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Formal thought disorder in autism spectrum disorder predicts future symptom severity, but not psychosis prodrome

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Abstract

Formal thought disorder (FTD) is a disruption in the flow of thought, which is inferred from disorganisation of spoken language. FTD in autism spectrum disorders (ASD) might be a precursor of psychotic disorders or a manifestation of ASD symptom severity. The current longitudinal study is a seven-year follow-up of 91 individuals aged 5–12 years with ASD. We tested (1) whether childhood FTD predicted prodromal symptoms of psychosis in adolescence and (2) whether childhood FTD was associated with greater ASD symptom severity in adolescence. ASD symptom severity was assessed in childhood (T1) and 7 years later (T2), using the autism diagnostic observation schedule (ADOS). At T1, the Kiddie-Formal Thought Disorder Rating Scale (KFTDS) was used to measure symptoms of FTD. At T2, the prodromal questionnaire (PQ) was used to assess prodromal symptoms of psychosis. FTD at T1 did not predict prodromal symptoms of psychosis at T2 in children with ASD. FTD symptoms at T1, namely illogical thinking, predicted ASD symptom severity at T2 and this effect remained significant after controlling for T1 ASD symptom severity. In children with ASD, illogical thinking predicts severity of ASD symptoms in adolescence, but FTD does not predict prodromal symptoms of psychosis.

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References

  1. Dochterty NM, McCleery A, Divilbiss M, Schumann EB, Moe A, Shakeel MK (2013) Effects of social cognitive impairment on speech disorder in schizophrenia. Schizophr Res 39(3):608–616

    Article  Google Scholar 

  2. Caplan R (1994) Thought disorder in childhood. J Am Acad Child Adolesc Psychiatry 33(5):605–615

    Article  CAS  PubMed  Google Scholar 

  3. Bearden CE, Wu KN, Caplan R, Cannon TD (2011) Thought disorder and communication deviance as predictors of outcome in youth at clinical high risk for psychosis. J Am Acad Child Adolesc Psychiatry 50(7):669–680

    Article  PubMed Central  PubMed  Google Scholar 

  4. Ozonoff S, Pennington B, Solomon M (2006) Neuropsychological perspectives on developmental psychopathology. In: Cichetti D, Cohen D (eds) Developmental psychopathology, vol 2: developmental neuroscience, 2nd edn. John Wiley & Sons Inc, Hoboken, pp 332–380

    Google Scholar 

  5. Docherty NM (2012) On identifying the process of underlying schizophrenic speech disorder. Schizophr Bull 38(6):1327–1335

    Article  PubMed Central  PubMed  Google Scholar 

  6. Caplan R, Guthrie D, Komo S, Siddarth P, Chayasirisobhon S, Kornblum H, Sankar R, Hansen R, Mitchell W, Shields WD (2002) Social communication in children with epilepsy. J Child Psychol Psychiatry 43(2):245–253

    Article  PubMed  Google Scholar 

  7. Andreasen NC (1979) Thought, language and communication disorders. Arch Gen Psychiatry 36:1315–1321

    Article  CAS  PubMed  Google Scholar 

  8. Caplan R, Guthrie D, Fish B, Tanguay PE, David-Lando G (1989) The Kiddie formal thought disorder rating scale: clinical assessment, reliability, and validity. J Am Acad Child Adolesc Psychiatr 28(3):408–417

    Article  CAS  Google Scholar 

  9. Caplan R, Guthrie D, Tang B, Komo S, Asarnow RF (2000) Thought disorder in childhood schizophrenia: replication and update of concept. J Am Acad Child Adolesc Psychiatry 2000(39):771–778

    Article  Google Scholar 

  10. Bleuler E (ed) (1950) Dementia praecox or the group of schizophrenia’s. International University Press, New York

    Google Scholar 

  11. Docherty NM, Gottesmann II (2000) A twin study of communication disturbances in schizophrenia. J Nerv Ment Dis 2000(188):395–401

    Article  Google Scholar 

  12. Docherty NM (2005) Cognitive impairments and disordered speech in schizophrenia: thought disorder, disorganization, and communication failure perspectives. J Abnorm Psychol 114:269–278

