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13-03-2013 | Mental health | Article

Asperger syndrome going undetected in patients with psychosis

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medwireNews: The prevalence of Asperger syndrome (AS) is considerably higher in patients with first-episode psychosis than it is in the general population, researchers report.

"Clinicians working in EIP [early intervention in psychosis] teams need to be adequately trained in identifying AS and alert to the possibility of AS when seeing patients," say Conor Davidson (Leeds Early Intervention in Psychosis Service, Leeds, UK) and co-workers.

In their study of 197 patients receiving treatment for their first episode of psychosis, the prevalence of AS was 3.6%.

"This is up to 12 times greater than the prevalence of AS in the general population," they report in Early Intervention in Psychiatry.

The researchers also note that possible study limitations, such as participant dropout or inaccurate diagnosis at screening or interview, mean that "the figure of 3.6% should be viewed as a minimum prevalence in this population."

The team used the Autism Spectrum Disorder in Adults Screening Questionnaire to screen the case notes of all 197 patients with first-episode psychosis, and 30 patients were found positive for AS, three of whom had already been diagnosed with the syndrome by child and adolescent mental health services.

Following review of the case notes of the patients testing positive for information relevant to AS, 13 were invited for a diagnostic interview. As a result, an additional four patients were diagnosed with AS, giving seven in total.

"Our results add weight to the idea that psychotic symptoms are more common in people with AS than the general population," Davidson and team write.

"It may be that in the majority this is brief and transient psychosis rather than major mental illness like schizophrenia, although common genetic risk factors are being found for schizophrenia and autism.

The researchers also highlight the fact that "over half the patients with AS in our sample were undiagnosed, despite being within mental health services for several years in some cases."

By Lucy Piper, Senior medwireNews Reporter

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