Autism And Schizophrenia Linked! Full Version

(this piece originally appeared in three parts in early May 2008)

Link Found Between Autism and Schizophrenia!

...in 1911.

Yes folks, all that news that has been screaming down the information superhighway from this "ground-breaking" study by Dr. Julie Daniels, based on Swedish mental health records is 97 years old.

Dr. Eugen Bleuler said he is sorry he couldn't get it to you sooner, but the Internet wasn't around in 1911 and he has spent the past 69 years a bit preoccupied with other matters.  Like being dead.

Here is some information taken from the standard press release which seems to have gone around the globe.

The study was most notable for its size, incorporating data on 1,237 children born in Sweden between 1977 and 2003 who had been diagnosed with autism before the age of 10, as well as about 31,000 controls...

...Both mothers and fathers with schizophrenia were roughly twice as likely to have a child with autism, the study found.

OK: here are some questions for you:

Question: Who first used the term “Autism” in psychiatric literature:
Answer:  Dr. Eugen Bleuler

Question: Who was Dr. Eugen Bleuler?
Answer: He was a psychologist, a psychiatrist, a psychotherapist and researcher (and an overachiever, apparently). He also just happens to have been the dude who coined the term “Schizophrenia” and defined it in 1911

 
Question: How did Dr. Bleuler define schizophrena?
Answer: The simple version was using the The 4 “A”s, One of which was "Autism" (see more below)

Now raise hands: Who here thinks –in light of this Bleuler information -that it is a total co-incidence that parents of Autistic children may have been diagnosed as schizophrenic?

<looks around>

Me neither.

Are Autism and Schizophrenia the same disorder? No. they diverged. i.e. Autism (as we currently understand (or not) the term) was officially defined in the 1940s. Now it appears that maybe they are converging again to come full circle. Or are they?

I wondered about this, so I dug a little deeper.

Dr. Eugen Bleuler (not to be confused with Dr. Manfred Bleuler, his son) redefined as "schizophrenia" a  condition that had previously been called  "dementia praecox" using his four "A"s:

• Autism (i.e. preoccupation with internal stimuli)
• Inappropriate Affect (external manifestations of mood)
• Associational Disturbances (Illogical or fragmented thought processes)
• Ambivalence (simultaneous, contradictory thinking)

Now that is interesting, isn’t it? 

You know, I always wondered how -with all the available Latin terms out there- both Dr Kanner in the US and Dr Asperger in Vienna managed to simultaenously coin the phrase "autism" for what are now known as "Kanners Autism" (aka "Classic Autism" and various other names) and Asperger's Syndrome.  The Autism history books make it sound like some kind of Divine Inspiration, but it makes more sense to me now to think that they must both have been familiar with Dr Bleuler's work. They probably learned about it in shrink school.

So yes “Autism” was -and probably is- considered a hallmark symptom of simple schizophrenia. There were other hallmark symptoms of schizophrenia too, like thought disturbances and hearing voices, which people with true Autism don't have.

But this is 2008, right?  We have known for years that Autism and Schizophrenia are very different animals, yeah?  One is a developmental disorder, and the other is a "mental illness" which -with modern imaging techniques is starting to look like it is actually a degenerative condition of the brain (many brains of schizophrenics have a distinctive pattern on MRI).  People with Autism (generally) learn and progress, people with schizophrenia -generally- regress.

So when I saw that study by Dr. Daniels, I thought maybe we have come full circle and she has made some kind of breakthrough to unify Bleuler’s work with Kanner’s and/or Asperger’s. Either that or it was totally backwards facing.

I mean like 60 years kind of backwards.

I decided to do a little digging to see if I could find out which it might be.

The study was an American analysis of Swedish data, which took children diagnosed with Autism between 1977 and 2003 and then looked at their parents for diagnoses of mental disorder Many of the parents –particular the mothers, had diagnoses of depression, “neuroses”, or personality disorders. However a statistically significant number of these parents –both genders- had been diagnosed as schizophrenic.

