As we learn more about Asperger's Syndrome and its position on the autism spectrum, studies about the people who present with the condition have begun. There has been some early work suggesting that there is a slightly higher percentage of people who have Aspergers that end up with different forms of psychosis than the normal population. The studies are preliminary, and the numbers of people tested are not large enough to make this a statistically unquestionable fact. Three factors play a large role in whether or not an Asperger's person ends up with a psychosis as well. Here is a look at each one, and how it may affect the chances of developing an additional condition:
One of the first ways in which those with Asperger's may develop psychosis is through lack of intelligence. The disorder limits the windows through which a person can view the world. For an Asperger's person, they see black and white, and do not understand emotion, empathy, or unspoken social rules. This is why they often immerse themselves deeply into the world of fact. Many go on to have Ph.D degrees, in a higher percentage than the average person. If the person has a lower intelligence, however, then the subtle nuances in the world of fact, such as the exceptions to the rules and the reasons for them, can be lost. This will leave them without a safe, logical place in which to find themselves, and they may descend into psychosis.
Drug use is a very common reason for psychosis in those with Asperger's syndrome. This can mean recreational drugs or prescription drugs. Any substances that can alter perception or the regulation of emotion will feel illogical and terrifying for those with Asperger's. Again, the inability to find a safe, logical place in which to anchor themselves may enhance their chances of going into a place that is far from reality.
Some people with Asperger's may fall somewhere in between autism and schizophrenia with their presentation, or their collection of symptoms. These people may avoid diagnosis or get competing diagnoses for some time, and they may have both conditions. More research must be done on this group of people to see if they need their own diagnosis, or if they fall into one or both categories.
Though it is unknown the exact mechanism for psychosis in autism patients, many cases have a similar presentation to some conditions that have also been known to cause temporary madness in others. Paris Syndrome, Jerusalem Syndrome, and Stendahl Syndrome are all cases of temporary hallucinations or other psychoses that were caused by intense emotional connection to religion, art, beauty, or extreme and uncomfortable culture shock. There may be a similar mechanism for the Asperger's patient at play when the right conditions present themselves.