Co-occurrence of autistic and psychotic traits: Implications for depression, self-harm and suicidality

Katie N. Sampson, Rachel Upthegrove, Ahmad Abu-Akel, Sayeed Haque, Stephen J. Wood, Renate Reniers

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: There is increasing interest in the clinical and aetiological overlap between autism spectrum disorders and schizophrenia spectrum disorders, reported to co-occur at both diagnostic and trait levels. Individually, sub-clinical autistic and psychotic traits are associated with poor clinical outcomes, including increased depressive symptomatology, self-harming behaviour and suicidality. However, the implications when both traits co-occur remain poorly understood. The study aimed to (1) examine the relationship between autistic and psychotic traits and (2) determine if their co-occurrence increases depressive symptomatology, self-harm and suicidality.

METHODS: Cross-sectional data from a self-selecting (online and poster advertising) sample of the adult UK population ( n = 653) were collected using an online survey. Validated self-report measures were used to assess sub-clinical autistic and psychotic traits, depressive symptomatology, self-harming behaviour and suicidality. Correlation and regression analyses were performed.

RESULTS: A positive correlation between sub-clinical autistic and positive psychotic traits was confirmed ( r s = 0.509, p < 0.001). Overall, autistic traits and psychotic traits were, independently, significant predictors of depression, self-harm and suicidality. Intriguingly, however, depression was associated with a negative interaction between the autistic domain attention to detail and psychotic traits.

CONCLUSIONS: This study supports previous findings that sub-clinical autistic and psychotic traits are largely independently associated with depression, self-harm and suicidality, and is novel in finding that their combined presence has no additional effect on depression, self-harm or suicidality. These findings highlight the importance of considering both autistic and psychotic traits and their symptom domains in research and when developing population-based depression prevention and intervention strategies.

Original languageAmerican English
Pages (from-to)1364-1372
Number of pages9
JournalPsychological Medicine
Volume51
Issue number8
DOIs
StatePublished - Jun 2021
Externally publishedYes

Keywords

  • Adult
  • Autistic Disorder/epidemiology
  • Cross-Sectional Studies
  • Depression/epidemiology
  • Humans
  • Self-Injurious Behavior/epidemiology
  • Suicide

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