Thought disorder in Asperger syndrome and schizophrenia: issues in the differential diagnosis. A series of case reports.

The relationship between Asperger syndrome (AS) and schizophrenia is still unclear. An unanswered question is, do hallucinations or delusions per se justify a diagnosis of schizophrenia when these symptoms appear in subjects with AS? The aims of the present study were: (1) to review the characteristics of thought disorder in AS and schizophrenia; (2) to describe the clinical features of six adult patients with AS who presented psychotic symptoms without mood symptoms; (3) to observe their clinical course and response to therapy in order to speculate possible relations between AS and schizophrenia. In the presence of its specific symptoms, it seems inappropriate to omit the diagnosis of AS because the DSM-IV-TR criteria for schizophrenia are also met, whether delusions and hallucinations appear early or late in the course of the disease. Recognizing and emphasizing the diagnosis of AS is not only important for clinicians to tailor the therapeutic strategy to the features of patients, but also for the patients and their relatives.