Although autism spectrum disorder and schizophrenia share overlapping symptoms, they are distinct conditions.
Autism spectrum disorder (ASD) and schizophrenia are considered separate disorders. The conditions have several different symptoms.
Although the conditions may share some overlapping symptoms, they are distinct. Understanding some of these distinctions is important for a correct diagnosis.
The
- restricted and repetitive behaviors
- difficulties communicating or being in social situations
Researchers consider schizophrenia to be a spectrum disorder since it “represents a broad and heterogeneous syndrome, rather than a specific disease entity, that is part of a multi-faceted psychosis spectrum.”
The
People with schizophrenia
Research suggests that autistic youth are three to six times more likely to develop schizophrenia than those without autism.
Genetics
ASD and schizophrenia may have a genetic link. Some disorders are due to changes to chromosomes, the molecules that carry genetic code. Studies have shown that a
According to another study, they’re unlikely to develop together. Scientists think that ASD and schizophrenia may be two different outcomes from the same genetic syndrome.
A 2021 study also suggests that children of parents with schizophrenia are more likely to have traits of autism. These findings support older studies, which showed that children of parents with schizophrenia were
Studies so far have had small sample sizes. More research is needed to understand how genetics influences ASD and schizophrenia.
Brain imaging
Both ASD and schizophrenia are neurodevelopmental disorders. This means they affect how the brain develops. Through brain imaging, scientists can see similarities between the brains of autistic people and those with schizophrenia.
According to
- reduced gray matter, the outer part of the brain where processing takes place
- altered white matter, deeper brain tissue where the brain’s connections occur
- reduced activity in parts of the brain related to social interactions and language
Experts group symptoms of both ASD and schizophrenia into the following categories:
- positive
- negative
- cognitive
We’ll explain what these mean, how they might appear in both conditions, and which symptoms are unique.
Positive symptoms
Positive symptoms are present in people with the condition but not in people without the condition.
Positive symptoms of ASD and schizophrenia tend to be unique to each condition. They’re the simplest way to tell the two conditions apart.
Symptoms vary significantly between individuals. But according to a 2020 study, some of the most common positive symptoms include:
| Symptom | ASD | Schizophrenia |
|---|---|---|
| hallucinations | ● | |
| delusions | ● | |
| exaggerated speech | ● | |
| incoherent speech | ● | |
| talking to oneself | ● | |
| echolalia | ● | |
| repetitive body movements | ● | |
| lack of body movements | ● | |
| repetitive behaviors | ● | |
| sensory sensitivities | ● |
Negative symptoms
Negative symptoms are the absence of standard functions. These are functions that are present in most people but absent in people with the condition.
Negative symptoms of ASD and schizophrenia tend to be similar. Research shows that such similarities mainly affect communication and emotional interactions with others. These may include:
- perceived inability to identify or express emotions
- “flat” voice tones
- lack of facial expressions
- reduced eye contact
- perceived disinterest
- reduced physical gestures
- social withdrawal or lack of social interest
- reduced speech
Cognitive symptoms
Cognitive symptoms may occur when understanding, memory, and concentration are impaired. This can affect someone’s ability to learn or complete tasks.
Like with negative symptoms, ASD and schizophrenia have some similar cognitive symptoms. But cognitive differences in people with schizophrenia tend to be more severe.
According to a
- processing speed
- attention
- verbal learning
- visual learning
- language comprehension
- working memory
- spatial perception
- reasoning and problem solving
In a 2020 study, people with schizophrenia had more severe impairments across the board than autistic people. This was especially true for working memory, language, perception, and reasoning. In schizophrenia, experts may describe a person’s self-world relationship as unstable or fragmented. In ASD, however, it is considered stable.
It’s important to know the difference between ASD and schizophrenia. This can help you get a correct diagnosis and connect you with helpful therapies and interventions.
Several other conditions may also co-occur with either ASD or schizophrenia. Many of these conditions share similar symptoms. This can further increase the chances of misdiagnosis.
