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StuartN
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28 Jul 2010, 3:07 am

Sora wrote:
AS criteria say:

DSM-IV-TR wrote:
F. Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia.


Expanded meaning:

DSM-IV-TR wrote:
By definition the diagnosis [of Asperger's] is not given if the criteria are met for any other specific Pervasive Developmental Disorder or for Schizophrenia (although the diagnoses of Asperger's Disorder and Schizophrenia may coexist if the onset of the Asperger's Disorder clearly preceded the onset of Schizophrenia) (Criterion F).


If you met the criteria for AS before your schizophrenia started, you can have both diagnoses.


It is really unfortunate that the summarised versions of the diagnostic criteria, without any exception that I could find, omit the statement that schizophrenia can co-exist with Asperger's syndrome. The relevant page of the DSM-IV is here http://books.google.ie/books?id=3SQrtpn ... &q&f=false

Schizophrenia actually appears to be more frequent in people with Asperger's (as are anxiety, depression and psychosis).

Pages that misleadingly state only that "Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia" (or similar) include these:

http://www.autreat.com/dsm4-aspergers.html
http://en.wikipedia.org/wiki/Diagnosis_ ... r_syndrome
http://www.aspergers.com/aspcrit.htm
http://autism.about.com/od/aspergerssyn ... aforas.htm

All pages summarising the DSM diagnostic criteria should include the additional text that "By definition the diagnosis is not given if the criteria are met for any other specific Developmental Disorder or for Schizophrenia (although the diagnosis of Asperger's Disorder and Schizophrenia may coexist if the onset of the Asperger's Disorder clearly preceded the onset of Schizophrenia) (Criterion F)."



katzefrau
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28 Jul 2010, 10:06 pm

Ravenclawgurl wrote:
i saw on wikipedia there is condition that some doctors believe is a cross between autism spectrum disorders and schizophrenia



Ravenclawgurl wrote:


i recently was involved with someone i was sure had AS and now the more i consider his responses and behaviors i wonder if he is schizophrenic. perhaps this ^ explains it. he was institutionalized as a teenager, but that was before AS as a diagnosis, so .. i assumed he was wrongly diagnosed (though he never spoke of what the diagnosis at the time was) .. he told me "consensus reality" is a matrix and we are actually living on the moon. i still do not know whether that is a delusion or more a metaphorical expression / exaggeration of his feeling of alienation - !?

i find it difficult to disengage from people like this (and i have known a few others), a puzzle i can't solve - is it a theory of mind problem or is the person delusional? my father is like this. schizo spectrum or AS? i don't know. i had never before considered both. undiagnosed / untreated, this is psychological territory that makes me very uneasy .. if you aren't sure whether someone has actual paranoid delusions, you don't know when they "snap" if it is just a meltdown or you are about to get stalked / stabbed.

can ToM impairment, unrecognized, look like delusion / true schiz paranoia when it is not? or externally do both just look similar enough to be easily mistaken for one another? i am talking about people who are undiagnosed, have not sought help. it can be difficult to understand what someone's experience is without their self-reporting. i wonder if i mix up AS / schizo when i see certain traits in others. and so .. i am scared of those i relate to, which isolates me further (since they are so few & far between, i am already very isolated). this sucks!!

spockezri wrote:
Here is a (rather long) quote from a UK medical journal-type site I found -
An experimental investigation of the phenomenology of delusional beliefs in people with Asperger syndrome



There is evidence that Asperger syndrome is associated with delusional beliefs. Cognitive theories of delusions in psychosis literature propose a central role for impaired theory of mind ability in the development of delusions. The present study investigates the phenomenology of delusional ideation in Asperger syndrome. Forty-six individuals with Asperger syndrome participated and were found to have relatively high levels of delusional ideation, primarily grandiose or persecutory. Factors associated with delusional belief were anxiety, social anxiety and self-consciousness, but not theory of mind ability or autobiographical memory. The findings indicate that delusional belief is a prominent feature in Asperger syndrome, but do not support a mentalization based account. A preliminary cognitive model of delusions in Asperger syndrome is proposed and the theoretical and clinical implications of the findings are discussed.


i would love to see more of this article. i am scared of my father (and my former friend, whom i discussed earlier) because i can't figure out what is really going on. i wish they would both seek help.