    Article  PubMed  Google Scholar 

  13. Solomon M, Ozonoff S, Carter C, Caplan R (2008) Formal thought disorder and the autism spectrum: relationship with symptoms, executive control, and anxiety. J Autism Dev Disord 38:1474–1484

    Article  PubMed  Google Scholar 

  14. Volden J, Lord C (1991) Neologisms and idiosyncratic language in autistic speakers. J Autism Dev Disord 21(2):109–130

    Article  CAS  PubMed  Google Scholar 

  15. Baltaxe CA, D’Angiola N (1992) Cohesion in the discourse interaction of autistic, specifically language-impaired, and normal children. J Autism Dev Disord 22(1):1–21

    Article  CAS  PubMed  Google Scholar 

  16. Van der Gaag R, Caplan R, van Engeland H, Loman F, Buitelaar JK (2005) A controlled study of formal thought disorder in children with autism and multiple complex developmental disorders. J Child Adolesc Psychopharmacol 15(3):465–476

    Article  PubMed  Google Scholar 

  17. Kanner L (1943) Autistic disturbances of affective contact. Nervous Child 1943(2):217–250

    Google Scholar 

  18. Rutter M (1972) Childhood schizophrenia reconsidered. J Autism Childhood Schizophrenia 2(4):315–337

    Article  CAS  Google Scholar 

  19. Volkmar FR, Cohen DJ (1991) Comorbid association of autism and schizophrenia. Am J Psychiatry 148(12):1705–1707

    Article  CAS  PubMed  Google Scholar 

  20. Bender L (1974) Psychopathic behaviour disorders in children. In: Lindner RM, Seliger RV (eds) Handbook of correctional psychology. Oxford Philosophical Library, Oxford, pp 360–377

    Google Scholar 

  21. King BH, Lord C (2011) Is schizophrenia on the autism spectrum ? Brain Res 1380:34–41

    Article  CAS  PubMed  Google Scholar 

  22. Rapaport J, Chavez A, Greenstein D, Addington A, Gogtay N (2009) Autism spectrum disorders and childhood onset schizophrenia: clinical and biological contributions to a relation revisited. J Am Acad Child Adolesc Psychiatry 48:10–18

    Article  Google Scholar 

  23. Wolff S (1991) ‘Schizoid’ personality in childhood and adult life. I: the vagaries of diagnostic labelling. III: The childhood picture. B. J Psychiatry 159(615–20):634–645

    Google Scholar 

  24. Wolff S, McGuire RJ (1995) Schizoid personality in girls: a follow-up study–what are the links with Asperger’s syndrome. Child Psychol Psychiatry 36(5):793–817

    Article  CAS  Google Scholar 

  25. Sporn AL, Addington AM, Gogtay N et al (2004) Pervasive developmental disorder and childhood-onset schizophrenia: comorbid disorder or a phenotypic variant of a very early onset illness? Biol Psychiatry 55(10):989–994

    Article  PubMed  Google Scholar 

  26. Van der Gaag RJ, Buitelaar J, Van den Ban E, Bezemer M, Njio L, Van Engeland H (1995) A controlled multivariate chart review of multiple complex developmental disorder. J Am Acad Child Adolesc Psychiatry 34(8):1096–1106

    Article  PubMed  Google Scholar 

  27. Van Engeland H, Van der Gaag RJ (1994) MCDD in childhood: a precursor of schizophrenic spectrum disorder. Schizophr Res 11(2):197

    Article  Google Scholar 

  28. Yung AR, McGorry PD (2007) Prediction of psychosis: setting the stage. B J Psychiatry 191(suppl. 51):s1–s8

    Article  Google Scholar 

  29. Loewy RL, Bearden CE, Johnson JK, Raine A, Cannon TD, Tyrone D (2005) The prodromal questionnaire (PQ): preliminary validation of a self-report screening measure for prodromal and psychotic syndromes. Schizophr Res 77:141–149

