Challenges in diagnosis: exploring comorbidities and differential diagnosis in a young adult with mild autism spectrum disorder and attenuated psychosis syndrome

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder, and its relationship with schizophrenia has been studied since the early 20th century. Several studies have shown a high prevalence of psychotic episodes in ASD, leading many authors to hypothesize that patients with neurodevelopmental disorders may have a substantial vulnerability to psychosis. In this paper, the authors describe the clinical case of a 19-year-old male showing social withdrawal and subthreshold persecutory ideas undergoing his first psychiatric evaluation. The patient's psychomotor development was unremarkable except for a slight speech delay. He has always exhibited introverted tendencies and became increasingly reserved during adolescence. Today, he experiences significant anxiety around his peers and prefers remaining indoors, spending most of the time playing on his smartphone or online games. The diagnostic challenge for clinicians lies in distinguishing between co-occurring disorders or determining whether the clinical manifestations are solely due to one of the conditions.