In popular speech, the term "schizophrenic" is often used to describe any kind of disturbed behavior, but in medicine this disorder is defined by fairly precise diagnostic criteria. Schizophrenia rarely starts before adolescence. The noticeable onset of Autism, on the other hand, almost always predates age three. The time of onset of a disorder is of crucial importance.
Schizophrenia involves hallucinations, delusions, and disorganized thoughts and is extremely rare in children. Autism is a neurological condition characterized by deficits in social interactions and communication and repetitive interests and behaviors.
Both involve the activation of phylogenetically earlier developmental brain structures to the partial exclusion of later developmental ones. Unlike schizophrenia, autism may not be physiologically obvious. That’s why diagnosing autism usually requires a complete physical and neurological evaluation. Some experts even say that autism is not a single condition but a group of several distinct conditions that manifest in similar ways.
There is no cure for autism but, with intense therapy and schooling, most children diagnosed with autism can improve their social and other skills. They can then fully participate in mainstream education and social events.
Autism and Schizophrenia: An overview
Autism is classified as a specific neuro-psychiatric disorder characterized by markedly different social interaction, communication ability, patterns of interests, and patterns of behavior. Schizophrenia is a psychiatric disorder characterized by mental impairments in the perception or expression of reality and by significant social or occupational dysfunction. The specific cause of autism is unknown, but many experts suspect that autism results from genetically mediated vulnerabilities to different environmental triggers.
Pervasive Developmental Disorders
Autism is one of five disorders that fall under the group of Pervasive Developmental Disorders, a category of neurological disorders characterized by severe impairment in several areas of development.
The five disorders listed under PDD are:
- Autistic Disorder
- Asperger's Disorder
- Childhood Disintegrative Disorder
- Rett's Disorder
- PDD-Not Otherwise Specified
Incidence of autism
Some experts estimate that autism occurs in as many as one in 166 of children in the USA, however some more serious studies give a more conservative estimate of one in 1000. Although autism is about 3 to 4 times more common in boys, girls with the disorder tend to have more severe symptoms and greater cognitive impairment. Autism knows no racial, ethnic, social boundaries, and isn't related to family income, lifestyle, or educational levels and can affect any family, and any child. Diagnosis is based on a list of psychiatric criteria.
Main characteristics of Autism and Schizophrenia
Every person with autism has a unique personality and combination of characteristics which can make the diagnosis of this disorder really complicated. Some mildly affected individuals may exhibit only slight delays in language and greater challenges with social interactions.
Persons with autism may also exhibit some of the following traits:
- Insistence on sameness; resistance to change
- Difficulty in expressing needs, using gestures or pointing instead of words
- Repeating words or phrases in place of typical, responsive language
- Laughing for no apparent reason, or showing distress for reasons not apparent to others
- Unresponsive to normal teaching methods
- Sustained odd play
- Spinning objects
- Preference for being alone
- Tantrums
- Difficulty in mixing with others
- Not wanting to cuddle or be cuddled
- Little or no eye contact
- Obsessive attachment to objects
- Apparent over-sensitivity or under-sensitivity to pain
- No real fears of danger
- Noticeable physical over-activity or extreme under-activity
- Uneven fine motor skills
- Non responsive to verbal cues
Symptoms characteristic to schizophrenia are markedly different. They could be divided into positive and negative. The most common positive symptoms of schizophrenia are delusions, hallucinations, disorganized speech and behavior. Some of the more common negative signs are affective flattening, alogia and avolition.
Possible causes of autism and schizophrenia
The exact cause of autism is still unknown, but it is generally accepted that it is caused by abnormalities in brain structure or function. Researchers are investigating a number of theories, including the link between heredity, genetics and medical problems. However no gene has yet been identified as the cause of autism. Other experts are investigating problems during pregnancy or delivery, as well as environmental factors such as viral infections, metabolic imbalances, and exposure to environmental chemicals. It is important to point out that this condition isn’t caused by bad parenting.
Risk factors for developing autism
Autism tends to occur more frequently among individuals who have certain medical conditions, including:
- Fragile X syndrome
- Tuberous sclerosis
- Congenital rubella syndrome
- Untreated phenylketonuria
Some harmful substances ingested during pregnancy have also been associated with an increased risk of autism.
There are several theories that have tried to explain the cause of schizophrenia.
Possible causes are:
- Genetic causes
- Abnormal brain development
- Infection
- Birth complications
- Head injury
- Psychological causes
- Drug use
Schizophrenia and autism: Differential diagnosis
Even now, experts sometimes have difficulty differentiating between these two disorders. Schizophrenia shouldn't be diagnosed separately from autism, unless delusions and hallucinations are prominent.
The main problem with the differential diagnosis of these two disorders is that the negative symptoms of schizophrenia and the symptoms of autism mimic one another. So when someone with autism is being considered for a schizophrenia diagnosis, the psychotic features and some negative symptoms are the the most important ones to be considered. People can avoid speaking for various reasons including language difficulties, speech difficulties, anxiety, etc. If a person does not speak, it doesn’t mean they are autistic nor that they even have autistic traits.
In the last several decades, considerable evidence has suggested that autism and schizophrenia are unrelated. However, recent reports have suggested that individuals with autism may be at greater risk for schizophrenia and that the conditions may be more closely related than generally believed.
Treatment of autism and schizophrenia
Social interaction skills
This is usually the base of a good autism treatment. Effective social programs teach a child early communication and social interaction skills. In children under 3 years of age, these interventions usually take place at home and they target specific deficits in learning, language, imitation, attention, motivation, compliance, and initiative of interaction. Children older than 3 usually have a school-based, individualized, special education.
During the middle and high school years, instruction will begin to address such practical matters as work, community living, and recreational activities. Similar life skills should be taught to people with schizophrenia. It is based on learning and using coping mechanisms to address these problems, which allows people with schizophrenia to attend school, work, and socialize.
Patients who receive regular psychosocial treatment also adhere better to their medication schedule and have fewer relapses and hospitalizations.
Medications
The medications used for autism are those that have been developed to treat similar symptoms in other disorders. Many of these medications have not been officially approved by the FDA for use in children, but doctors may prescribe these medications if they feel they are appropriate for your child. So-called antipsychotic medications are the foundation of pharmacological treatment for schizophrenia medication.
Older antipsychotic medications include:
- chlorpromazine (Thorazine®), haloperidol (Haldol®)
- perphenazine (Etrafon®, Trilafon®)
- fluphenzine (Prolixin®)
- risperidone (Risperdal®),
- olanzapine (Zyprexa®),
- quietiapine (Seroquel®),
- sertindole (Serdolect®),
- ziprasidone (Geodon®)
Dietary interventions
These interventions are based on the idea that food allergies cause symptoms of autism. Many experts believe also that an insufficiency of a specific vitamin or mineral may cause some autistic symptoms.
Prognosis
There are many different potential outcomes of schizophrenia but there is no cure. Autism is also a lifelong disorder. Many people with schizophrenia and autism find that their symptoms improve with medication and/or therapy respectively, and some achieve substantial control of the symptoms over time. One of the big problems is that many parents of autistic children face financial difficulties as they must often pay for essential support and therapeutic services but still they are sometimes not eligible to receive financial aid.