Autistic and schizotypal traits and global functioning in bipolar I disorder

Research output: Contribution to journalArticle


  • Ahmad Abu-Akel
  • Jennifer Clark
  • Amy Perry
  • Liz Forty
  • Nick Craddock
  • Ian Jones
  • Katherine Gordon-Smith
  • Lisa Jones

Colleges, School and Institutes

External organisations

  • Department of Psychological Medicine, University of Worcester, Worcester, United Kingdom.
  • Cardiff University
  • Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health


OBJECTIVE: To determine the expression of autistic and positive schizotypal traits in a large sample of adults with bipolar I disorder (BD I), and the effect of co-occurring autistic and positive schizotypal traits on global functioning in BD I.

METHOD: Autistic and positive schizotypal traits were self-assessed in 797 individuals with BD-I recruited by the Bipolar Disorder Research Network. Differences in global functioning (rated using the Global Assessment Scale) during lifetime worst depressive and manic episodes (GASD and GASM respectively) were calculated in groups with high/low autistic and positive schizotypal traits. Regression analyses assessed the interactive effect of autistic and positive schizotypal traits on global functioning.

RESULTS: 47.2% (CI=43.7-50.7%) showed clinically significant levels of autistic traits, and 23.22% (95% CI=20.29-26.14) showed clinically significant levels of positive schizotypal traits. In the worst episode of mania, the high autistic, high positive schizotypal group had better global functioning compared to the other groups. Individual differences analyses showed that high levels of both traits were associated with better global functioning in both mood states.

LIMITATIONS: Autistic and schizotypal traits were assessed using self-rated questionnaires.

CONCLUSIONS: Expression of autistic and schizotypal traits in adults with BD I is prevalent, and may be important to predict illness aetiology, prognosis, and diagnostic practices in this population. Future work should focus on replicating these findings in independent samples, and on the biological and/or psychosocial mechanisms underlying better global functioning in those who have high levels of both autistic and positive schizotypal traits.


Original languageEnglish
Pages (from-to)268-275
Number of pages8
JournalJournal of Affective Disorders
Early online date3 Oct 2016
Publication statusPublished - 1 Jan 2017


  • autism , global functioning , psychosis , schizophrenia , schizotypy