. Comorbidity of psychosis and depression exhibits poorer cognitive performance likely responsible for the slower response rate to targets. Experiencing paranoia and/or hallucinations during the test pulls full attention further missing targets or responding with significant time in between. The low mood with anxious and intrusive thoughts interrupts their ability to focus and process targets efficiently on the CPT-II.

18.3 Closing the Service Gap for System-Involved Youth With Comorbid Psychosis and Trauma

18.3 Closing the Service Gap for System-Involved Youth With Comorbid Psychosis and Trauma

Aberrant Dopamine System Function in the Ferrous Amyloid Buthionine (FAB) Rat Model of Alzheimer's Disease.

Antipsychotics increase the risk of death in elderly patients with Alzheimer's disease (AD). Thus, there is an immediate need for novel therapies to treat comorbid psychosis in AD. Psychosis has been attributed to a dysregulation of the dopamine system and is associated with aberrant regulation by the hippocampus. Given that the hippocampus is a key site of pathology in AD, we posit that aberrant regulation of the dopamine system may contribute to comorbid psychosis in AD. A ferrous amyloid buthionine (FAB) rodent model was used to model a sporadic form of AD. FAB rats displayed functional hippocampal alterations, which were accompanied by decreases in spontaneous, low-frequency oscillations and increases in the firing rates of putative pyramidal neurons. Additionally, FAB rats exhibited increases in dopamine neuron population activity and augmented responses to the locomotor-inducing effects of MK-801, as is consistent with rodent models of psychosis-like symptomatology. Further, working memory deficits in the Y-maze, consistent with an AD-like phenotype, were observed in FAB rats. These data suggest that the aberrant hippocampal activity observed in AD may contribute to dopamine-dependent psychosis, and that the FAB model may be useful for the investigation of comorbid psychosis related to AD. Understanding the pathophysiology that leads to comorbid psychosis in AD will ultimately lead to the discovery of novel targets for the treatment of this disease.

Psychosis in autism spectrum disorder: a clinical review

IntroductionAutism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by frequent comorbidity including mood, anxiety and psychotic disorders. Psychiatric comorbidity in ASD has been associated with poor prognosis.ObjectivesTo summarize clinical data regarding the relationship between autism spectrum disorder and psychosis comorbidity, namely its epidemiology, diagnosis, treatment and prognosis.MethodsWe conducted a non-systematic review of the literature relevant to the topic published in the PubMed database. Articles were selected based on title and abstract review.ResultsEpidemiological studies report significant rates of comorbidity between ASD and psychosis. According to a recent systematic review, prevalence of non-affective psychosis in ASD has been estimated at 9,56%, despite heterogeneity across included studies.The differential diagnosis of psychosis in a patient with ASD is frequently a challenge and depends on the severity of intellectual and language impairment, medical comorbidities (including epilepsy and associated pharmacological iatrogenic factors), psychiatric comorbidities and substance use. Conversely, establishing the diagnosis of ASD in a patient presenting with psychosis is not always clear, and clinicians must rely on collecting a detailed developmental history.There are no large controlled studies regarding the treatment of psychosis in this specific patient group, but risperidone and aripiprazole have been used based on efficacy in primary psychotic disorders, as well as efficacy and safety profile in other symptomatic clusters of ASD, namely irritability.ASD and psychosis comorbidity has been associated with lower response rates to antipsychotic treatment and negative long-term prognosis.ConclusionsPsychosis is a common and serious comorbidity of ASD, with limited data regarding treatment options. Further research is needed to improve global outcomes.Disclosure of InterestNone Declared

Challenges in differential diagnosis between autism spectrum disorder and psychotic disorders

AbstractData from literature show that people with Autism Spectrum Disorders (ASD) are more likely to develop a psychosis than the general population. They also have a higher chance of developing schizophrenia than neurotypical controls. In order to diagnose comorbid psychosis in ASD in an adult, first a full psychiatric examination is necessary to decide on the directions of possible further diagnostics and, if necessary, to recommend appropriate additional tests, e.g. psychological tests using professional scales and questionnaires for adults. In the case of diagnostic doubts, there are indications to refer the patient to more specialized centers. Although the two conditions are different, they share some common features, such as social withdrawal and communication disorders. This can lead to problems in the diagnosis of psychosis in people with autism. The basic symptoms of the mentioned diseases usually differ between the two disorders. For this reason, it’s important to try to get regular screenings and get care from the right professionals. A case report is presented of a patient, who received a diagnosis of ASD in the childhood, and later as an adult developed psychotic symptoms, which led to a change of diagnosis to schizophrenia.Disclosure of InterestNone Declared

Improved psychotic symptoms following resection of amygdalar low-grade glioma: illustrative case.