For example, 2020 research found that ASD can co-occur with:
- anxiety
- attention deficit hyperactivity disorder (ADHD)
- depression
- intellectual and developmental disorders
- tic disorders
Schizophrenia may co-occur with:
Diagnosing ASD
A healthcare professional, such as a pediatrician, may diagnose ASD during a young child’s wellness exam. The pediatrician will ask the child’s caregiver a series of questions about the child’s development, such as their speech and communication skills. They will also ask about any restricted and repetitive behaviors.
ASD is a complex condition. Your child’s pediatrician may refer them to one or more of the following professionals for additional evaluation:
- pediatric neurologist
- child psychologist or psychiatrist
- neuropsychologist
- speech-language pathologist
- occupational therapist
Diagnosing schizophrenia
A mental health professional may make a schizophrenia diagnosis after someone has experienced symptoms of psychosis. They may focus less on developmental stages and social-communication skills.
The first episode of psychosis will usually occur in late adolescence or early adulthood. The
Childhood-onset schizophrenia
In rare instances, doctors may diagnose schizophrenia in someone under the age of 13 years. This is known as childhood-onset schizophrenia (COS). Less than 1 in 40,000 children get this diagnosis, according to a 2019 review. Because COS is so rare, it is not well understood and difficult to diagnose.
Early negative symptoms of COS can look like autism. In fact, until 1980, autism was called “childhood schizophrenia.”
It can also be difficult to accurately identify positive symptoms in COS. Some behaviors in children can be confused with psychosis. It’s also harder for children to describe their symptoms to a doctor.
Before positive symptoms occur, children usually show warning signs. These may include:
- shyness
- loneliness
- depression
- aggression
- thoughts of suicide
- theft
- unusual behavior
Therapies and support for ASD
“Treatment” for ASD is a subjective term. Instead, you may consider “treatment” as a way to help you feel better and function in social situations, work, and school.
Interventions for ASD may start at a young age and include a combination of the following:
- behavioral therapy
- social groups
- occupational therapy
- speech therapy
- educational support, such as an individualized education plan at school
- medications to help treat anxiety, aggression, and other concerns if needed
Treating schizophrenia
Treatment for schizophrenia mainly involves medications and therapies, including:
- antipsychotic drugs to help treat symptoms of psychosis
- cognitive behavioral therapy, which may also help address negative symptoms
- psychosocial therapies to help improve coping skills for participating in school, work, and social situations
- coordinated specialty care, which combines the above medications and therapies for a comprehensive treatment approach
- community support to assist people with repeated hospitalizations or homelessness
ASD and schizophrenia share genetic components. Research suggests genetics may increase the chances of developing either condition, and sometimes both. However, no single gene is known to predict whether or not they will develop.
Factors that increase the chance of having ASD may include:
- having a low birth weight
- being born to older parents
- having an autistic sibling
- the presence of certain genetic conditions, such as fragile X syndrome, Down syndrome, or Rett syndrome
The
- brain changes that may occur before birth or during puberty
- exposure to viruses before birth
- nutritional problems before birth
- growing up in a high stress environment
- living in poverty
It’s important to understand that having any one of these factors doesn’t automatically mean a person will develop ASD or schizophrenia.
Both ASD and schizophrenia tend to develop at a young age. Therapies and other interventions may be most effective when started at a younger age.
The symptoms of each condition can differ from person to person, as can the outlook.
ASD is considered lifelong, but early interventions can increase the likelihood of independence in adulthood.
The outlook for schizophrenia is also varied. Some people experience periods of remission from their symptoms. Others may continue to experience symptoms or go through periods of remission and recurrence. The World Health Organization (WHO) estimates that
ASD and schizophrenia share some similar symptoms, especially when it comes to social interaction and communication. However, despite these similarities, ASD and schizophrenia are two separate conditions that have unique symptoms.
It’s important to avoid self-diagnosing any developmental or mental health condition. If seeking therapies or other interventions, a professional diagnosis is essential to help you get started.