Now Dr. Daniels and her team are heralding this “discovery” as some kind of a huge breakthrough and an opportunity to prevent  (how? By sterilizing all schizophrenics?) or treat Autism. However, knowing what I now know about the relationship -diagnostically speaking- between Autism and Schizophrenia, I wonder if there is a much more simple explanation? I wonder how many of the parents were misdiagnosed as schizophrenic when in fact they had Asperger’s Syndrome or some other high-function Autistic Spectrum disorder, -which was not an official diagnosis way back in the way-backs?

I know some people are reading this and shaking their heads, thinking that OSM has finally lost her last marble. But bear with me here. I did a quite bit of research in this and I don’t think it is as outlandish a theory as many might think. I’ll outline it for you, and you can make your own decision.

Part II

I figured the place to start was at the beginning and have a look into how these respective diagnoses originated as official diagnoses as opposed to theory and research. Of course, there have been Schizophrenia and Autism long before there was psychiatric medicine, but I think –especially as regards this particular study and these particular diagnoses- that the timing is key. As is the location. The study was preformed in the US. However, the patients, doctors and the diagnoses were all Swedish. Do the Swedes use the same diagnosing standards as the Americans? No. They use a different manual. (The ICD as opposed to the DSM in the States) That was accounted for in the study –kinda - although they did not take into account *when* the parents' diagnoses were made. Which I think is key. Also I wonder if there was a human factor at play here that may have been overlooked? Numbers are seldom purely random if humans are involved.

What do I mean by a human factor? Well, there are more than one. For a start let’s look at human doctors: A doctor goes to med school and learns whatever is in vogue to teach at the time. Later he (this is Europe 30/40 and more years ago. It is probably safe to assume the majority of shrinks were male) goes into practice and may or may not keep current with the research. He will get his updated diagnostic reference guide every 10 years and may or may not use it. Say a doctor practices for 40 years in his career, there will be at least 3 or four changes to the diagnostic manual in that time: What will a doctor gravitate towards? What he learned in school, or what is around now? I think many –being only human will go back to what they learned in school. I think this explains in part why these manuals take so long to evolve.

An old doctor diagnosing one of the older parents from earlier in the study who may have been diagnosed as a child, could conceivably have been applying 19th century psychiatry, which has now ended up in this 21st century study.  Think about it

And the manuals do take a long time to evolve. “Dementia praecox” was debunked as a diagnosis in 1911 –replaced by schizophrenia. However the term still appears in the manuals as late as 1968! Asperger’s Syndrome was first defined in 1944, but it first appeared in the US DSM Manual in 1994. Fifty years later! So what of all those Aspies who were born in the States in the intervening 50 years? Food for thought, eh?

Indeed, what of the Auties and Aspies born in Sweden from the 1940s to the 1980s? We know they started to get identified in 1977 (whop-de-do!), but what of their parents?

Now –just for the record and to keep things simple: I am not disputing the Autism diagnoses of the children in the group study. Let’s assume they are sound. I am most curious about the diagnoses of the parents, because that is where I think the timing is most suspect.

The current diagnostic standard in use in Europe is the ICD-10. There have been ICDs 1 through 9 also. The manuals covering the period in which we are interested; if we assume the parents were between 20 and 40 when the kids were born, and could have been diagnosed anytime in their lifetimes, we are looking at a big window from 1937ish to the late 1980s or beyond (not taking the doctor's age and education into account).

 
So what tools were in use in Sweden in that timeframe?
The ICD-5  was introduced in 1939
The ICD-6 - 1949
The ICD-7 - 1958
The  ICD-8A - 1968
The ICD-9 -1979 (probably not used for most of the parents)
The ICD-10 1999 (probably not used for the parents)

I found ICD numbers 7-10 online. I am kind of glad I couldn’t find #5 or #6, because I was kind of shocked by some of the stuff the later versions contained. Now, I am used to reading published papers and research on conditions that I find on the Internet. I am used to the reading the current thinking on each subject. What I did not expect (and this explains a lot, considering the situation in which I currently find myself) was for the *official diagnostic manual* to lag so far behind the research across the board. If the diagnoses were made by the book, then there are definitely some problems with Dr. Daniels study.