Epilepsy-associated psychoses are poorly understood, and management is focused on treating epilepsy. Chronic, interictal psychosis that persists despite seizure control is typically treated with antipsychotics. Whether resection of a mesial temporal lobe lesion may improve interictal psychotic symptoms that persist despite seizure control remains unknown. In a 52-year-old man with well-controlled epilepsy and persistent comorbid psychosis, brain magnetic resonance imaging (MRI) revealed an infiltrative, intraaxial, T2 fluid-attenuated inversion recovery intense mass of the left amygdala. The patient received an amygdalectomy for oncological diagnosis and surgical treatment of a presumed low-grade glioma. Pathology was ganglioglioma, World Health Organization grade I. Postoperatively, the patient reported immediate resolution of auditory hallucinations. Patient has remained seizure-free on 2 antiepileptic drugs and no antipsychotic pharmacotherapy and reported lasting improvement in his psychotic symptoms. This report discusses improvement of psychosis symptoms after resection of an amygdalar glioma, independent of seizure outcome. This case supports a role of the amygdala in psychopathology and suggests that low-grade gliomas of the limbic system may represent, at minimum, partially reversible etiology of psychotic symptoms.

Neurobiological mechanisms of psychosis in epilepsy: Findings from neuroimaging studies.

Despite the high prevalence and clinical importance of comorbid psychosis in epilepsy, its neurobiological mechanisms remain understudied. This narrative mini-review aims to provide an overview of recent updates in in vivo neuroimaging studies on psychosis in epilepsy, including structural and diffusion magnetic resonance imaging (MRI) and functional and molecular imaging, and to discuss future directions in this field. While the conventional morphological analysis of structural MRI has provided relatively inconsistent results, advanced methods, including brain network analysis, hippocampal subregion volumetry, and machine learning models, have recently provided novel findings. Diffusion MRI, for example, has revealed a reduction in white matter integrity mainly in the frontal and temporal lobes, as well as a disruption of brain white matter networks. Functional neuroimaging, such as perfusion single-photon emission computed tomography (SPECT) or fluorodeoxyglucose positron emission tomography (FDG-PET), often identifies hyperactivity in various brain regions. The current limitations of these more recent studies may include small and sometimes heterogeneous samples, insufficient control groups, the effects of psychoactive drugs, and the lack of longitudinal analysis. Further investigations are required to establish novel treatments and identify clinical diagnostic or disease-monitoring biomarkers in psychosis in epilepsy.

Current state of the evidence on community treatments for people with complex emotional needs: a scoping review

BackgroundImproving the quality of care in community settings for people with ‘Complex Emotional Needs’ (CEN—our preferred working term for services for people with a “personality disorder” diagnosis or comparable needs) is recognised internationally as a priority. Plans to improve care should be rooted as far as possible in evidence. We aimed to take stock of the current state of such evidence, and identify significant gaps through a scoping review of published investigations of outcomes of community-based psychosocial interventions designed for CEN.MethodsWe conducted a scoping review with systematic searches. We searched six bibliographic databases, including forward and backward citation searching, and reference searching of relevant systematic reviews. We included studies using quantitative methods to test for effects on any clinical, social, and functioning outcomes from community-based interventions for people with CEN. The final search was conducted in November 2020.ResultsWe included 226 papers in all (210 studies). Little relevant literature was published before 2000. Since then, publications per year and sample sizes have gradually increased, but most studies are relatively small, including many pilot or uncontrolled studies. Most studies focus on symptom and self-harm outcomes of various forms of specialist psychotherapy: most result in outcomes better than from inactive controls and similar to other specialist psychotherapies. We found large evidence gaps. Adaptation and testing of therapies for significant groups (e.g. people with comorbid psychosis, bipolar disorder, post-traumatic stress disorder, or substance misuse; older and younger groups; parents) have for the most part only reached a feasibility testing stage. We found little evidence regarding interventions to improve social aspects of people’s lives, peer support, or ways of designing effective services.ConclusionsCompared with other longer term mental health problems that significantly impair functioning, the evidence base on how to provide high quality care for people with CEN is very limited. There is good evidence that people with CEN can be helped when specialist therapies are available and when they are able to engage with them. However, a much more methodologically robust and substantial literature addressing a much wider range of research questions is urgently needed to optimise treatment and support across this group.

Positive Allosteric Modulation of α5-GABAA Receptors Reverses Stress-Induced Alterations in Dopamine System Function and Prepulse Inhibition of Startle.

