I am trying to do a systematic review on whether autism spectrum disorder (ASD) is predictive of later psychosis. I have decided to look at studies that follow-up cohorts of children with ASD who go on to develop psychosis (looking at prevalence rates of ASD and psychosis co-morbidity). I can't however decide on a comparison group. Do i look at prevalence rates of individuals with psychosis who have no history of ASD?
Thanks in advance.
I would recommend having both a somatic and a psychiatric control group, matched for age at contact with healthcare. If you have access to multiple registers, this should be possible.
Best of luck,
Morten
It depends on your research question. If it is: "is ASD a good predictor of later psychosis?" then looking at patients with no history of ASD isn't going to benefit you much. Ideally you need to be reviewing studies identifying groups of children with ASD that subsequently followed them up to see what proportions went on to develop psychosis or SMI and what proportions did not. These will probably be few and far between in which case you might want to look at it from the other side and identify studies of patients diagnosed with SMIs where a history of ASD was recorded. Taking your research further, you might be interested in using data from The UK Health Improvement Network (THIN) primary care database and looking at the numbers of patients there with an SMI and previous diagnosis of ASD. A good paper relating to THIN is: Hardoon S, Hayes JF, Blackburn R, Petersen I, Walters K, Nazareth I, et al. (2013) Recording of Severe Mental Illness in United Kingdom Primary Care, 2000–2010. PLoS ONE 8(12): e82365. https://doi.org/10.1371/journal.pone.0082365
Good Luck!
Colin Ridyard
Thank you for your response - that is really helpful.
My question is: Are people with autism spectrum disorders more likely to develop psychotic illnesses than people not on the spectrum?
Would it not make sense to look at cohort data comparing people with ASD who go on to develop psychotic illness compared to those without a history of ASD who develop psychotic illness?
Not really unless you know how representative both groups are of the population as a whole. I think the problem you have is there would be too much heterogeneity between the two groups but you might want to run this past a statistician, too. You could alternatively run them as two separate reviews and use these as a justification for going down the THIN study route.
Colin Ridyard I understand. I think you're right that this question can't really be answered in one systematic review.
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