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

NCT02800681 | Completed

• 1 other identifier: E-61120-06
• Study Type: observational
• Target: 59
• Locations: 1 country
• Sites: 2

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.

Conditions

Asperger Syndrome; Autism Spectrum Disorder; Schizotypal Personality Disorder

Keywords

Asperger Syndrome; Autism Spectrum Disorder; Schizotypal disorder; Schizophrenia Spectrum Disorder; Psychopathology; Examination of Anomalous Self Disorder; Autism Diagnostic Observation Schedule; Phenomenology; Differential diagnosis; Young Adult

Outcome Measures

Primary Outcomes (2)

• Level of altered experiences

  Total score, Examination of Anomalous Self Experience (EASE)

  Assessed within 1,5 years from study inclusion start

• Pattern of most occurring altered experiences

  Pattern of individual items, Examination of Anomalous Self Experience (EASE)

  Assessed within 1,5 years from study inclusion start

Secondary Outcomes (5)

• Autism Spectrum symptom load

  Assessed within 1,5 years from study inclusion start

• Schizophrenia Spectrum symptom load

  Assessed within 1,5 years from study inclusion start

• Self-reported Autism Spectrum symptom load

  Assessed within 1,5 years from study inclusion start

• Self-reported Schizotypia symptom load

  Assessed within 1,5 years from study inclusion start

• Self-reported well-being

  Assessed within 1,5 years from study inclusion start

Other Outcomes (2)

• Global severity of symptoms assessment

  Assessed within 1,5 years from study inclusion start

• Global functioning assessment

  Assessed within 1,5 years from study inclusion start

Study Arms (2)

Asperger syndrome

1. Expert panel evaluation for identification of participants with typical symptoms 2. Semi-structured psychopathological interviews for general psychopathology, psychopathology within the schizophrenia spectrum, and psychopathology within the autism spectrum 3. Self-administered rating scales for assessment of autistic traits, schizotypal personality and subjective psychological well-being 4. Other general interviewer ratings for assessing functioning and severity of psychopathology

Other: Expert panel evaluation; Other: Semi-structured psychopathological interviews; Other: Self-administered rating scales; Other: Other general interviewer ratings

Schizotypal disorder

1. Expert panel evaluation for identification of participants with typical symptoms 2. Semi-structured psychopathological interviews for general psychopathology, psychopathology within the schizophrenia spectrum, and psychopathology within the autism spectrum 3. Self-administered rating scales for assessment of autistic traits, schizotypal personality and subjective psychological well-being 4. Other general interviewer ratings for assessing functioning and severity of psychopathology

Other: Expert panel evaluation; Other: Semi-structured psychopathological interviews; Other: Self-administered rating scales; Other: Other general interviewer ratings

Interventions

Expert panel evaluation OTHER

From the medical records, described social and psychiatric history and observed psychiatric symptoms will be summarized and presented to two senior psychiatric consultants. The panels evaluation ensures the identification of subjects with typical symptoms, according to a best estimate clinical consensus. The panel divides the participants into 4 groups: 'participant with symptoms typical of AS', 'participant with symptoms typical of SD', 'participant with inconclusive/non typical symptoms' and 'non eligible participant'.

Asperger syndrome; Schizotypal disorder

Semi-structured psychopathological interviews OTHER

Included participants are asked for a detailed social and developmental history and interviewed with 3 semi-structured interviews: 1. Schedules for Assessment in Neuropsychiatry (SCAN); Covering psychopathology and behaviour associated with the major psychiatric disorders. 2. Autism Diagnostic Observation Schedule (ADOS), module 4; An assessment to identify symptoms within the autism spectrum. 3. Examination of anomalous self-experience (EASE); A checklist for exploration of experiential anomalies. The Ph.D.-student will obtain social and developmental history and carry out SCAN and EASE interviews. ADOS will be carried out by a consultant psychologist at The Danish Autism Centre.

Asperger syndrome; Schizotypal disorder

Self-administered rating scales OTHER

1.The Autism Quotient (AQ), a 50 question scale, for the assessment of autistic traits, 2. The Schizotypal Personality Questionnaire (SPQ), a 74 item scale, for the assessment of schizotypal personality, 3. The WHO-5 Well-Being Index (WHO-5), a 5 item scale, for the assessment of subjective psychological well-being.

Asperger syndrome; Schizotypal disorder

Other general interviewer ratings OTHER

1\. Global Assessment of Functioning (GAF), a numeric scale (1 through 100) for assessing social, occupational, and psychological functioning, 2. The Clinical Global Impressions scale (CGI-Severity), an assessment of the clinician's global view of the patient's severity of psychopathology on a 7 point scale.

Asperger syndrome; Schizotypal disorder

Eligibility Criteria

• Age: 18 Years - 30 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)
• Sampling Method: Non-Probability Sample

Study Population

Only already diagnosed participants are recruited, from specialised units. This is essential, as inclusion of participants with typical symptoms, reduces confounding of the results by diagnostic uncertainty. Participants with SD will be recruited from OPUS-teams (a specialized treatment program for patients with first episode of schizophrenia spectrum disorder), within the Mental Health Services in the Capitol Region of Denmark, and participants with AS from The Danish Autism Centre (a non-profit organization for people with ASD).

You may qualify if:

• ICD-10 diagnosis of Asperger syndrome (F84.5) or infantile autism (F84.0) with normal IQ and no language impairments or schizotypal disorder (F21)
• Age 18-30 (both inclusive)

You may not qualify if:

• Known non-verbal IQ \< 80 (verbal IQ \< 70) or an educational level corresponding to \<9 years of primary education
• Diagnosed with both Schizophrenia Spectrum Disorder and Autism Spectrum Disorder
• Psychotic symptoms (\< 1 day of duration, lifetime)
• Severe physical illness (life-limiting, or limiting interview capacity)
• Organic brain disorder (corresponding to ICD-10 chapter F00-09)
• Active heavy alcohol or substance abuse (corresponding to ICD-10 definitions)
• Not fluent in the Danish language
• Forensic patients

Sponsors & Collaborators

• Mental Health Centre Copenhagen, Bispebjerg and Frederiksberg Hospital: lead
• The Danish Autism Centre: collaborator

Study Sites (2)

Mental Health Centre Ballerup, Mental Health Services, The Capitol Region, Copenhagen

Ballerup Municipality, Copenhagen, 2750, Denmark

Location

The Danish Autism Centre

Herlev, 2730, Denmark

Location

MeSH Terms

Conditions

Asperger Syndrome; Autism Spectrum Disorder; Schizotypal Personality Disorder

Condition Hierarchy (Ancestors)

Child Development Disorders, Pervasive; Neurodevelopmental Disorders; Mental Disorders; Personality Disorders

Study Officials

• Sidse Arnfred, MD, dr.med.

  Mental Health Services, Region Zealand, Denmark

  STUDY CHAIR

• Peter Handest, MD, Ph.d.

  Mental Health Services, the Capitol Region, Denmark

  STUDY CHAIR

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: MD, PhD-student

Study Record Dates

• First Submitted: May 24, 2016
• First Posted: June 15, 2016
• Study Start: June 1, 2016
• Primary Completion: December 1, 2018
• Study Completion: December 1, 2018
• Last Updated: March 10, 2020

Record last verified: 2020-03

Data Sharing

• IPD Sharing: Will not share

Locations

DK (2)