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

Katie N. Sampson, Rachel Upthegrove, Ahmad Abu-Akel, Sayeed Haque, Stephen J. Wood, Renate Reniers

Research output: Contribution to journalArticlepeer-review


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
Pages (from-to)1364-1372
Number of pages9
JournalPsychological Medicine
Issue number8
StatePublished - Jun 2021
Externally publishedYes

Bibliographical note

Funding Information:
Financial support. KNS received an intercalated degree bursary from the Sir Arthur Thomson Trust and a £500 grant from the University of Birmingham Population Sciences and Humanities Intercalated Degree course (grant number not applicable).

Publisher Copyright:
Copyright © The Author(s) 2020. Published by Cambridge University Press.


  • Autistic spectrum disorders
  • autistic traits
  • depression
  • psychotic traits
  • schizophrenia spectrum disorders
  • self-harm
  • suicidality

ASJC Scopus subject areas

  • Applied Psychology
  • Psychiatry and Mental health


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