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katzefrau
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28 Jul 2010, 10:40 pm

capriwim wrote:
I think with the autistic spectrum, paranoia is more a logical result of not being able to read other people or know how they are reacting to you, and frequently having people interpret you as rude and thus be unfrriendly to you as a result. While I don't have a doom-laden sense of the universe being out to get me, I am often not sure whether people are being friendly or unfriendly, or I can sense that they are a bit 'off' but I'm not sure why, so I assume it's my fault because I observe people behave in a certain manner with people they are annoyed with. I also have difficulty distinguishing between whether someone is temporarily irritated with me or permanently dislikes me - black and white thinking makes me assume the latter.

Thinking about it, I'd say that schizophrenic people's paranoia results from trusting their own distorted sense of the world above other people's, whereas mine tends to be a result of distrusting my own sense of the world and thus having nothing to trust.


yes. precise. very well said.


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28 Jul 2010, 10:49 pm

Persecutory delusions?

Hon, you're not paranoid if everyone's out to get you. You've gotta realize, we develop our beliefs in an environment where everyone else communicates in ways we don't understand and expects us to be in on some grand secret. They seem shocked and annoyed when we don't pick up on things they don't bother to say. Then when you're about eight or so, previously friendly people suddenly exclude you. They pick on you. Not just your peers, but then adults sometimes join in.

We're not delusional; we have perfectly rational beliefs, given our experiences.

(With regard to grandiosity, yes. You don't understand the way they communicate, so you can't grasp what they're telling you. They call you stupid, but of course, you're not. Also, the average IQ would probably be higher, given that it's a requirement that you not be ret*d; it's reasonable for you to think you're surrounded by idiots. Also, you get annoyed with being considered worthless, and come to consider them worthless. And they don't grasp things that come easily to you. We are not delusional.)

Also, you won't pick up society's "normal" beliefs very easily. Cultural context is very important, because then we could, say, diagnose all Christians as being delusional. In the case of many Aspies, the cultural context is different from that of their next-door neighbors. A lot of things are literal to us that aren't to most people. (I would be utterly incapable of being the sort of Christian that's most common nowadays. I am incapable of believing a document I do not take literally. It's either atheist who rejects everything in it, or extreme literalist Christian who believes every word, none of which is nonliteral except explicitly marked out parables and maybe some of the more surreal prophecies. And I'm a little fuzzy on whether the parables actually happened and are just being used as analogies; after all, you're not supposed to lie... So given that I'm going to be a Christian, I have no choice about sounding a little crazy; the other option is forsaking God entirely, and becoming something which is also often rejected by the culture. And I tried that anyway.)

So when you try to figure out what beliefs are delusional, bear in mind that anything that could seem reasonable if you had a black-and-white worldview and took some common metaphors literally...

Also, there are so many people saying things, all the time, of the form "all humans are X," where X is a trait shared only by most NTs. "Humans are social animals." Plug that and "I am not a social animal" into a syllogism and you get "I am not human." There's too much stuff like that to pronounce an Aspie delusional just because he believes some weird things.

Also, herd mentality may blind you to some truths. Also, what seems sensible from an NT may sound weirder from one of us, because we can't put it delicately (or know not to put it at all).

At the moment, I've read three memoirs by people with schizophrenia. Two of these recound the schizophrenic calling up a friend or confidante to explain what happened on 9/11. In both cases, they were told to take their pills. Be very careful assuming someone is delusional.


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katzefrau
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28 Jul 2010, 11:15 pm

DandelionFireworks wrote:
Hon, you're not paranoid if everyone's out to get you. You've gotta realize, we develop our beliefs in an environment where everyone else communicates in ways we don't understand and expects us to be in on some grand secret. They seem shocked and annoyed when we don't pick up on things they don't bother to say. Then when you're about eight or so, previously friendly people suddenly exclude you. They pick on you. Not just your peers, but then adults sometimes join in.

We're not delusional; we have perfectly rational beliefs, given our experiences.


100% agree.

i don't know if you were responding to my post(s) above yours; if so i should clarify, in re the two people i was discussing, if either of them were to be DXed with Asperger's, my fear / distrust would cease. the concern was specifically where apparent paranoid behavior was rooted - if in AS (therefore, reactive to experience), it makes sense. impossible for me to tell, in these 2 instances, from outside observation. (these are two very high functioning individuals, who present as eccentric but socially competent)

also, i should add: i don't fear schizophrenia either; what i fear is the undiagnosed who does not know his unreality is unreality. i know someone with paranoid schizophrenia who is akin to a kitten.


