ABSTRACT
This chapter focuses on lesser-understood comorbidities, illustrating the clinical challenges of embracing diagnostic uncertainty and managing complexity. The comorbidities creating some of the greatest challenges in Early Intervention for Psychosis are autism spectrum disorder (ASD), personality disorder and substance use disorder. Prevalence rates of ASD are rising as a result of broadening diagnostic boundaries and increasing awareness rather than a spontaneous epidemiological phenomenon. There is significant overlap between psychosis and ASD, with ASD increasingly recognised as an important comorbidity in psychosis. ASD, a neuro-developmental disorder, encompasses a wide-ranging spectrum of characteristics with differing degrees of disability across multiple contexts. There are two core features: Social and communication deficits. Individuals with ASD often respond atypically to expressions of emotion. Social-emotional reciprocity deficits include difficulties engaging in two-way conversation and initiating or responding to social interactions. Notably psychosis in comorbid ASD is more commonly affective in presentation.