Schizophrenia was put in the book sometime in the early part of the last century (I don’t know exactly when). Autism didn’t make it in until the 1980s. Asperger’s was even farther behind that. And -back to my “human” point- we have no idea when the diagnosing doctors were trained.

So let’s take a little look at that data with new eyes: This time with a view to the historical thinking on mental health. You get a different picture.

I didn’t have access to the ICD 6, but I reckon that it is safe to assume that it is even more outmoded than  #7 and #8. Autism was not defined as a separate disorder in either of them, but simple schizophrenia is (remember the 4 “A”?).

Interesting...

Also interesting are some of the other treasures of outmoded medical thinking to be unearthed in these diagnostic manuals. Here are some lovelies taken from straight from the The ICD- 7, the official diagnostic guide in use in Europe during the 1960s.

325 Mental deficiency

325.0 Idiocy
325.1 Imbecility
325.2 Moron
325.3 Borderline intelligence
325.4 Mongolism

Congenital malformations (750-759)

750 Monstrosity

So "Idiocy" and “Imbecility” were official diagnoses as recently as the 1968. Nice! So was "Malingering", BTW (795.1) and "nervousness" (790.0).   

But Autism was not.

So any of our parents who may have been Autistic and were diagnosed -in the State hospitals, people- in Sweden did not have a place in the book. The closest fit for them was probably one of these:

Psychoses (300-309)

300 Schizophrenic disorders (dementia praecox)

300.0 Simple type
300.1 Hebephrenic type
300.2 Catatonic type
300.3 Paranoid type
300.4 Acute schizophrenic reaction
300.5 Latent schizophrenic
300.6 Schizo-affective psychosis
300.7 Other and unspecified

 

OK so that maybe covers some of the older parents. But the manual was re-issued about every 10 years, right? Strides were made in the sixties and the benefits reaped in the 70’s right?

Well… yes... Some were.

However, the currently-no-longer-used term "Simple Schizophrenia” (4 “A”s) was still in use -inconveniently code-changed to 295.0. And no! Autism is not there. However "Involutional melancholia " (296.0) is! As is "Hysterical neurosis" (300.1) "Homosexuality" (302.0) (I swear I am not making this up!)  and this lot of lovelies which I just put in wholesale (who -in the name of God can physically affect their endocrine system? Or their “organs of special sense” Wha…?)

305 Physical disorders of presumably psychogenic origin

• 305.0 Skin
• 305.1 Musculoskeletal
• 305.2 Respiratory
• 305.3 Cardiovascular
• 305.4 Hemic and lymphatic
• 305.5 Gastrointestinal     
• 305.6 Genitourinary
• 305.7 Endocrine
• 305.8 Organs of special sense
• 305.9 Other

306 Special symptoms not elsewhere classified

• 306.0 Stammering and stuttering
• 306.1 Specific learning disturbance
• 306.2 Tics
• 306.3 Other psychomotor disorders
• 306.4 Specific disorders of sleep
• 306.5 Feeding disturbance
• 306.6 Enuresis
• 306.7 Encopresis
• 306.8 Cephalalgia
• 306.9 Other

"Malingering" still there in the 70s, BTW, now code 796.1

You know, all this would be funny, but I keep thinking of the real people and the real lives who were affected by this bullshit, and I just want to weep for them.

So where are we up to? Ah yes. We are coming into the 1980s. The parental diagnoses are probably tapering off, and the kids are being diagnosed. The ICD-9 was released in 1979. Maybe the ICD-9 will save us!