    Article  PubMed  Google Scholar 

  30. Yung AR, Yuen HP, McGorry PD et al (2005) Mapping the onset of psychosis: the comprehensive assessment of at-risk mental states. Aust N Z J Psychiatry 39(11–12):964–971

    Article  PubMed  Google Scholar 

  31. Fusar-Poli P, Bonoldi I, Yung AR et al (2012) Predicting psychosis. Meta-analysis of transition outcomes in individuals at high clinical risk. Arch Gen Psychiatry 69:220–229

    Article  PubMed  Google Scholar 

  32. Yung AR, Phillips LJ, Yuen HP et al (2003) Psychosis prediction: 12-month follow up of a high-risk (“prodromal”) group. Schizophr Res 60(1):21–32

    Article  PubMed  Google Scholar 

  33. Yung AR, Phillips LJ, Yuen HP, McGorry PD (2004) Risk factors for psychosis in an ultra high-risk group: psychopathology and clinical features. Schizophr Res 67(2–3):131–142

    Article  PubMed  Google Scholar 

  34. Cannon TD, Cadenhead K, Comblatt B et al (2008) Prediction of psychosis in youth at high clinical risk: a multisite longitudinal study in North America. Arch Gen Psychiatry 65:28–37

    Article  PubMed Central  PubMed  Google Scholar 

  35. American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders, fourth edition, text revision. Author, Washington DC

    Book  Google Scholar 

  36. De Bruin EI, De Nijs PF, Verheij F, Hartman CA, Ferdinand RF (2007) Multiple complex developmental disorder delineated from PDD-NOS. J Autism Dev Disord 37(6):1181–1191

    Article  PubMed  Google Scholar 

  37. Mandy W, Charman T, Skuse D (2012) Testing the construct validity of proposed criteria for DSM-5 autism spectrum disorder. J Am Acad Child Adolesc Psychiatry 51:41–50

    Article  PubMed  Google Scholar 

  38. Skuse DH (2012) DSM-5′s conceptualization of autistic disorders. J Am Acad Child Adolesc Psychiatry 51:344–346

    Article  PubMed  Google Scholar 

  39. Shaffer D, Fisher P, Lucas CP, Dulcan MK, Schwab-Stone ME (2000) NIMH diagnostic interview schedule for children version IV (NIMH DISC-IV): description, differences from previous versions, and reliability of some common diagnoses. J Am Acad Child Adolesc Psychiatry 39(1):28–38

    Article  CAS  PubMed  Google Scholar 

  40. Caplan R, Guthrie D, Tang B, Neuchterlein KH, Asarnow RE (2001) Thought disorder in attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 40(8):965–972

    Article  CAS  PubMed  Google Scholar 

  41. Lord C, Rutter M, DiLavore PC, Risi S (1999) Autism diagnostic observation schedule-WPS (ADOS-WPS). Western Psychological Services, Los Angeles

    Google Scholar 

  42. Volkmar FR, State M, Klin A (2009) Autism and autism spectrum disorders: diagnostic issues for the coming decade. J Child Psychol Psychiatry 50(1–2):108–115

    Article  PubMed  Google Scholar 

  43. Klosterkotter J, Hellmich M, Steinmeyer EM, Schultze-Lutter F (2001) Diagnosing schizophrenia in the initial prodromal phase. Arch Gen Psychiatry 58:158–164

    Article  CAS  PubMed  Google Scholar 

  44. WISC-R Projectgroep: Van Haasen, PP, De Bruyn EEJ, Pijl YJ, et al (1986) WISC-R. Wechsler Intelligence Scale for Children-Revised, Dutch version. Swets & Zeitlinger, Lisse

  45. Achenbach TM (1991) Manual for the child behavior Checklist/4-18 and 1991 profiles. Department of Psychiatry, University of Vermont, Burlington

    Google Scholar 

  46. Gadow KD (2012) Schizophrenia spectrum and attention-deficit/hyperactivity disorder symptoms in autism spectrum disorder and controls. J Am Acad Child Adolesc Psychiatry 51(10):1076–1084

