QUASI-PSYCHOTIC PHENOMENA IN AUTISM SPECTRUM DISORDERS

The article presents a diagnostically ambiguous clinical case of Yakov, a disabled person from childhood with "schizophrenia, childhood type, oligophrenia-like defect", who was repeatedly hospitalized in psychiatric hospitals from the age of three, and underwent antipsychotic therapy. During a special examination at the age of 23, the diagnosis of schizophrenia was not confirmed, since it did not correspond to the observed picture of psychopathological symptoms. It is stated that the diagnosis of "childhood schizophrenia" was given to the patient based on an erroneous interpretation of the observed behavioral disorders and symptoms of "emotional-volitional defect" - since childhood the boy was uncommunicative, unsociable, uninitiative, emotionless, was prone to committing "strange" acts, and there was a delay in mental and speech development. Later, the lag in intellectual and speech development was eliminated, but the "oddities" of behavior, communication difficulties, infantilism, as well as the tendency to fantasize and live in an imaginary reality remained. No distinct positive psychopathology was registered. When Yakov was examined at the age of 23, the dominant disorders remained communication difficulties, autism, and speech disorders specific to ASD, which allowed him to be diagnosed with autism spectrum disorder instead of schizophrenia. Attention was drawn to the fact that the symptoms detected in the patient, assessed as delusional, hallucinatory, as well as fragmented and incoherent thinking, could be interpreted as quasi-psychotic, associated with a violation of cognitive processing of information, and not as psychotic. An analysis of the literature was conducted and the attention of colleagues was drawn to the problem of overdiagnosis of schizophrenia and ignoring the possibility of similar symptoms as related to ASD.