The Prevalence of Psychotic Experiences in Autism Spectrum Disorder and Autistic Traits: A Systematic Review and Meta-analysis
Open accessAbstract
Several reports have highlighted an association between psychotic experiences (PEs) and autism spectrum disorder/autistic traits; however, no systematic review of the evidence has been done. We searched PubMed, PsycINFO, Web of Science, and Cochrane database on November 20, 2018, for studies providing statistical results on the association between PEs and autism spectrum disorder/autistic traits. Meta-analyses were conducted for both the prevalence of PEs in autism spectrum disorder and the correlation coefficients between PEs and autistic traits. Subgroup analyses were conducted for each PE subtype. Among the 17 included studies, 9 had data about prevalence and 8 had data about correlation. The pooled prevalence of PEs in autism spectrum disorder was 24% (95% confidence interval [CI] 14%–34%). However, subanalyses found that prevalence varied between PE subtypes (hallucinations, 6% [95% CI 1%–11%] and delusions, 45% [95% CI 0%–99%]). Pooled results showed that PEs and autistic traits had a weak to medium correlation (r = .34 [95% CI 0.27–0.41]). Based on our meta-analysis, PEs seem to be more prevalent in individuals with autism spectrum disorder/autistic traits than in the general population, but this finding may vary according to the PE subtype. Future studies should focus on statistical results for each PE subtype separately. More studies should be conducted to clarify the relationship between autism spectrum disorder/autistic traits and PEs by subtype.
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Psychotic experiences are significantly higher in people with ASD compared to neurotypical individuals.
“psychotic experiences are significantly higher in people with ASD compared to neurotypical individuals”
From The revival of psilocybin between scientific excitement, evidence of efficacy, and real-world challenges (2024) · cites this paper as [108]
The Discussion reports a pooled prevalence of 24% in people with ASD versus 5%–12% in the general population, supporting a higher prevalence. It says psychotic experiences *seem* more prevalent, however, and notes that too few studies were available to calculate pooled odds ratios directly. The claim’s unqualified assertion of a significant difference is therefore stronger than the paper’s conclusion. (LLM, conf=0.88)
Experimental — accuracy not yet measuredAnother risk of using PAP in ASD may be related to rare psychotic-like symptoms potentially induced by psilocybin.
“another risk of using PAP in the ASD population may be related to the rare psychotic-like symptoms potentially induced by psilocybin. 108”
From The revival of psilocybin between scientific excitement, evidence of efficacy, and real-world challenges (2024) · cites this paper as [108]
The Results of Meta-analyses section reports psychotic experiences in people with ASD, including hallucinations, and the Discussion suggests they may be more prevalent than in the general population. The paper does not address psilocybin, psychedelic-assisted psychotherapy (PAP), or whether psilocybin induces such symptoms, so it does not support that proposed treatment risk. (LLM, conf=0.87)
Experimental — accuracy not yet measured
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ASD and Psychosis in Young People: Diagnostic Challenges and Clinical Implications
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- Authors
- Kiyono, T., Morita, M., Morishima, R., Fujikawa, S., Yamasaki, S., Nishida, A., Ando, S., & Kasai, K.
- Affiliations
- The University of Tokyo (JP)
- Tokyo Metropolitan Institute of Medical Science (JP)
- The University of Tokyo Institutes for Advanced Study (JP)
- Corresponding author
- Kiyono, Tomoki
- Venue
- Schizophrenia Bulletin Open
- Publisher
- Oxford University Press (OUP)
- Published
- 2020-01-01
- Volume
- 1
- Issue
- 1
- Pages
- sgaa046-sgaa046
- ISSN
- 2632-7899 (ISSN-L)
- PMC
- PMC13701002
- OpenAlex
- W3082024886
- Cited by
- 45
- References
- 56
- Citations by year
- 2026: 12 · 2025: 14 · 2024: 5 · 2023: 4 · 2022: 9 · 2021: 1
- FWCI
- 0.47
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Schizophrenia Bulletin Open (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- PubMed Central (publishedVersion, cc-by-nc)
- Funders
- Japanese Society for the Promotion of Science (JP16H06395, 16H06398, 16H06399, 16K21720, 17H05931, 17H04244)
- Japan Agency for Medical Research and Development (JP19ek0109369)
- Takeda Science Foundation
- UTokyo Center for Integrative Science of Human Behavior
- International Research Center for Neurointelligence
- University of Tokyo Institutes for Advanced Study
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Life Sciences › Neuroscience › Cognitive Neuroscience › Hallucinations in medical conditions
- Keywords
- psychotic experiences, autism spectrum disorder, autistic traits, prevalence, hallucinations, delusions
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