Co-occurrence of autistic an psychotic traits: implications for depression, self-harm and suicidality

Research output: Contribution to journalArticle

External organisations

  • The Medical School, University of Birmingham, Birmingham, UK.
  • Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.
  • Centre for Youth Mental Health, University of Melbourne
  • Institute of Psychology, University of Lausanne


Background: There is increasing interest in the clinical and aetiological overlap between Autism Spectrum Disorders and Schizophrenia Spectrum Disorders, reported to co-occur at both diagnostic and trait levels. Individually, sub-clinical autistic and psychotic traits are associated with poor clinical outcomes, including increased depressive symptomatology, self-harming behaviour and suicidality. However, the implications when both traits co-occur remain poorly understood. The study aimed to (1) examine the relationship between autistic and psychotic traits and (2) determine if their co-occurrence increases depressive symptomatology, self-harm and suicidality. Methods: Cross-sectional data from a self-selecting (online and poster advertising) sample of the adult UK population (n=653) were collected using an online survey. Validated self-report measures were used to assess sub-clinical autistic and psychotic traits, depressive symptomatology, self-harming behaviour, and suicidality. Correlation and regression analyses were performed. Results: A positive correlation between sub-clinical autistic and positive psychotic traits was confirmed (rs = 0.509, p < 0.001). Overall, autistic traits and psychotic traits were, independently, significant predictors of depression, self-harm and suicidality. Intriguingly, however, depression was associated with a negative interaction between the autistic domain attention to detail and psychotic traits. Conclusions: This study supports previous findings that sub-clinical autistic and psychotic traits are largely independently associated with depression, self-harm and suicidality, and is novel in finding that their combined presence has no additional effect on depression, self-harm or suicidality. These findings highlight the importance of considering both autistic and psychotic traits and their symptom domains in research and when developing population-based depression prevention and intervention strategies.


Original languageEnglish
JournalPsychological Medicine
Publication statusAccepted/In press - 14 Jan 2020


  • Autistic Spectrum Disorders, Schizophrenia Spectrum Disorders, autistic traits, psychotic traits, depression, self-harm, suicidality