Good news! Infantile Autism (Kanner’s Autism) finally made it into the manual! It is 299.0 and it explicitly excludes schizophrenic syndrome of childhood (299.9)

Bad news: many of our parents would have been adults or teens in the 1980s (remember the first kids in the study were born in 1977) and would probably therefore already have diagnosis, or would not be considered for this diagnosis. What about Asperger’s syndrome? Is that in the ICD-9?

Actually, it is! …but it is not terribly obvious. It made it in as an AKA under the new category: “Other specified pervasive developmental disorders”:

ICD-9-CM Diagnosis 299.8

Other specified pervasive developmental disorders

· A childhood disorder predominately affecting boys and similar to autism (AUTISTIC DISORDER). It is characterized by severe, sustained, clinically significant impairment of social interaction, and restricted repetitive and stereotyped patterns of behavior. In contrast to autism, there are no clinically significant delays in language or cognitive development. (From DSM-IV)

· 299.8 is a non-specific code that cannot be used to specify a diagnosis (OSM Note: I took this from a 2008 version of the ICD-9 which is still in use in the US for billing and coding purposes. I think we can assume it was a valid code back in the 80s)

 

299.8 also known as:

· Asperger's disorder

· Atypical childhood psychosis

· Borderline psychosis of childhood

299.8 excludes:

· simple stereotypes without psychotic disturbance (307.3)

And in the ICD-9 there are now six  (6) different categories for simple schizophrenia (295.00-295.05)

So, if you are a doctor in Sweden looking to diagnose an adult, and these were your choices, which might you pick? One of the schizophrenias? Yeah. Me too. It is and established diagnosis and six times more likely than this new, unknown shit, right? Or maybe you would go with a simpler option like neurosis, a personality disorder or depression.

Um-hmmm….

I know some of you are saying that this is all pure and rather fantastical speculation on my part. So I read a few other papers.

Part III

I want to make a few things clear here: I am not claiming that every parent in this study who was diagnosed as schizophrenic was misdiagnosed. I don’t doubt that there could be a correlation between schizophrenia in parents and Autism in their children. However, I am saying that any correlation this study claims is probably not nearly as strong as it suggests. I suspect that it is highly probable given the timing of the study and the diagnostic tools available at the time, that at least some of the parents may in fact have Autistic Spectrum Disorders (ASDs) as opposed to true schizophrenia.

Here is the core problem as I see it: Dr Daniels is an epidemiologist. Nothing wrong with that at all.  Here is MedicineNet’s definition of the same.

Epidemiologist: A person engaged in epidemiology (not confined to epidemics). Epidemiologists include people with an M.D., Ph.D., D.P.H. (Doctor of Public Health), M.P.H. (Master of Public Health), R.N., and a number of other degrees.

So I suppose Epidemiologists are kind of like the actuaries of the medical world.  They are essentially number crunchers, not diagnosticians. They assess risk. They are much needed to track progression and potential  distribution patterns of transmissible diseases such as flu and SARS in large populations. Their science works very well for this kind of information, because most of these diseases tracked are easily identifiable, and there are definite tests for them.

However applying the principles of epidemiology to something like the Swedish data is fraught with error potential. I  know the control group was huge, but the subject group was tiny in epidemiological terms.  Especially when you consider the timeframe and the fact that several of the diagnoses in question did not exist for a lot of the first generation in the study. I think this means that the subject data sample is more than likely tainted, and Dr Daniels, -not being a psychologist, a psychiatrist or a neurologist, is not qualified to determine which of the cases (sorry. I cannot bring myself to say “cohorts”) in each dataset are real, and which may have been misdiagnosed.

Therefore I think Dr Daniels –in attempting to look purely at numbers- overlooked some circumstance of history and climate in Sweden at the time, and failed to establish if the diagnoses which may have been made years ago would hold up today, given the advances made in psychiatry and the changes in thinking which have transpired in the intervening years.

So in my opinion, the whole study was built on a house of cards. I would love to see someone like Dr Fitzgerald (keep going, he appears a bit later) get a hold of it.

