overlap between personality disorders and autism spectrum disorders

1. Is there a link between
Autism Spectrum
Disorder and
Personality Disorders ?
Ehab Elbaz, MD, MBA
Consultant Psychiatrist, Egyptian Armed Forces
Director of psychiatry hospital, Maadi Military Medical Complex
Lecturer of psychiatry, Military Medical Academy

2. ASD in DSM-5

3. ASD in
DSM-5

6. Age specifier of ASD in DSM-IV
and DSM-5
DSM-5 DSM-IV Key differences
Symptoms must be
present in the
early
developmental
period (but may
not become fully
manifest until
social demands
exceed limited
capacities, or may
be masked by
Delays or
abnormal
functioning in at
least one
of the 3
behavioral areas
must be present
prior to
age 3 years
In DSM-5:
Symptoms do not
have to be
apparent before
age 3
Lost
generatio
n

7. PD in DSM-5

9. Aim
• to evaluate the
psychiatric history
of a group of adults
who received the
first diagnosis of
ASD in two Italian
university centers.
Sample
• 161 participants,
of which 114 (79.5%)
were males.

10. Results
•The median age of diagnosis was 23 years (range 18–
55)
•median IQ of 100 (range 30–145).
•The first evaluation by a mental health professional
was performed at a median age of 13 years, with a gap
of 11 years between the first evaluation and the
diagnosis of ASD
•33.5% of participants had never received a
psychiatric diagnosis, while the rest of the sample
had received one or more diagnoses different from ASD
•The most common past diagnoses were intellectual
disability, psychoses, personality disorders, and
depression.

13. Aim
• Describe the
clinical and
demographic
characteristics
of the
participants
Sample
•500 adults
diagnosed with
ASD
•Mean age : 31.7

17. • To investigate the presence of
possible Axis II disorders in a
group of young adults with a
clinical diagnosis of AS
Aim
•54 adults diagnosed with
Asperger syndrome
•Mean age : 27
Sample

20. •15 studies , 7 were included in meta-analysis
•From 1996 - 2016
Number of studies
•to summarize the existing research on personality
and personality pathology in adults with ASD and
to conduct a meta-analysis of temperament,
character, and PDs in adults with ASD
Aim

21. Results of Personality Disorders
Meta-analysis
Personality disorder %
Obsessive compulsive PD 31 %
Schizoid PD 24 %
Avoidant PD 23 %
Paranoid PD 20 %
Schizotypal PD 14 %

22. Results of Temperament Meta-
analysis
Adults with ASD have lower scores on
novelty seeking and reward
dependence .
Higher scores on harm avoidance and
persistence .

23. Results of Character Meta-
analysis
Lower scores on self-directedness
and cooperativeness
Higher score on self-
transcendence

24. Correlation with the big five
personality traits
Positive correlation between ASD (severity)
and neuroticism
Negative correlation between ASD (severity)
and extraversion, openness to experience,
agreeableness, and conscientiousness.

25. Conclusion
Level one ASD or high functioning autism could be missed in
diagnosis in early development.
There is a significant overlap between autistic traits in
adults and personality disorders traits.
Autistic traits in children shape the personality and its
development.
Clinicians should conduct a full developmental history before
making a diagnosis of personality disorder.