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DandelionFireworks
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29 Jul 2010, 2:26 am

Even if he doesn't know he's delusional, a schizophrenic is in more danger himself than he poses to you.

And for all that I would assume otherwise (in anyone, even someone floridly psychotic, until I could be sure), it's still possible that an Aspie has snapped and gone totally crazy and is going to kill you. If someone sets off my warning bells, I don't breathe easier just because they have a particular diagnosis.


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Matterik
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03 Sep 2010, 12:02 pm

Ticker wrote:
kittenmeow wrote:

How do psychiatrists know if an internal defense mechanism switch that flips on when similar event triggers it is not just a reaction to bad things that have occured and is actually PTSD?

I know if people are being manipulative, outcast and try to bully me, I sure do feel persecuted. Does the mere feeling itself make it a delusion?


A good psychologist should be able to tell PTSD for what it is and not confuse it with being delusional or Schizo. PTSD actually is a internal defence mechanism that is innate just like Dissociation is according to my psychologist. She has also stated trauma from Aspergers can create PTSD if its severe enough. She even stated Dissociation was a very beautiful defense mechanism that some minds are capable of in order to protect a young person that is being abused or neglected. Sounds like some of you have some bad therapists.


Yes but the problem occurs when you have someone that have some indicators of schizophrenia like great imagination and OCD and so on and this person can also easily end up in a PTSD state and at that point, in a state of anxiety and depression, if there are no files on the person, no knowledge about his background, he might just be treated as if he was a paranoid schizophrenic. This is where files, journals patient files can come in handy, psychological profiles from school etc to eliminate the chance of people being mistreated.



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29 Sep 2010, 12:12 pm

I think what has frightened me about Schitzephrenia (can't spell it) is this book my mum read about a person named Nancy somebody, and she was so awful that it shocked the reader. My mum had to dare herself to read on, and all this Nancy woman had was this Schitzephrenia. That has scared the s**t out of me. And the story was actually a true story.

And with Bipolar - Stacie in Eastenders scared the s**t out of me when her character had Bipolar because she was really freaking out at everybody, and I'm scared I'll suddenly get it out of the blue when walking in the street and then go all mad.
I know it was just an act, but the acts are still meant to be relevent to real life situations.

I think brains are so unpredictible. They're not as good as they're cracked up to be.


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29 Sep 2010, 12:32 pm

I would say that the lack of ability to communicate would count as both, as you said, but the blunted emotions or innapropriate display of it could contribute to the dual diagnoses.



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07 Nov 2010, 10:21 pm

What if schizophrenia involves a sudden rapid change in the way the brain processes information?

If you have processed information the same way your entire life the brain will integrate it together over time and try to make sense of it in a way consistent with your needs as you interact with the environment. The brain would come to understand certain patterns of sensory information as certain things. Its even suggested by some psychiatric researchers that infants experience hallucinations during this process of sensory integration.

Then if your brain changed the way information was being processed you would be receiving sensory information in a way the brain is not used to, so it wouldn't be able to understand it and might not be able to tell the difference between a bunch of different lights glaring together in a certain way that makes patterns and something that's really there.

Life experience also factors into this. A lot of us on the spectrum will occassionally here noises and mistake them for voices. Someone who hasn't been experiencing this their whole life and suddenly the way the brain processes sound changes profoundly might interpret this as a "voice in their head".

This also fits the dopamine hypothesis of schizophrenia. Dopaminergic drugs are prescribed for ADHD and sometimes AS, because they help in paying attention. If you think about it paying attention necessarily involves temporarily adjusting the way the brain processes sensory input. Too much dopamine and the brain's processing of information would be out of control, and the brain wouldn't have time to integrate the information in a way it can understand, causing hallucinations and delusions.

If this is correct doctors should be careful with prescribing dopaminergic drugs. Starting with too strong a drug or too high a dose could lead the patient to develop psychosis over time because while it would make attention easier it would also make it more difficult for the brain to correctly integrate sensory experiences. Considering that ADHD involves too little dopamine and people with ADHD sometimes develop schizophrenia it could be that the strength of the prescription drugs correlates with schizophrenia risk. I'd be interested to see if there are any studies on this. It could also be that the relative level of dopamine rather than absolute level is the key factor. One person with a high level of dopamine will be used to these changes enough to stay sane. One person with a low level who suddenly has the former person's level might experience psychosis.



violetchild
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08 Nov 2010, 4:55 am

It is possible to have two completely different illnesses (no matter what any medical people say).. to say it isnt possible, is the same as telling someone with a broken wrist, that it isnt possible to trip and fall over and end up with a broken leg on top.