...and speaking of him: I promised you some backup for me theory, didn’t I?

Well, I wondered if my hypothesis could be correct: i.e. that some people with Autism could have been misdiagnosed as schizophrenic, especially some years ago, before Autism made it onto the map –so to speak. Even today, the diagnosis of psychological and neurological conditions is a tricky business. The DSM, The manual most commonly used in the USA, comes with it’s own set of disclaimers, of which I am sure the following is only one:

This is also an important limitation of the DSM system.   Patients sharing the same diagnostic label do not necessarily have disturbances that share the same etiology nor would they necessarily respond to the same treatment.   It is therefore critical to understand that the diagnostic terms and categories in the DSM represent only our current knowledge about how symptoms cluster together.   We fully expect that, over the coming decades, the DSM system will be radically reorganized as the etiologies of mental disorders become better understood.

Recently, I found an interesting paper published by a couple of my countrymen (the aforementioned Dr. Fitzgerald)a few years ago. It is a great read about how Asperger’s syndrome can be mistaken or misdiagnosed, and outlines the potential misdiagnoses and the differentials.  Here is a excerpt from that paper.

Schizophrenia is a disorder in which psychotic symptoms (delusions or hallucinations), thought disorder and so called 'negative symptoms' cause social and/or occupational dysfunction over time. Because individuals with Asperger syndrome have  normal cognitive ability, restrictive behaviours and impairments  in social interaction and communication can be misinterpreted as evidence of schizophrenia. People with Asperger syndrome have difficulty understanding the subtleties of social behaviour, but this should not be confused with evidence of psychotic disorder. In a clinical setting, asking individuals with Asperger syndrome whether they hear voices may induce a positive response, and they might concur that they hear voices "when people aren't there", but they may be refering to the voices of people in an adjacent room. Deficiencies in concrete thinking and in understanding how other minds think may cause patients with Asperger syndrome to misinterpret what is said to them, and they might as a result be labelled paranoid. Misinterpreting social contacts can also lead to inappropriate emotional responses, contributing to this impression. Persons with Asperger syndrome sometimes speak their thoughts out loud, which again can be misinterpreted by a psychiatrist. 

That is interesting, isn’t it?    There’s more..

Schizoid personality in childhood (DSM-IV)
Schizoid personality in childhood is defined by solitariness, lack of empathy, emotional detachment, increased sensitivity, at times paranoid ideation, and single-minded pursuit of special interests. All these features are seen in Asperger syndrome, and comorbid issues (depression or behaviour problems in particular) are likewise similar for both conditions. On the basis of evidence presented in Wolff's (1998) discussion of schizoid personality in childhood, we have concluded that there is significant overlap between schizoid personality in childhood and Asperger syndrome. 

Schizotypal personality disorder (DSM–IV)
The DSM–IV diagnosis of schizotypal personality isorder depends on odd beliefs or magical thinking, bizarre fantasies or preoccupations, odd thinking and speech, odd, eccentric or peculiar behaviour and appearance, lack of close friends and social anxiety. All of these criteria can also occur in Asperger syndrome, and Wolff (1998) regards "Asperger syndrome and schizoid/schizotypal disorders as interchangeable terms that identify roughly the same group of children". The conditions do differ in at least three important respects. First, there appears to be an increased rate of develop-ment of schizophrenia in schizotypal personality disorder. Second, schizotypal personality disorder and schizophrenia co-occur in families and appear genetically related. Third, prospective research of children at high risk of schizophrenia (Erlenmeyer-Kimling et al, 2000) suggests that some individuals later diagnosed with schizotypal personality disorder developed without impairments in reciprocal social interaction and communication.

And here is some interesting information that it can and has happened, even here in the States:

"David Mandell, an epidemiologist at the University of Pennsylvania medical school, recently surveyed the adult patients in Norristown State Hospital in Eastern Pennsylvania, nearly all of whom are labeled schizophrenic, and found that about 20 percent of them meet the behavioral criteria for being autistic."

