Prevalence and Comorbidity of Autism Spectrum Disorder and Schizophrenia in Psychiatric Care and Development Centers in Guayaquil, Ecuador.

Abstract

This research aimed to determine the prevalence and describe the comorbidity pattern between Autism Spectrum Disorder (ASD) and Schizophrenia in patients from specialized health and development centers in Guayaquil, Ecuador, during the 2021-2025 period, due to a critical lack of updated and specific epidemiological data in the region that hinders adequate health planning. ASD and Schizophrenia, while currently conceptualized as separate entities, share an underlying vulnerability due to common genetic and neurobiological risk factors, with a significant overlap in polygenic risk and shared deficits in cognitive domains such as Theory of Mind and executive functions. The adopted methodology was an observational, descriptive, and retrospective study based on the review of anonymized clinical records from reference centers. The diagnostic challenge lies in interpreting the symptoms, as the negative symptoms of Schizophrenia can be mistaken for the social deficits inherent to ASD, and the onset of positive psychotic symptoms must represent a qualitative change beyond the basal autistic profile. It is estimated that approximately 70% of individuals with ASD will present at least one concurrent psychiatric disorder during their lifetime. Although the methodological section validates the data extraction and diagnostic verification, the numerical prevalence and comorbidity results derived directly from the Guayaquil clinical sample are not explicitly detailed in the text. Nevertheless, the study is supported by prior findings confirming a high burden of psychiatric morbidity in ASD, including a 0.6% prevalence of psychosis in population-based studies in children and adolescents, and the relevance of Schizophrenia as the third most frequent diagnostic category in other morbidity studies in Ecuador. The study concludes by establishing the scientific and clinical relevance of this comorbidity and reaffirming the urgency of using these findings to characterize the affected population and optimize care models and health resources in Guayaquil.