    Article  PubMed  Google Scholar 

  47. Verhulst FC, van der Ende J, Handleiding ASEBA (2013) Vragenlijsten voor leeftijden 6 tot en met 18 jaar. ASEBA Nederland, Rotterdam

    Google Scholar 

  48. Amone-P’Olak K, Ormel J, Oldehinkel A, Reijneveld SA, Verhulst FC, Burger H (2010) Socioeconomic position predicts special mental health service use independent of clinical severity: the TRAILS study. J Am Acad Child Adolesc Psychiatry 49(7):647–655

    PubMed  Google Scholar 

  49. Demjaha A, Valmaggia L, Stahl D, Byrne M, McGuire P (2012) Disorganization/cognitive and negative symptom dimensions in the at-risk mental state predict subsequent transition to psychosis. Schizophr Bull 38(2):351–359

    Article  PubMed Central  PubMed  Google Scholar 

  50. Armenteros JL, Davies M (2006) Anti-psychotics in early onset schizophrenia. Systematic review and meta-analysis. Eur Child Adolesc Psychiatry 15:141–148

    Article  PubMed  Google Scholar 

  51. Van Os J, Hanssen M, Bijl RV, Volleberg W (2001) Prevalence of psychotic disorder and community level of psychotic symptoms: an urban-rural comparison. Arch Gen Psychiatry 58:663–668

    Article  PubMed  Google Scholar 

  52. Poulton R, Caspi A, Moffitt TE, Cannon M, Murray RM, Harrington H (2000) Children’s self-reported psychotic symptoms and adult schizophreniform disorder: a 15-year longitudinal study. Arch Gen Psychiatry 57:1053–1058

    Article  CAS  PubMed  Google Scholar 

  53. Arango C (2011) Attenuated psychotic symptoms syndrome: how it may affect child and adolescent psychiatry. Eur Child Adolesc Psychiatry 20:67–70

    Article  PubMed  Google Scholar 

  54. Ziermans TB, Schothorst PF, Sprong M, van Engeland H (2001) Transition and remission in adolescents at ultra high-risk for psychosis. Schizophr Res 126(1–3):58–64

    Google Scholar 

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Acknowledgments

The authors thank all children and parents who participated in the study. We appreciated very much that such a large proportion of the original participants were willing to engage in this seven-year follow-up study. This study is based on collaboration between Erasmus University Medical Center—Sophia, Rotterdam and Yulius, Organisation for Mental Health, Dordrecht/Barendrecht. The project was supported financially by a grant from the Sophia Foundation for Scientific Research (SSWO; grant 586, 2009), by a grant from the Nuts Ohra Foundation 0803-53), by a grant from the Netherlands Organisation for Scientific Research (NWO/ZonMw/OOG-100-002-006) and by the participating centres. We thank all our research colleagues for their helpful suggestions.

Conflicts of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Child and Adolescent Psychiatry, Erasmus Medical Center Sophia Rotterdam, Wytemaweg 8, 3015 CN, Rotterdam, The Netherlands

    Mart L. J. M. Eussen, Anneke Louwerse, Jan van der Ende, Fop Verheij, Frank C. Verhulst & Kirstin Greaves-Lord

  2. Department of Child and Adolescent Psychiatry, Autism Department, Yulius Mental Health, Yulius Academy, P.O Box 753, 3300 AT, Dordrecht, The Netherlands

    Mart L. J. M. Eussen, Arthur R. Van Gool, Anneke Louwerse & Kirstin Greaves-Lord

  3. Research Institute of Child Development and Education, University of Amsterdam, Nieuwe Prinsengracht 130, 1018 VZ, Amsterdam, The Netherlands

    Esther I. de Bruin

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  1. Mart L. J. M. Eussen
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Correspondence to Mart L. J. M. Eussen.

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Eussen, M.L.J.M., de Bruin, E.I., Van Gool, A.R. et al. Formal thought disorder in autism spectrum disorder predicts future symptom severity, but not psychosis prodrome. Eur Child Adolesc Psychiatry 24, 163–172 (2015). https://doi.org/10.1007/s00787-014-0552-9

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  • DOI: https://doi.org/10.1007/s00787-014-0552-9

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