...and a link to the Full Article http://www.post-gazette.com/pg/08037/854963-114.stm

You know, The more I dig into this issue and the more I question it, the more it seems very likely that Julie Daniels study has grossly exaggerated many of the numbers and ratios regarding parental mental illness and autistic children. I believe history will show a more logical conclusion; that parents with an Autistic Spectrum Disorder (ASD) are more likely to have children with an Autistic Spectrum Disorder. I hope it will have a positive effect (negative for Dr. Daniels) of highlighting how misunderstood was Autism in the past, and how many ASD people –now adults- were misdiagnosed as mentally ill in the not-very-distant past.

Now, I gave Julie Daniels a chance. I read her full article on the Pediatrics Website (linked below), I figured somewhere in there she would give some kind of a nod to the fact that she was comparing contemporary apples to historical oranges. The only thing I found is this:

"Diagnostic practices in psychiatry continue to change, and case definitions become more narrow for both adult and childhood psychiatric disorders. Thus, it will be important to  assess the relationships between parental psychiatric disorders and an offspring's risk of autism in other data with more detailed and complete ascertainment of psychiatric disorders for parents and offspring."

No shit, Sherlock.

Well Julie,. Perhaps you should have thought of that before you set a whole generation of parents –who have quite enough on their plates already, -thank you very much –back about 60 years.

Why not just be done with it bring back the term “Refrigerator Mother”?

I just thought of a new name for Dr. Daniel’s study. “Researcher vacuum-sealed researcher reinvents the refrigerator parent”.

Thanks, Julie Daniels. Thanks from the bottom of my arse.

 

References:

Text of the study in Pediatrics magazine  http://pediatrics.aappublications.org/cgi/content/full/121/5/e1357

Diagnosis and differential diagnosis of Asperger’s syndrome by Michael Fitzgerald and Aiden Corvin http://apt.rcpsych.org/cgi/content/full/7/4/310

The ICD-10 The DSM-IV-TR  http://www.dsmivtr.org/index.cfm

Comments

[Grace]

I haven't read your full blog entry yet. but I'd like to let you know that that is not necessarily the case. Autism and Schizophrenia, while being different disorders, have similar genetic patterns and do tend to run in families, although they seem to be the opposite problem. This is common in genetics, and although it is paradoxical, it has been a well documented trend over the last 100 years of studying genetics. She was not being derogatory. It is becoming more common in autistic literature that the Broad Autism Phenotype is coming about, but you can't actually publish anything unless it is 100% provable. Therefore, you need to read inbetween the lines to understand what the author is saying. Its a different use of logic then the one you're used to. If you actually understood the article, the definition of autism they were using was simply after 1987, because the subjects looked at had to be at least 10 at age diagnosis if using an old diagnosis (1987), or 5 if using the new diagnosis (2008). Autism spectrum disorders, specifically aspergers, run in my family. I understand how offensive researchers can sound, but researchers have their heads in the clouds because they are thinking so deeply about the subject they work on. They dedicate their entire life to one subject, and I really respect that. If you need to be angry at something, don't pick on the researchers. Pick on society or something more relevant to the problem. There is nothing wrong with being autistic or having aspergers. The DSM IV is outdated, and their definitions are being revised currently. If you read more than one article, then you'll see that. The DSM IV was written at a time when the Autism Spectrum wasn't very well understood, and it doesn't account for coping mechanisms. In the research community, it is well understood that the DSM IV is only accurate for severe cases. Before you go on a rant, please immerse yourself in the literature so you actually understand the language, and therefore what they are saying. You're using the wrong definitions.

[One Sick Mother]

Grace,

I didnt read your full comment because you didnt read my full piece.  However I am not going to waste either of our time commenting on your comment that I didnt read, because I may make points that you already made that *I* had already made and it would all get a bit redundant. 

