AUTISM is strongly associated with the psychosis spectrum, both at trait and diagnostic levels, a new systematic review and meta-analysis has found.1
However, it was previously unknown whether the link was due to methodological issues.
For example, it could have arisen from people with autism misinterpreting psychosis questionnaires or clinicians having difficulty distinguishing between the two conditions.
Experiencing One Condition Leads to Higher Odds of the Other
Researchers included studies in the review assessing autism and psychosis-spectrum measurements, as well as co-morbidity and quantitative data.
Almost seven million participants were included in analysis.
A strong association was found between autism and the psychosis spectrum, at both trait and diagnostic levels.
People with one condition had approximately seven times higher odds of being diagnosed with the other.
They also scored substantially higher on trait measures of the other condition.
Negative psychosis-spectrum traits, meaning a lessening or absence of normal behaviours and functions related to motivation, interest, or expression,2 were most strongly tied to autistic traits.
Whereas, measures of positive traits, relating to the presence of unusual traits or experiences,3 showed weaker correlations.
Researchers pointed to an overlap in expression and measurement to explain the variable symptomatic links.
High Heterogeneity and Inconsistent Reporting
Authors warned, however, of high heterogeneity and inconsistent reporting among included studies.
Further research, they reported, should aim to remedy these issues to better understand the crossover between autism and psychosis.
References
1 Miles MR, Golm D, Palmer-Cooper E. The association between autism and psychosis and the tools used to measure it: an updated systematic review and meta-analysis. Br J Clin Psychol. 2026;65(2):374–400.
2 Correll CU, Schooler NR. Negative symptoms in schizophrenia: a review and clinical guide for recognition, assessment, and treatment. Neuropsychiatr Dis Treat. 2020;16:519–534.
3 Northwell Health. Understanding “positive” and “negative” psychosis symptoms. 2026. Available at: https://www.northwell.edu/behavioral-health/programs-services/early-treatment-program/blog/understanding-positive-and-negative-psychosis-symptoms#:~:text=Positive%20symptoms%20can%20include%20experiences,dream%20and%20what%20is%20reality.. Last accessed: 1 July 2026.
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