“During the last while back I have noticed that noises all seem to be louder to me than they were before. It’s as if someone had turned up the volume. . . . I notice it most with background noises– you know what I mean, noises that are always around but you don’t notice them. Now they seem to be just as loud and sometimes louder than the main noises that are going on. . . . It’s a bit alarming at times because it makes it difficult to keep your mind on something when there’s so much going on that you can’t help listening to” (Description from patient with schizophrenia, from Torrey, 2001, p. 34).
Though they are considered distinct conditions, schizophrenia and autism have a shared past. At one point, many cases of autism were simply considered “childhood schizophrenia” and it was Bleuler himself who, in writing of the schizophrenic break from reality, popularized the term “autism”.
Some of their historical overlap is more than diagnostic gaffe however. While current research is addressing overlap of genetic and environmental risk factors, there are some similarities in terms of behavioral and cognitive symptomotology. Though the psychosis and delusions are probably schizophrenia’s most conspicuous symptoms, known otherwise as “positive symptoms,” the negative symptoms, e.g., executive dysfunction, blunted affect, monotonic and monosyllabic speech, disinterest in socialization, etc., tend to be the most debilitating.
Artwork by Chris Mars, who was inspired as a young boy by visits to a mental institution where his older 16 year-old brother was being treated for schizophrenia.
Alterations of the senses, according to Torrey (2001), also occur in the earliest stages of the illness in about 2/3rds of schizophrenic patients. The patient description given at the beginning of this blog seems particularly striking, describing a similar experience to those described by autistic people with auditory sensitivity. Obviously, the developmental progression is dissimilar, as autistic people are born with the propensity for sensory disturbances; meanwhile in schizophrenia, in what appears to be a regressive phenomenon, they acquire it. Nevertheless, there may be some functional commonality that produces this cognitive overlap in sensory experiences.
“Colours seem to be brighter now, almost as if they are luminous painting. I’m not sure if things are solid until I touch them. I seem to be noticing colours more than before, although I am not artistically minded. The colours of things seem much clearer and yet at the same time there is something missing. The things I look at seem to be flatter as if you were looking just at a surface. Maybe it’s because I notice so much more about things and find myself looking at them for a longer time. Not only the colour of things fascinates me but all sorts of little things, like markings in the surface, pick up my attention too” (Patient description, Torrey, 2001, p. 34).
A fractal cat, painted by Louis Wain, who entered psychosis later in life and was committed at age 64.
In fact, there is so much overlap between schizophrenia and autism that the two primary differences are psychosis and the fact that schizophrenia, though a neurodevelopmental condition, is regressive and exhibits traits of progressive degeneration. Alongside acuteness of the senses, sensory overload also occurs:
“Everything seems to grip my attention although I am not particularly interested in anything. I am speaking to you just now, but I can hear noises going on next door and in the corridor. I find it difficult to shut these out, and it makes it more difficult for me to concentrate on what I am saying to you. Often the silliest little things that are going on seem to interest me. That’s not even true: they don’t interest me, but I find myself attending to them and wasting a lot of time this way” (Torrey, 2001, p. 36).
For those who are well acquainted with autism, does this description sound familiar regarding attention and sensory gating seen in the spectrum?
“I can probably tell you as much or more about what really went on those days than lots of people who were sane: the comings and goings of people, the weather, what was on the news, what we ate, what records were played, what was said. My focus was a bit bizarre. I could do portraits of people who were walking down the street. I remembered license numbers of cars we were following into Vancouver. We paid $3.57 for gas. The air machine made eighteen dings while we were there” (Torrey, 2001, p. 36).
And this, reminiscent of the touch sensitivity many autistic people display:
“[It] was terrible to be touched. . . . Once a nurse tried to cut my nails. The touch was such that I tried to bite her” (Torrey, 2001, p. 39).
Schizophrenia and autism certainly seem like different conditions. Yet the traits they share suggest that there may be common ground as well, perhaps in terms of disturbances to connectivity and neuronal function. As such, it may be useful for researchers to study these conditions together, in the hopes that in understanding one, we may better understand the other. In any case, the overlap is curious and has certainly peeked my attention lately. Hopefully more on this topic later.