Persistent differences in autistic symptom severity after one year in individuals at clinical high risk of psychosis and with first-episode psychosis

Background

Autistic symptoms have been shown to influence functional outcomes and prognosis not only in schizophrenia but also in individuals at clinical high-risk of psychosis (CHR-P) and those experiencing their first-episode psychosis (FEP). However, it remains unclear whether these symptoms reflect enduring traits that persist over time or whether they are states that can improve with treatment in CHR-P and FEP. This study aimed to investigate the one-year trajectory of autistic symptoms in individuals at CHR-P and with FEP.

Methods

A total of 59 participants who completed a one-year follow-up [CHR-P, n = 34; FEP, n = 25] were categorized into high and low autistic symptom groups based on baseline symptom severity, as assessed by the Positive and Negative Syndrome Scale Autism Severity Score. We then examined changes in psychiatric symptoms, including autistic symptoms, as well as global and cognitive function, between the two groups over one year.

Results

After one year of follow-up, psychiatric symptoms other than autistic symptoms, as well as global and cognitive function, improved in both groups. The significant differences in these symptoms and functions at baseline disappeared after one year. However, while autism symptoms demonstrated some improvement from baseline, the significant differences between the high and low autistic symptom groups persisted.

Conclusion

These findings suggest that autistic symptoms may exhibit both transient state and enduring traits in individuals at CHR-P and with FEP. Further studies with larger sample sizes and follow-up periods exceeding one year are needed to validate the long-term stability of these symptoms.