[Focusing on profound autism: validity of clinical taxonomy and management of treatment-resistant symptoms].

Clinical characteristics of Autism Spectrum Disorder in older adults: a scoping review.

There is an urgent need for prospective longitudinal studies to adequately map the aging trajectories of this population of older adults with ASD, which constitute a vulnerable population.

NEW DIAGNOSTIC CRITERIA OF AUTISM: IMPLICATIONS FOR RESEARCH AND PRACTICE IN THE MIDDLE

Somatic, Psychiatric and Neurodevelopmental Comorbidities in People with Autism Spectrum Disorder (ASD): A Narrative Review

A narrative review of papers published between 1 January 2015 and 16 February 2026 that were pertinent to comorbidity and autism finds how the variable risk of comorbidity mimics the heterogeneity present in autism, thus inviting further investigations.

Diagnostic complexities of autism and psychosis: A commentary on the ANZJP GRADE guidelines for the management of schizophrenia.

The Australian and New Zealand Journal of Psychiatry GRADE Evidence Guidelines for Schizophrenia highlight the importance of considering psychiatric comorbidities, including autism spectrum disorder. These guidelines acknowledge that there is limited empirical research to guide the management of individuals with schizophrenia who also have these comorbid conditions. This lack of evidence poses challenges for clinicians, especially those working in early psychosis services, where the possibility of a missed diagnosis of autism spectrum disorder is increasingly being examined, and pre-existing diagnoses of autism spectrum disorder are not uncommon. This commentary explores the complex overlaps among shared histories, risk factors and symptomatology, as well as the difficulties stemming from the absence of validated assessment tools to aid in diagnostic clarification. Psychotic symptoms may complicate the recognition and differentiation of underlying neurodevelopmental characteristics of autism spectrum disorder. Considering the limited available evidence, practical guidance is offered to assist clinicians in their decision-making when a strong evidence base is lacking. In the context of early psychosis, diagnostic formulation should be considered provisional, with assessment of a possible a missed ASD diagnosis occurring after the stabilisation of psychotic symptoms wherever possible.

Clozapine for Severe Treatment-Resistant Disruptive Behaviors in Youth with Autism Spectrum Disorder: A Prospective Real-World Interventional Study.

OBJECTIVE Severe disruptive behaviors in youth with autism spectrum disorder (ASD) frequently persist despite conventional treatments, contributing to functional impairment. Although clozapine has antiaggressive properties, evidence guiding its use in treatment-resistant cases in autistic youth remains predominantly observational and retrospective. This study aimed to evaluate systematically and prospectively the effectiveness and safety of clozapine for treatment-resistant disruptive behaviors (TR-DB) in youth with ASD under routine conditions. METHODS This single-arm, open-label trial enrolled participants aged 10-17 with ASD. Inclusion required TR-DB after ≥2 antipsychotic trials and a Clinical Global Impression-Severity score ≥5. Following flexible titration, clozapine was maintained for 12 weeks. The primary outcome was change on the caregiver-rated Aberrant Behavior Checklist-Irritability (ABC-I). Secondary measures included global improvement, autism symptom severity, adaptive behavior, and caregiver quality of life. Response was defined as ≥30% ABC-I reduction plus a CGI-Improvement (CGI-I) of 1 to 2; remission required ≥80% ABC-I reduction and a CGI-I of 1. RESULTS Thirty-one participants initiated clozapine treatment (mean age 13.4 years; 90.3% male), and 28 completed the trial. ABC-I scores decreased from 32.0 ± 7.7 to 7.4 ± 5.1 (Cohen's dz -2.5; p < 0.001). Overall, 83.9% responded, and 38.7% remitted. Global severity improved from 6.1 ± 0.6 to 3.8 ± 1.6 (p < 0.001). Significant improvements were observed in daily living skills, caregiver quality of life, and reduced polypharmacy. Adverse drug reactions were mostly mild-to-moderate; however, metabolic changes comprised significant weight gain and triglyceride elevation (both p < 0.05). Serious events included seizures (n = 4) and pneumonia (n = 1). CONCLUSIONS Clozapine was associated with robust, rapid TR-DB reductions and high retention in autistic youth. However, safety risks mandate rigorous monitoring. Controlled trials are needed to confirm efficacy and refine the benefit-risk profile.

Selective mutism and autism spectrum disorder in girls: a critical narrative review

A critical narrative review of contemporary literature examining the interface between SM and ASD in girls, with emphasis on neurobiological mechanisms, dimensional psychopathology, and diagnostic and therapeutic implications reveals converging evidence of shared neurobiological substrates including amygdala hyperreactivity and altered connectivity within social brain networks.