Psychosis in adults with autism spectrum disorder and attention deficit hyperactivity disorder at acute psychiatric wards

Background and objectives Psychotic symptoms, such as delusions and hallucinations, in autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) have been increasingly reported in recent literature. In the present study, the prevalence and duration of psychotic symptoms, comorbid psychotic disorders, and clinical characteristics of adults with ASD and ADHD were retrospectively examined via a chart review. Methods The participants were 98 adults (mean age, 28.5 years; 72 men) who were admitted to the psychiatric emergency wards of Showa University Karasuyama Hospital, and who were diagnosed with ASD and/or ADHD according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria. Results Among 69 individuals with ASD, 21 (30.4%) experienced psychotic symptoms, and among 29 individuals with ADHD, 5 (17.2%) exhibited psychosis. While all psychotic symptoms were classified as transient and none had comorbidity with schizophrenia and other psychotic disorders in adults with ADHD, 38.1% of psychosis was classified as prolonged and 10.3% had comorbidity with schizophrenia and other psychotic disorders in adults with ASD. Conclusion The results showed that a significant proportion of adults with ASD and ADHD experience psychosis during their course of illness, and provide evidence for the existence of a shared etiology between neurodevelopmental and psychotic disorders. (AU)

Spontaneous theory of mind in adults with attention-deficit/hyperactivity disorder.

Spontaneous theory of mind (ToM) is an unconscious and automatic understanding of others' mental states. Recently, individuals with attention-deficit hyperactivity disorder (ADHD) have been shown to have social and communication difficulties, and ToM in ADHD has come under scrutiny. Although some studies have employed explicit ToM tasks to this end with contradictory results, none, to our knowledge, has investigated spontaneous ToM in individuals with ADHD. Therefore, we performed this study to examine implicit mentalizing in adults with ADHD using the anticipatory-looking paradigm designed by Senju et al. (2009) with a sample of 24 adults with ADHD and 18 neurotypical adults. The total fixation times to three areas of interest, i.e., the actor and the false-belief congruent and incongruent sides of the scene were measured. We found that neither group showed looking bias toward either the false-belief congruent or incongruent side. We interpret that this similar gaze pattern and the absence of looking bias to the false-belief incongruent side in both groups is indicative of intact implicit ToM in adults with ADHD. Adults with ADHD looked significantly less at the actor than did neurotypical individuals, possibly due to inattention and further experimental modifications should be considered.