Abstract

Autistic spectrum disorders and schizophrenia are highly comorbid. Both entail socioemotional deficits so the additional diagnosis of schizophrenia requires the emergence or substantial worsening of psychotic and features for a month, or less if they are successfully treated. This manuscript illuminates the potential for the misdiagnosis of adult ASD as schizophrenia when patients are evaluated cross-sectionally without developmental information. Moreover, worsening suspiciousness in an adult with childhood ASD upon the development of severe gastrointestinal symptoms were diagnosed as paranoid and somatic delusions, leading to a diagnosis of schizophrenia, years of ineffective antipsychotic medication treatment and institutionalization. His GI symptoms predominated his course. Upon receiving information on his childhood developmental condition and adult functioning his diagnosis was reformulated as ASD. He was placed on probiotic treatment, taken off all psychiatric medications and improved across all domains and was discharged to a supervised residence. The so-called delusions evidenced his lifelong suspiciousness and GI condition. Arguably, symptoms due to a medical disorder do not fulfill diagnostic criteria for schizophrenia at any rate. In addition to elucidating how some ASD symptoms are not evidence of psychosis this report highlights the improvement associated with probiotic treatment and the discontinuation of psychotropic medications in an adult with ASD.

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