Clinical Trial: Psychopathological Differences Between Asperger Syndrome and Schizotypal Disorder in an Adult Sample

Study Status: Recruiting
Recruit Status: Recruiting
Study Type: Observational

Official Title: Psychopathological Differences Between Asperger Syndrome/Normal IQ, no Language Impairment Autism Spectrum Disorder and Schizotypal Disorder in an Adult Sample

Brief Summary:

The purpose of this study is to identify psychopathology (psychiatric symptoms) that can differentiate between Schizotypal Disorder (SD) and Asperger Syndrome (normal IQ, no language impairment Autism Spectrum Disorder) (AS) in young adults.

With our present knowledge, the differentiation between AS and SD can be difficult, as they both present with social difficulties, odd (but not psychotic) behaviour, and a 'feeling of not being as everyone else'. Studies suggest that adults with AS symptoms are either overlooked, or diagnosed within the schizophrenia spectrum in Adult Psychiatry.

A 'correct' diagnosis is important, as it is the first step towards the most optimal plan, treatment and rehabilitation for the patient. The only way to diagnose psychiatric illness is the description of present psychopathology.

To identify symptoms that can differentiate between the two disorders, we will use semi-structured interviews to explore present psychopathology in young adults with typical symptoms of SD and AS respectively, with special focus on presence of alterations in self-experience. Alterations in self-experience are typical for the schizophrenia spectrum, and are therefore not thought to be equally present in AS and SD.

The hypotheses are that the total level of altered experiences is higher in SD, than in AS, and with a different pattern of altered experiences in SD than in AS. If the hypotheses are true, an examination of altered self-experience will be valuable to aid clinical differentiation between the two disorders.


Detailed Summary:

Background: SD is a non-psychotic disorder within the Schizophrenia Spectrum (in ICD-10), and has a prevalence of 3.9 % in adult samples. Autism Spectrum Disorder (ASD), a pervasive developmental disorder (including AS), has a prevalence of 1 %.

SD is typically diagnosed in young adults, whereas AS typically is diagnosed in childhood. Sometimes however, the AS symptoms first become invalidating in young adulthood, where social demands exceed the individual's capacity. In these cases, patients with symptoms corresponding to AS, might first be diagnosed as young adults. In Adult Psychiatry though, experience with diagnosing ASD is scarce, and studies suggest that adult patients presenting with symptoms corresponding to AS, are either overlooked, or diagnosed within the schizophrenia spectrum.

Psychiatric diagnosis: Description of present psychopathology is the only way to diagnose psychiatric illness. An accurate diagnosis is crucial for a relevant treatment and rehabilitation plan for the individual patient, as the diagnosis guides the help and support offered. Further, to properly guide neuro-psychiatric research, high diagnostic accuracy is imperative. This study will refer to the diagnostic criteria defined in ICD-10, when including participants, as ICD-10 is the principal diagnostic system in Denmark.

Altered self-experience: Alterations in self-experience are considered highly specific for the schizophrenia spectrum, and are therefore not thought to be present in equal amounts and/or distribution in ASD. If this is true, an examination of anomalous self-experiences would be valuable to aid clinical differentiation between SD and AS. For patients with altered self-experience, the experience of him-/herself as a subject is disturbed. This means that the form and structure
Sponsor: Mental Health Services in the Capital Region, Denmark

Current Primary Outcome:

  • Level of altered experiences [ Time Frame: Assessed within 1,5 years from study inclusion start ]
    Total score, Examination of Anomalous Self Experience (EASE)
  • Pattern of most occurring altered experiences [ Time Frame: Assessed within 1,5 years from study inclusion start ]
    Pattern of individual items, Examination of Anomalous Self Experience (EASE)


Original Primary Outcome: Same as current

Current Secondary Outcome:

  • Autism Spectrum symptom load [ Time Frame: Assessed within 1,5 years from study inclusion start ]
    Total score, Autism Diagnostic Observation Schedule (ADOS), module 4
  • Schizophrenia Spectrum symptom load [ Time Frame: Assessed within 1,5 years from study inclusion start ]
    Score, Schedules for Assessment in Neuropsychiatry (SCAN)
  • Self-reported Autism Spectrum symptom load [ Time Frame: Assessed within 1,5 years from study inclusion start ]
    Score, The Autism Quotient (AQ)
  • Self-reported Schizotypia symptom load [ Time Frame: Assessed within 1,5 years from study inclusion start ]
    Score, Schizotypal Personality Questionnaire (SPQ)
  • Self-reported well-being [ Time Frame: Assessed within 1,5 years from study inclusion start ]
    Score, World Health Organization Well-Being Index (WHO-5)


Original Secondary Outcome: Same as current

Information By: Mental Health Services in the Capital Region, Denmark

Dates:
Date Received: May 24, 2016
Date Started: June 2016
Date Completion: September 2018
Last Updated: June 17, 2016
Last Verified: June 2016