Trends in Psychiatry and Psychotherapy
http://www.trends.periodikos.com.br/article/doi/10.47626/2237-6089-2025-1104
Trends in Psychiatry and Psychotherapy
Review Article

Autism Spectrum Disorder and Personality Disorders: Differential Diagnosis or Comorbidity?

Tiago Figueiredo, Leonardo Caixeta

Downloads: 3
Views: 83

Abstract

Objective
The clinical overlap between autism spectrum disorder (ASD) and Personality Disorders (PDs) poses significant diagnostic challenges. Shared features—such as social communication difficulties, rigidity, and emotional dysregulation—often lead to misdiagnosis or delayed diagnosis, especially in adults and underrepresented populations (e.g., women). 

Methods
This narrative review synthesizes current evidence on the differential diagnosis and comorbidity of ASD and PDs to guide clinical practice. 

Results
Findings highlight substantial symptom overlap, particularly in social cognition and emotional regulation. For instance, both ASD and Schizotypal PD may exhibit social withdrawal, while ASD and Borderline PD share impulsivity and identity disturbances—though with distinct etiologies (neurodevelopmental vs. trauma-related). 

Conclusions
Clinicians must adopt a developmental perspective to disentangle ASD from PDs, integrating longitudinal history, neuropsychological testing, and multidisciplinary evaluations. Future research should prioritize biomarker-based diagnostics and tailored interventions for comorbid presentations.

Keywords

Autism Spectrum Disorder, Personality Disorders, Differential Diagnosis, Comorbidity, Schizotypal Personality Disorder, Borderline Personality Disorder

Submitted date:
05/14/2025

Accepted date:
09/17/2025

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