OSM

[Grace]

I read your full entry as soon as I got home, and I wasn't flaming you, I had class to get to. If you take the time to read my full comment, you'll see that. If not, oh well. I wanted to have a serious discussion about the subject, because like you, Autism runs in my family. And I explained what you saw as flaws in her research, because this is a field I am looking to be scientifically involved in. I'm not going to re invent the wheel here, but if you want to understand from the perspective of the researcher and their implications of the above mentioned article, read my post.

[One Sick Mother]

I find comments along the lines of  "I didn't bother to read all of what you had to say, but this is where you're wrong" to be rude, unproductive and unworthy of my time. I will read your original comment and respond in detail later.

In the meantime, if you wish to add or change anything; -having actually read the full piece, feel free to do so.

OSM

[Grace]

Thank you.

[Grace]

Also there is one flaw in my first comment, being that the age at diagnosis had to be the age of 10. In addition, in order to participate in this kind of study there are consent forms, so the parents were aware that they were being involved in an analysis. If they did not agree with the diagnosis, they were probably not included.

[One Sick Mother]

Let's address all of these comments from you, shall we? (to be continued -typepad idiosyncrasies necessitate some finessing on the comments, sometimes)

OK. Now I can use punctuation. Sorta. Your original comments are enclosed in these **

*I haven't read your full blog entry yet. but I'd like to let you know that that is not necessarily the case.*

What exactly, isn't necessarily the case, Grace? I made more than one point in the entire piece.

*Autism and Schizophrenia, while being different disorders, have similar genetic patterns and do tend to run in families, *

I agree. The contentious point is if they run together or separately in those families.

*although they seem to be the opposite problem.* That is a matter of opinion . See my piece on autistic myths.

*This is common in genetics, and although it is paradoxical, it has been a well documented trend over the last 100 years of studying genetics.* Autism hasn't been around as a diagnosis for 100 years, so I call bullshit on that statement.

*She was not being derogatory. It is becoming more common in autistic literature that the Broad Autism Phenotype is coming about, but you can't actually publish anything unless it is 100% provable.* I didn't say she was being derogatory. I said she is probably WRONG.

*Therefore, you need to read inbetween the lines to understand what the author is saying. Its a different use of logic then the one you're used to.* ohhh. The Sooper Seekrit Hidden Meaning Defence, with a side of "you're stupid" thrown in for good measure. But you're not flaming me, right?

*If you actually understood the article, the definition of autism they were using was simply after 1987, because the subjects looked at had to be at least 10 at age diagnosis if using an old diagnosis (1987), or 5 if using the new diagnosis (2008). Autism spectrum disorders, specifically aspergers, run in my family.* You've lost me on these points, and then you tried to correct and lost me again, but I think they are irrelevant, because the points I was making about misdiagnosis was not about the 1977-2003 generation. It was about the previous generations. The parents; most of whom were evaluated before Autism was heard of.

*I understand how offensive researchers can sound, but researchers have their heads in the clouds because they are thinking so deeply about the subject they work on. They dedicate their entire life to one subject, and I really respect that. If you need to be angry at something, don't pick on the researchers.*

I'm not choosing researchers on which to vent my "anger" Shoddy work makes me angry. Being WRONG and publishing resulting dross makes me angry.

*Pick on society or something more relevant to the problem.* What? Society causes Autism now? It's not genetic with an environmental insult? Please publish something on this, quick, so I can rip it to shreds

*There is nothing wrong with being autistic or having aspergers.* I never said there was. Both my kids are on the Spectrum, remember? And they are perfect.

*The DSM IV is outdated, and their definitions are being revised currently.* I used the ICD in most of the piece, because that's what's in use in Sweden. But I agree that it's outdated. But if you are trying to say the ICD or DSM is wrong, then you are saying the entire study shoudl be thrown out, because it has no basis in anything.

*If you read more than one article, then you'll see that.* Yes that's rigfht. I have only ever read one article in my entire life.

