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Abstract

Between Autistic Spectrum Disorder (ASD) and Childhood Onset Schizophrenia (COS): A Proposal for a Passerella Syndrome

Author(s): Galli Carminati G, Tagan C, Zecca G, Carminati F

Background

Even if childhood-onset of schizophrenia is described in the literature, and there are several case reports of concomitant autism spectrum disorders (ASD) and childhood-onset schizophrenia (COS), early diagnosis of comorbidity remains less the norm than the exception. The definition of a specific syndrome – which we propose to call Passerella – describing this comorbidity condition can help focusing diagnosis and initiate early treatment avoiding dangerous delays in care.

Method

We report the detailed clinical history of 4 patients, 2 women and 2 men. The case of one of the women has been previously reported. The evolution of the clinical state of the patients is reported together with the diagnosis provided by the caregivers, the pharmacological and psychological treatment and the patient’s clinical evolution.

Results

The delay in formulating a diagnosis of concomitant ASD and COS, as well as the emphasis on the achievement of school or social results, have been an aggravating factor for the patients’ sequel of crisis and relapses. The clinical status of the patients has presented a marked improvement when the comorbidity has been acknowledged and properly treated, both pharmacologically and via an appropriate reduction of the stressful demands for school or social performance.

Conclusion

Early diagnosis of psychiatric comorbidities in ASD allows a more effective therapeutic strategy and the adoption of a psychopedagogic approach adapted to the vulnerability of these patients with respect to stress. The definition of a specific syndrome can help orienting caregivers toward earlier diagnosis and more appropriate intervention.


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