Correlation of family history with specific autistic subgroups: Asperger's syndrome and bipolar affective disease.
Asperger's and bipolar illness cluster only in high-functioning autism families, so family history can flag which autism pathway you are dealing with.
01Research in Context
What this study did
Saunders et al. (1988) looked at family trees of people with autism. They split the families into two groups: high-functioning and low-functioning. Then they counted how many relatives had Asperger's or bipolar illness in each group. It was a small case-series, so they just described what they saw.
What they found
Asperger's and bipolar disorder showed up together only in the relatives of high-functioning people with autism. The low-functioning group did not have this pattern. This hints that high-functioning autism may travel through families in a different way.
How this fits with other research
Ghaziuddin (2005) repeated the idea and found the same family clustering, but saw more depression and schizophrenia instead of bipolar. The pattern stayed the same: only Asperger families carried the extra load.
Pickering et al. (1985) had already shown that severe autism with intellectual disability gives a different sibling risk. Saunders et al. (1988) add the mood-disorder angle, strengthening the two-pathway story.
Chien et al. (2021) used a huge national sample and confirmed that bipolar and schizophrenia-spectrum disorders are more common across all ASD, but the risk is highest in the Asperger/PDD-NOS group, matching the 1988 hint.
Why it matters
When you take a family history, ask specifically about Asperger traits, bipolar, depression, and schizophrenia. If these pop up, the client likely sits on the high-functioning side and may need mood monitoring. If they do not, the genetic route may be different and your treatment plan can shift accordingly.
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02At a glance
03Original abstract
The etiology of infantile autism is not known. To assess the possible role of familial psychopathology, we investigated a group of autistic subjects subgrouped by level of language function. Family histories were obtained by the family history method. Neurological status was assessed by neurological diagnostic examination and prenatal and perinatal history. The results showed a high incidence of Asperger's syndrome in family members of high-functioning autistic subjects only. The rate of bipolar affective disorder in family members was 4.2%, higher than in the general population; it was significantly higher in families with Asperger's syndrome, suggesting an etiological link between Asperger's syndrome and manic depression. Positive neurological findings were concentrated in the low-functioning subgroup. These findings imply different etiologies for high- versus low-functioning autism, with high-functioning autism related to familial factors, especially Asperger's syndrome.
Journal of autism and developmental disorders, 1988 · doi:10.1007/BF02211877