BackgroundUp to 64% of patients diagnosed with posttraumatic stress disorder (PTSD) experience psychosis, likely attributable to aberrant dopamine neuron activity. We have previously demonstrated that positive allosteric modulators of α5-GABAARs can selectively decrease hippocampal activity and reverse psychosis-like physiological and behavioral alterations in a rodent model used to study schizophrenia; however, whether this approach translates to a PTSD model remains to be elucidated.MethodsWe utilized a 2-day inescapable foot shock (IS) procedure to induce stress-related pathophysiology in male Sprague-Dawley rats. We evaluated the effects of intra-ventral hippocampus (vHipp) administration GL-II-73, an α5-GABAAR, or viral overexpression of the α5 subunit, using in vivo electrophysiology and behavioral measures in control and IS-treated rats.ResultsIS significantly increased ventral tegmental area dopamine neuron population activity, or the number of dopamine neurons firing spontaneously (n = 6; P = .016), consistent with observation in multiple rodent models used to study psychosis. IS also induced deficits in sensorimotor gating, as measured by reduced prepulse inhibition of startle (n = 12; P = .039). Interestingly, intra-vHipp administration of GL-II-73 completely reversed IS-induced increases in dopamine neuron population activity (n = 6; P = .024) and deficits in prepulse inhibition (n = 8; P = .025), whereas viral overexpression of the α5 subunit in the vHipp was not effective.ConclusionsOur results demonstrate that pharmacological intervention augmenting α5-GABAAR function, but not α5 overexpression in itself, can reverse stress-induced deficits related to PTSD in a rodent model, providing a potential site of therapeutic intervention to treat comorbid psychosis in PTSD.

Psychotic Symptomatology in Adolescentes witch Autistic Spectrum Disorder

IntroductionINTRODUCTION: Patients with autistic spectrum disorders may exhibit symptoms that can also appear in psychotic disorders, such as isolation and difficulties in social interaction. In addition, these patients may also present psychotic symptoms throughout their lives, sometimes difficult to differentiate from the patient’s own idiosyncrasies.ObjectivesOBJECTIVES: To deepen the knowledge of the comorbidity of autism spectrum disorders, in particular psychosis, as well as the differential diagnosis in order to establish an adequate treatment plan and a multidisciplinary approach.MethodsMETHODS: A detailed description is given of two cases of adolescents diagnosed with Autistic Spectrum Disorder who have presented time-limited psychotic symptomatology in the last year. In addition, a literature search was conducted on the comorbidity of psychosis in patients with ASD.ResultsRESULTS: Both patients have required several hospital admissions to psychiatric units when they have had psychotic decompensations and psychopharmacological treatment with antipsychotics has been initiated.ConclusionsCONCLUSIONS: Patients with autistic spectrum disorders have a wide comorbidity. Psychosis can appear in these patients, often starting in adolescence, a time when social demands increase and patients can become decompensated. They require rapid, multi-level intervention.DisclosureNo significant relationships.

A Case of Adult Attention Deficit Hyperactivity Disorder with Non-Organic Psychosis Comorbidity

IntroductionAlthough ADHD is the most frequently diagnosed psychiatric disorder in childhood, the majority of adults with ADHD are not diagnosed and 90% of the cases remain untreated. One of the main reasons that may lead to the missed diagnosis of ADHD in adults may be the high rate of comorbid psychiatric conditions masking the main symptoms.ObjectivesIn this study, it was aimed to present a case who was followed up with the diagnosis of ADHD since childhood and developed psychosis after a recent traumatic life event.MethodsA 19-year-old male patient was consulted because of his complaints of persecution delusions, and disorganized speech that started 2 years ago. IIt was learned that the first psychiatry application of the patient was 10 years ago with complaints of impulsivity, aggression, increased psychomotor movements, and methylphenidate treatment was started during this period. The patient, whose current clinical picture was evaluated as psychosis, was discharged after the symptoms subsided with paliperidone depot 100mg/month treatment after hospitalization. It is understood that his psychotic complaints completely regressed in the follow-ups.ResultsIt is stated that approximately 80% of adult ADHD cases have at least one accompanying psychiatric disorder. However, there are limited studies in the literature on the relationship between psychotic disorders and ADHD.ConclusionsRecent studies indicate that beyond the fact that ADHD is a feature of the schizophrenia prodrome, ADHD diagnosis may be associated with an increased risk of psychosis in the future. Therefore, this association can be better clarified in further studies on comorbidities.DisclosureNo significant relationships.

