- QuestionMark wrote:
- sscc wrote:
- What makes you believe that a diagnosis of schizophrenia is more appropriate than autism?
He plainly admitted to having psychotic episodes and delusions about people watching him. Last I checked, autistic people don't lose touch with reality in that way.
Having both schizophrenia and autism is definitely possible, but we can say for sure Adam had schizophrenia.
You are incorrect in equating psychosis with schizophrenia so it's possible that he did
not have schizophrenia, and I recently posted about that in another thread.
A major depressive episode can cause psychosis in some people, including both hallucinations and delusions. Since we know that Adam was severely and chronically depressed, an alternate hypothesis is that his episodes of psychosis were related to depressive episodes.
Aside from that, even certain vitamin deficiencies can cause symptoms of psychosis (as well as depression) and Adam was vegan as well as anorexic and proven to be chronically malnourished so it would not be unthinkable that he had those vitamin deficiencies. Here is a description of a case where psychotic symptoms were caused by B12 deficiency in a 16 year old male, including delusions and hallucinations along with affective symptoms
[You must be registered and logged in to see this link.] and it's worth noting that the main sources of B12 in the average diet come from animal products so it is a common problem for vegans who are not careful.
Aside from those possibilities, there are other less likely possibilities like bipolar disorder (though episodes of psychosis with accompanying hallucinations are not as common in bipolar disorder and there is very little evidence that he may have had any form of the disorder, aside from his cyclical worsening of depression mixed with short bursts of intense activity, though that is probably better explained in other ways) and other less common psychotic disorders. It is fully possible that Adam had autism and did
not have schizophrenia even if he did have a psychotic episode.
I would also like to point out that the professionals who studied his e-mails extensively in his last months stated that Adam was not actively psychotic, despite his bizarre thinking in regard to mass murder
and that Adam's issues began as early as before the age of three yet supposedly, he did not have his first psychotic episode until late adolescence. This suggests that a diagnosis of autism is appropriate, as most of the people who evaluated him concluded, even if you want to assume that he had adult onset schizophrenia as well, based on evidence of psychotic episodes (though as I noted, this is jumping to a conclusion anyway because there are other explanations).
Since you are saying that he did not have autism, how do you explain the fact that there is proof that he satisfied all of the criteria for an autism diagnosis? Some of these symptoms cannot explained by schizophrenia.
[You must be registered and logged in to see this link.]A. Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history (examples are illustrative, not exhaustive, see text):
1. Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to
reduced sharing of interests, emotions, or affect; to
failure to initiate or respond to social interactions.2. Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to
abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication.
3. Deficits in developing, maintaining, and understanding relationships, ranging, for example, from
difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends;
to absence of interest in peers.
B. Restricted, repetitive patterns of behavior, interests, or activities, as manifested by
at least two of the following, currently or by history (examples are illustrative, not exhaustive; see text):
1. Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypies, lining up toys or flipping objects, echolalia, idiosyncratic phrases).
2.
Insistence on sameness, inflexible adherence to routines, or ritualized patterns or verbal nonverbal behavior (e.g.,
extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat food every day).
3.
Highly restricted, fixated interests that are abnormal in intensity or focus (e.g, strong attachment to or preoccupation with unusual objects,
excessively circumscribed or perseverative interest).
4.
Hyper- or hyporeactivity to sensory input or unusual interests in sensory aspects of the environment (e.g.,
apparent indifference to pain/temperature,
adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).
C.
Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life).
D.
Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.
E.
These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay. Intellectual disability and autism spectrum disorder frequently co-occur; to make comorbid diagnoses of autism spectrum disorder and intellectual disability, social communication should be below that expected for general developmental level.
In addition to these recognized symptoms of the disorder, Adam also had a severe anxiety disorder, and it's almost certain that he had OCD and anorexia (both anxiety related disorders), which have been recognized as frequently being associated with autism.
Subject: If Lanza couldn't feel pain... 
Tue Oct 31, 2017 9:08 am
