Autism-spectrum traits in First Episode Psychosis: Psychopathological and prognostic considerations from a 2-year follow-up study.

Researchers followed 132 people experiencing their first episode of psychosis for 2 years. About 1 in 5 had significant autism traits. Those with autism traits were younger when they first became unwell and had more severe symptoms. Over 2 years, they were less likely to recover and needed more ongoing support. The autism traits stayed consistent over time, suggesting they are permanent characteristics that affect how well someone recovers from psychosis.

This 2-year follow-up study examined autism-spectrum traits in 132 people with first episode psychosis (FEP) using the Autism-spectrum Quotient (AQ). Participants with high autism traits (21.2% scoring ≥26 on AQ) were younger at presentation and showed more severe psychotic symptoms, particularly negative symptoms. Over 2 years, those with autism traits had significantly poorer outcomes including lower rates of symptom remission, functional recovery, and higher service engagement. AQ scores remained stable over time, suggesting these represent trait-like characteristics rather than temporary features.

The findings indicate autism traits identify a distinct FEP subgroup requiring specialized therapeutic approaches and predict poorer long-term outcomes in early psychosis services.

Early psychosis services should screen for autism traits using validated tools like the AQ. Those with autism traits may require modified treatment approaches, longer intervention periods, and specialized support strategies. Clinicians should adjust outcome expectations and develop autism-informed therapeutic approaches for this subgroup requiring specific therapeutic needs.

Study type not specified in metadata. Sample size appears modest for subgroup analyses. Limited to 2-year follow-up period. Relies on self-report autism screening tool rather than diagnostic assessment. No control group of individuals without psychosis for comparison of autism trait prevalence.

There's a general lack of knowledge about autism attributes in early psychosis, although little initial evidence showed that having autistic features contributes to poorer recovery over time. The main aim of this examination was to compare sociodemographic and clinical variables between FEP patients with or without autistic characteristics treated within an "Early Intervention in Psychosis" (EIP) service both at entry and across 2 years of follow-up. We also examined the longitudinal course of autism severity levels in FEP to investigate whether they truly represented trait-like attributes. FEP participants completed the AQ-spectrum Questionnaire (AQ), the Positive And Negative Syndrome Scale (PANSS), and the Global Assessment of Functioning (GAF) at baseline and over time.

Inter-group comparisons were examined using Chi-Squared or Mann-Whitney test, Kaplan-Meyer survival analysis, mixed-design ANOVA, and binary logistic regression. AQ score longitudinal stability was explored using Wilcoxon test for repeated measures and Spearman correlation coefficient. 132 subjects were recruited (28 [21.20 %] scored above the AQ cut-off score of≥26). At presentation, they showed younger age and higher severity in psychopathology (especially negative symptoms). Across the follow-up, the AQ+ subsample had lower incidence rates of service disengagement, PANSS symptomatic remission, and GAF functional remission.

AQ scores showed longitudinal stability over time. The AQ represents a valid instrument to assess "trait-like" autistic features in FEP subjects. Specifically, it captures a distinct FEP subgroup characterized by more severe clinical presentation, poorer clinical and functional outcomes, and specific therapeutic needs.