Although Asperger’s and schizophrenia are different conditions, their symptoms may overlap.

Asperger’s and schizophrenia symptoms can include difficulties with social interactions, communication, and language.

This overlap in symptoms can create challenges in diagnosing each condition correctly. It is also possible for people to have both conditions.

This article looks at the similarities between Asperger’s and schizophrenia, the diagnostic criteria of each condition, and their treatment.

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Asperger’s, which healthcare professionals now class under the umbrella term autism spectrum disorder (ASD), and schizophrenia share certain cognitive features.

People with ASD and schizophrenia both have difficulty processing social information. They may also lack typical social and communicative behaviors.

However, the onset of each condition varies. ASD usually appears in childhood, while schizophrenia typically develops in late adolescence and early adulthood.

According to 2021 research, children who have parents with schizophrenia have an increased chance of having autistic traits.

Genetic factors play a role in both conditions. Researchers also found a significant link between environmental factors, including socioeconomic status, and the occurrence of autistic traits.

A 2019 review also found that people with schizophrenia spectrum disorders (SSDs) have more autistic symptoms than those without SSDs, which may be due to shared genetic risk factors.

Learn more about schizophrenia and autism in our mental health hub here.

To diagnose schizophrenia, a mental health care professional will assess symptoms and conduct tests to rule out other possible conditions.

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) states the following criteria for a schizophrenia diagnosis:

  • Two or more of the following, of which at least one of the first three listed must be present, occurring significantly for 1 month:
    1. delusions
    2. hallucinations
    3. incoherence or disorganized speech
    4. unresponsive or significantly disorganized behavior
    5. decreased speech, lack of emotional expression, or lack of motivation.
  • Significant decrease in how a person functions in one or more major areas of their life, such as work, relationships, or self-care.
  • Symptoms of schizophrenia persist for at least 6 months.
  • A mental health care professional has ruled out other medical conditions, including schizoaffective disorder, depressive disorder, or bipolar disorder.
  • Symptoms are not due to medication or drug use.

If people have a history of ASD or a childhood communication disorder, they must fulfill the above criteria and have experienced delusions or hallucinations for at least 1 month to receive a schizophrenia diagnosis.

Learn about the different types of schizophrenia here.

To diagnose Asperger’s in children, a mental health care professional will assess symptoms and monitor their development and behavior.

In adults, a mental health care professional may ask questions about behavior patterns and administer tests to assess cognition, language, social communication skills, and restricted and repetitive behaviors and interests.

The DSM-5 now classifies Asperger’s under the umbrella term of ASD. The DSM-5 lists the following criteria for ASD:

  • persistent lack of social communication and interaction, such as being unresponsive in conversations, abnormal eye contact or body language, lack of facial expressions, or lack of interest in peers
  • restricted or repeated patterns of behavior, such as insisting on keeping to the same routine, rigid thinking patterns, intense attachment to unusual objects, or abnormal response to stimuli such as lights or sound

For an ASD diagnosis, a person must display the following:

  • a persistent deficit in each of three areas of social communication and interaction
  • at least two out of four types of restricted or repetitive behaviors

According to the National Institute of Neurological Disorders and Stroke (NINDS), children with Asperger’s still show early language skills.

Learn about the levels of autism here.

Symptoms of Asperger’s and schizophrenia can overlap and may share the following symptoms:

Hallucinations and delusions

People with schizophrenia may have psychosis symptoms, such as hallucinations and delusions.

Many people with schizophrenia hear voices. People may also have sensory experiences of things that are not real. People with schizophrenia may also have delusions, such as irrational beliefs that are not true.

Up to 34.8% of people with ASD may have psychotic symptoms. Difficulty processing information, such as in ASD, may increase the risk of developing psychosis symptoms, such as hallucinations and delusions.

People with ASD may have unusual sensory experiences. Delusional beliefs may stem from a lack of understanding of expected social conventions.

Sometimes, doctors and other healthcare professionals have difficulty detecting hallucinations or delusions in children with communication problems.


When a person with schizophrenia displays negative symptoms, they lack certain feelings or motivations that people without the condition would likely have. People with schizophrenia may have a flat affect, meaning they may respond without facial expression or in a monotone voice.

People with ASD may exhibit similar characteristics, such as reduced eye contact, lack of facial expression, and limited use of gestures.

Social relationships

People with ASD or schizophrenia may have difficulty creating or maintaining social relationships. Social withdrawal may be a symptom of both conditions.

Some people may have difficulty identifying humor, irony, or metaphors in conversation and may not be able to understand the emotional aspects of a social situation.

Theory of mind

Theory of mind allows people to recognize mental states, such as emotions, desires, and beliefs, within themselves and others.

People with ASD or schizophrenia may have deficits in theory of mind. People may find it difficult to identify other people’s emotions or intentions and lack self-awareness.

Social communication

Language difficulties may be present in both ASD and schizophrenia. People with these conditions may not initiate conversations and speak vaguely and repetitively.

Learn more about autism with schizophrenia here.

Treatment of Asperger’s may include:

  • training in social and communication skills
  • CBT
  • reinforcement of positive behaviors
  • medication for any co-existing conditions

Learn more about Asperger’s in adults, including treatment.

Sometimes, mental health care professionals may find it easier to differentiate between extreme cases of ASD and schizophrenia than mild cases of each condition.

People may need to work with a team of healthcare professionals to ensure they receive the correct diagnosis and begin effective treatment.

Treatments for schizophrenia may help people manage their symptoms and improve how they function in education, work, and relationships.

Early diagnosis and treatment of Asperger’s may increase a child’s chance of success in school and independence in adulthood.

Asperger’s, or mild ASD, and schizophrenia have overlapping symptoms, including psychosis and reduced social, language, and communication skills. Both conditions may share similar genetic risk factors.

Receiving the correct diagnosis helps ensure people get effective treatment. Healthcare professionals will assess symptoms and examine cognition, language, and behavior to diagnose ASD and schizophrenia.