Multisite randomised controlled trial of trauma-focused cognitive behaviour therapy for psychosis to reduce post-traumatic stress symptoms in people with co-morbid post-traumatic stress disorder and psychosis, compared to treatment as usual: study protocol for the STAR (Study of Trauma And Recovery) trial

BackgroundPeople with psychosis have high rates of trauma, with a post-traumatic stress disorder (PTSD) prevalence rate of approximately 15%, which exacerbates psychotic symptoms such as delusions and hallucinations. Pilot studies have shown that trauma-focused (TF) psychological therapies can be safe and effective in such individuals. This trial, the largest to date, will evaluate the clinical effectiveness of a TF therapy integrated with cognitive behaviour therapy for psychosis (TF-CBTp) on post-traumatic stress symptoms in people with psychosis. The secondary aims are to compare groups on cost-effectiveness; ascertain whether TF-CBTp impacts on a range of other meaningful outcomes; determine whether therapy effects endure; and determine acceptability of the therapy in participants and therapists.MethodsRater-blind, parallel arm, pragmatic randomised controlled trial comparing TF-CBTp + treatment as usual (TAU) to TAU only. Adults (N = 300) with distressing post-traumatic stress and psychosis symptoms from five mental health Trusts (60 per site) will be randomised to the two groups. Therapy will be manualised, lasting 9 months (m) with trained therapists. We will assess PTSD symptom severity (primary outcome); percentage who show loss of PTSD diagnosis and clinically significant change; psychosis symptoms; emotional well-being; substance use; suicidal ideation; psychological recovery; social functioning; health-related quality of life; service use, a total of four times: before randomisation; 4 m (mid-therapy); 9 m (end of therapy; primary end point); 24 m (15 m after end of therapy) post-randomisation. Four 3-monthly phone calls will be made between 9 m and 24 m assessment points, to collect service use over the previous 3 months. Therapy acceptability will be assessed through qualitative interviews with participants (N = 35) and therapists (N = 5–10). An internal pilot will ensure integrity of trial recruitment and outcome data, as well as therapy protocol safety and adherence. Data will be analysed following intention-to-treat principles using generalised linear mixed models and reported according to Consolidated Standards of Reporting Trials-Social and Psychological Interventions Statement.DiscussionThe proposed intervention has the potential to provide significant patient benefit in terms of reductions in distressing symptoms of post-traumatic stress, psychosis, and emotional problems; enable clinicians to implement trauma-focused therapy confidently in this population; and be cost-effective compared to TAU through reduced service use.Trial registrationISRCTN93382525 (03/08/20)

(PO-136) The relationship Between Glycemic Control and Food Insecurity in People with Diabetes Mellitus and Comorbid Psychosis

(PO-136) The relationship Between Glycemic Control and Food Insecurity in People with Diabetes Mellitus and Comorbid Psychosis

Recognizing Psychosis in Autism Spectrum Disorder.

There is strong evidence for the existence of a high comorbidity between autism and psychosis with percentages reaching up to 34. 8% and several significant implications for treatment and prognosis of these patients. However, the identification of comorbid psychosis in patients with Autism Spectrum Disorder represents a complex challenge from a psychopathological point of view, in particular in patients with greater deficits in verbal communication. Intercepting the onset of a psychotic breakdown in autism may be very difficult, both disorders in fact occur along a phenotypic continuum of clinical severity and in many cases, psychotic symptoms are present in an attenuated form. In this paper, we reviewed the available scientific literature about comorbidity between psychosis and autism, focusing our attention on four specific dimensions: delusions, hallucinations, negative symptoms, and clinical course. The aim of this paper is to provide clinical tools to identify these psychotic phenomena in autistic patients, even when they occur in their attenuated form.

Addictiveness as a risk factor for verbal memory deficit in schizophrenia: a case-control study

Cognitive deficit is one of the main prognostic predictors in schizophrenia, mainly the deficit in verbal memory. The causal relationship between substances use, substance use disorders and psychotic syndrome is probably multidirectional and still is under the possible effect of confusion factors. The Addictiveness in the Psychotic Syndrome Assessment Scale (APSAS) evaluates in a global mode the dimension of adictivity taking in account all these factors: beginning, frequency, length, and intensity. The objective of the study is to know if the dimension of adictivity is associated to memory disorders. A group of psychotic subjects with memory deficits (n = 47) and a control group of psychotic subjects without memory deficits (n = 58) are compared obtaining a major adictivity in the first group. According to our results, the score of APSAS &gt; 55 indicates possible memory deficits. This measuring can provide relevant information on the actual state, evolution and prognose of patients with comorbidity of psychosis and addiction.