Authors: Verity Chester, Samuel Tromans, Chaya Kapugama, Ignatius Gunaratna, Peter Langdon, Regi T Alexander
Purpose
The diagnosis of psychosis in individuals with autism spectrum disorder poses a unique clinical challenge. The presence of intellectual disability further complicates the diagnostic picture. Reliable and timely diagnosis of psychosis in such individuals minimizes the duration of untreated psychotic symptoms and the subsequent impact on the quality of life of the patients concerned.
Design/methodology/approach
The authors present four patients with psychosis, autism spectrum disorder and intellectual disability, who have received care within forensic mental health and intellectual disability settings. These examples demonstrate the interaction between these conditions, as well as issues pertaining to diagnosis and management.
Findings
In all four patients, sustained use of antipsychotic medication was objectively associated with an improvement in psychotic symptoms and quality of life. In instances where autistic phenomena were accentuated upon development of psychosis, such features returned to the baseline levels evident prior to the onset of psychosis.
Practical implications
The discussion and related case examples could improve understanding of the possibility of psychosis in individuals with autism spectrum disorder and intellectual disability, and increase awareness of this diagnostic possibility among healthcare professionals.
Originality/value
This is the first published case series illustrating the challenges of diagnosing psychosis in individuals with autism spectrum disorder and intellectual disability.