PANNS Autism Severity Score (PAUSS) as a measuring tool for determining risk of schizophrenia in patients with at risk mental state or high functioning autism spectrum disorder

Abstract

Background: Schizophrenia is a mental illness that affects more than 21 million people worldwide and is one of the main causes of disability due to illness. At risk mental state (ARMS) people present prodromal symptoms that do not yet meet the diagnostic criteria for schizophrenia, however, they present an increased risk of suffering a first psychotic episode. High-functioning autism spectrum disorder (ASD) patients present clinical features that overlap with the negative symptomatology of schizophrenia. Studies show that these patients have an increased risk of developing schizophrenia with a predominance of negative symptomatology, which results in a worse prognosis. Today the pathogenesis of schizophrenia is unknown and there is a need of research into biomarkers to help differentiate these two disorders and the likelihood of progression from ASD to schizophrenia. From the Positive and Negative Syndrome Scale (PANNS) has emerged the PANNS Autism Severity Score (PAUSS), which measures mainly the negative symptomatology. This could be a useful tool to predict the development of schizophrenia in patients with ARMS or high-functioning ASD. Objective: The main objective is to assess in patients with high-functioning ASD or ARMS whether the presence of autistic features, measured by the PAUSS, determines a higher probability of developing schizophrenia with higher forms of negative symptomatology compared to those who do not. Study design: A prospective and observational cohort study that will be carried out in the Xarxa de Salut Mental i Addiccions (XSMA) of the region of Girona between February 2022 and December 2027. Participants: 225 young people over or equal to 16 years old with high functioning ASD or who meet at least one ARMS criteria which are being followed by the Centres de Salut Mental Infato Juvenil (CSMIJ) and by the Equips d ́Intervenció Precoç a la Psicosi (EIPP). In addition, there will be a control group, so for each participant of the study, a neurotypical person of the same age and gender will be added