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ORIGINAL RESEARCH article

Front. Psychiatry
Sec. Schizophrenia
Volume 15 - 2024 | doi: 10.3389/fpsyt.2024.1493158
This article is part of the Research Topic Underlying Neurobiological, Genetic, and Behavioral Mechanisms in Schizophrenia and Autism Spectrum Disorder View all 8 articles

Predictive model using Autism Diagnostic Observation Schedule, Second Edition for differential diagnosis between schizophrenia and autism spectrum disorder

Provisionally accepted
Dan Nakamura Dan Nakamura 1*Yoichi Hanawa Yoichi Hanawa 1Shizuka Seki Shizuka Seki 1Misato Yamauchi Misato Yamauchi 1Yuriko Iwami Yuriko Iwami 1Yuta Nagatsuka Yuta Nagatsuka 1Hirohisa Suzuki Hirohisa Suzuki 1Keisuke Aoyagi Keisuke Aoyagi 1Wakaho Hayashi Wakaho Hayashi 1Takeshi Otowa Takeshi Otowa 2Akira Iwanami Akira Iwanami 1
  • 1 Showa University, Shinagawa, Japan
  • 2 Nagoya City East Medical center, Minato-Ku, Japan

The final, formatted version of the article will be published soon.

    Background. Although schizophrenia and autism spectrum disorder (ASD) are currently conceptualized as distinct disorders, the similarity in their symptoms often makes differential diagnosis difficult. This study aimed to identify similarities and differences in the symptoms of schizophrenia and ASD to establish a more useful and objective differential diagnostic method and to identify ASD traits in participants with schizophrenia. Methods. A total of 40 participants with schizophrenia (13 females, mean age: 34±11 years) and 50 participants with ASD (15 females, mean age: 34±8 years) were evaluated using the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) and other clinical measures. Results. ADOS-2 Module 4 original and revised algorithms did not significantly discriminate schizophrenia and ASD, whereas the "Predictive Model" combining the A7, A10, B1, B6, B8, and B9 showed superior accuracy in differentiating both disorders. Both algorithms in the ADOS-2 had high schizophrenia false-positive rates, and significant positive correlations were observed between all domains and the total scores of both algorithms in the ADOS-2 and Positive and Negative Syndrome Scale (PANSS) negative scale scores in the schizophrenia group. The PANSS negative-scale scores were significantly higher in patients positive for autism spectrum cut-offs (CutOff-POS) than in patients negative for autism spectrum cut-offs (CutOff-NEG) for both algorithms in the ADOS-2. Logistic regression analysis revealed that the positivity for both algorithm scales in the ADOS-2 was predicted using only the PANSS negative scale scores. Conclusions. This study showed that a combination of several items in the ADOS-2 is useful for discriminating between ASD and schizophrenia. The study's findings could help develop strategies benefiting ASD and schizophrenia treatments.

    Keywords: Schizophrenia, Autism Spectrum Disorder, Autism Diagnostic Observation Schedule, Second edition, differential diagnosis, predictive model

    Received: 13 Sep 2024; Accepted: 19 Nov 2024.

    Copyright: © 2024 Nakamura, Hanawa, Seki, Yamauchi, Iwami, Nagatsuka, Suzuki, Aoyagi, Hayashi, Otowa and Iwanami. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Dan Nakamura, Showa University, Shinagawa, Japan

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.