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Master Thesis

Antécédents de traits autistiques dans la schizophrénie : une moins bonne tolérance neurologique aux Antipsychotiques Atypiques

Abstract : The main cause for discontinuation of neuroleptic treatments among patients with schizophrenia is the occurrence of adverse effects, especially neurological effects. After reviewing the literature on the evolution of the notions of schizophrenia and autism throughout history, on the neurodevelopmental model of schizophrenia and on tolerance to atypical antipsychotics (AAP), we present a retrospective study to evaluate neurological tolerance to AAP among patients with schizophrenia based on the presence of autistic traits in their early neurodevelopmental pathways. Sixty-six subjects with schizophrenia were included in this study. The occurrence of autistic features and symptoms in the early developmental trajectory was assessed with the Autism Diagnostic Interview-Revised. Neurological tolerance to treatment was measured with the Simpson-Angus Scale for parkinsonism, with the Barnes Akathisia Scale and with the Abnormal Involuntary Movement Scale. Subjects with schizophrenia who exhibited autistic symptoms during their neurodevelopment have a more severe psychopathology and a higher parkinsonism score under AAP compared to subjects who did not exhibit these symptoms, regardless of the dose received up to moderate doses. Our results extend the data in the literature suggesting a poorer neurological tolerance to AAP in schizophrenic subjects with a poorer premorbid functioning, i.e. the most vulnerable in terms of neurodevelopment. They are part of current reflections regarding the hypothesis of an autism-schizophrenia continuum. It seems essential to offer to identify autistic traits in the early trajectory, particularly in subjects experiencing a first psychotic episode, in order to adapt the pharmacological care. Nevertheless, this study has limitations and its results will have to be confirmed by a prospective study on a larger sample.
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Master Thesis
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Submitted on : Friday, December 3, 2021 - 9:41:37 AM
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Léa Connen de Kerillis. Antécédents de traits autistiques dans la schizophrénie : une moins bonne tolérance neurologique aux Antipsychotiques Atypiques. Médecine humaine et pathologie. 2020. ⟨dumas-03464229⟩



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