My father is clearly an Aspie (had to go to special schools etc due to this) ... and when he was in his late 40s? he developed schizophrenia. To me they are very distinct illneses but yeah sure they do share some symptoms that are the same.

With the schizophrenia.. he basically looses his normal mind (well what is normal for him).. he starts halluncinating (eg seeing cameras come out of peoples eyes), believes the government is after him trying to kill him.. etc etc etc. The schizophrenia will make his behaviour become very erratic and different to normal etc. (He'll stop talking to those he usually talks to and becames extremely paranoid).

Anyone very familiar in these two illnesses, will be able to tell them apart. (make sure any asperger's diagnoses is given by an actual expert in it.. and not just a normal psychriastrist who doesnt specialise in this field).



LeeAnderson
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08 Nov 2010, 6:51 am

I have heard voices before. I have only ever been diagnosed as having Asperger's. But every once in a while, out of nowhere, I'll hear voices or get slight hallucinations. Thought that might be of interest.



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29 Dec 2010, 7:49 am

hi, I live in Sweden so if my english is not the best that´s the reason..:-)

Have a daughter age 16 who is diagnosed asperger, adhd and bipolar but I still have my doubts about her diagnoses. It´s much more difficult to get the proper diagnoses here in Sweden beaucase there is a common attitude that´s against medicin and early diagnoses on children in particular. So if you want the right help you have to fight til you drop...

First she got her adhd and got very aggressive on adhd medication and ended up i mania every evening/night. Then she got her asperger diagnose and after that I had to fight for her bipolar diagnose (I read books about different states until my eyes were bleeding), one thing I knew for sure was that she had mania and that had to be stopped. Lots of years later know she´s on seroquel 800 mg a day and that has really improved her. But still she gets very aggresive now and then and have a very high anxiety level. So I believe her to be szhizoaffective as well because she´s on a medication typical for schizoaffective/schizophrenia. Lithium for exampel did not work on her, she got agressive. And she only gets into mania - never depression. And that is also typical for schizoaffective - either to be the mania type OR the depressive type.
One thing that I wonder is - does a medication put a stop for schizophrenia to develop or does develop anyway??



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30 Dec 2010, 7:02 pm

Evho wrote:
One thing that I wonder is - does a medication put a stop for schizophrenia to develop or does develop anyway??


Nothing will prevent the development of schizophrenia and all available drugs are to control the symptoms of schizophrenia. Controlling the symptoms - agitation, aggression, upsetting thoughts - are sometimes as much for the benefit of other people as for the benefit of the person with schizophrenia. At their best, drugs are a helpful means of taming the difficult symptoms of schizophrenia. At their worst, drugs are a chemical cosh to sedate the person with schizophrenia into a docile and controllable state.

Schizophrenia is not a constant state (sometimes it is bad, sometimes it may not be obvious), but it will always be present in some form. Appropriate drugs can help to make life pleasant.



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30 Dec 2010, 7:27 pm

DGuru wrote:
If this is correct doctors should be careful with prescribing dopaminergic drugs. Starting with too strong a drug or too high a dose could lead the patient to develop psychosis over time because while it would make attention easier it would also make it more difficult for the brain to correctly integrate sensory experiences. Considering that ADHD involves too little dopamine and people with ADHD sometimes develop schizophrenia it could be that the strength of the prescription drugs correlates with schizophrenia risk. I'd be interested to see if there are any studies on this. It could also be that the relative level of dopamine rather than absolute level is the key factor. One person with a high level of dopamine will be used to these changes enough to stay sane. One person with a low level who suddenly has the former person's level might experience psychosis.

While I agree that too much dopamine can cause problems (it gives me hypertension and many other problems) I've never heard of any person with ADHD developing psychosis.
Some people really do need medication to function. Doctor's will always start people on the lowest possible dose.
Anyway, before I was on medication I would see demons everywhere or mythological creatures. It's hard to know what is an over active imagination or a hallucination.
Although I do have very loud auditory hallucinations and visual hallucinations before a temporal lobe seizure. I think the medication may have aggravated it.


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05 Apr 2011, 10:28 am

*subscribes*