*The DSM IV was written at a time when the Autism Spectrum wasn't very well understood, and it doesn't account for coping mechanisms. In the research community, it is well understood that the DSM IV is only accurate for severe cases.*
I didn't see any disclaimers in the Daniels' study.

*Before you go on a rant, please immerse yourself in the literature so you actually understand the language, and therefore what they are saying. You're using the wrong definitions.* So now I'm stupid, uninformed and linguistically impaired. But you're not flaming me, right?

And I'll rant all I want! (although I didn't rant very much here at all -for me) This IS my blog. Hello?

SECOND COMMENT

*I read your full entry as soon as I got home, and I wasn't flaming you, I had class to get to. If you take the time to read my full comment, you'll see that.* See what? That you had a class to get to? (no, don't see it). Or that you weren't flaming me? (Don't see that, either)

*If not, oh well. I wanted to have a serious discussion about the subject,* No, you didn't. You wanted to tell me how wrong and stupid I was. Had you wanted a discussion, you would have asked at least ONE question or asked for a clarification, maybe. Or maybe included a friendly overture. You didn't.

*because like you, Autism runs in my family.And I explained what you saw as flaws in her research,* No, you didn't. You 'splained that poor Dr daniels must have her head in the clouds and I was reading the study all wrong because ethics constraints meant that the Real Meaning of the study was -not in the content- but between the lines.
*because this is a field I am looking to be scientifically involved in. I'm not going to re invent the wheel here,* Actually, I think you just did. Tell me more about this between-the-line-reading of study presentation.

*but if you want to understand from the perspective of the researcher and their implications of the above mentioned article, read my post.* I did. It didn't help her case (or yours) at all. Sorry.

*Also there is one flaw in my first comment, being that the age at diagnosis had to be the age of 10. In addition, in order to participate in this kind of study there are consent forms, so the parents were aware that they were being involved in an analysis. If they did not agree with the diagnosis, they were probably not included.*
So there were 32,237 consent forms signed for this study? Impressive. Prove it.

"Grace": Again, you have completely missed my core point: That the Schizophrenia diagnosis of the PARENTS was probably incorrect. Not that the Autism/AS/PDD diagnoses may be incorrect.

You'll be a fabulous researcher because you seem incapable of grasping the macro as opposed to the micro picture.

God help us all.

[Georgia Scott]

the parents drank the same milk from the same family of cows

[Lulu]

Okay.. Well I found this site after someone told me that a teen couldn't get diagnosed with schizophrenia when he has autism. Im a nurse that just graduated and know that this is crazy after taking psych. I also have a son who is autistic and never lol...have anyone in either family been diag. With Any mental disorder. But what I do agree with is the old dr.s who need to please continue their education and keep current. I can't believe the crap they say and all i say is google it cause thats not current practice. So thank you for clarifying what I already knew. I will tell them to get a second opinion because the dr. Might be using the 4 As. Cause even I know there is a huge different between the two diagnosis being discussed here.

[Sharon]

So...is Autism = Schizophrenia? Or Schizophrenia = Autism?
Im actually writing a paper for my Psych Class and am trying to gather info on the two so I can write about if they are the same or not. My step father was diagnosed with Schizophrenia after an accident and my 2 little brothers (james - Full Brother, and Bubba - half-brother) are diagnosed with autism, one being more severe than the other. James has Aspergers Syndrome and Bubba's is..more severe. Bubba is my stepfathers son and James is my fathers son. Could that mean that the two cases are x-linked through my mother and Bubba's is a more severe case BECAUSE his father is schizophrenic? ...My psych teacher said no while my biology teacher said maybe. (Im just looking for feedback for my psych paper).

[Christine Morgan]

maybe we could help you.....we have a 24 yr old autistic son who is regressing quite badly and is showing all the symptoms of schizophrenia. He also has epilepsy, dyspraxia and semantic pragmatic disorder. please email me on [email protected]
if you are interested for any project or assignment you may need to do for your studies.
Regards, cris