Distinctive Rorschach profiles of young adults with schizophrenia and autism spectrum disorder

Objective: The differential diagnosis of schizophrenia (SZ) versus autism spectrum disorder (ASD) can be clinically challenging because accumulating evidence suggests both clinical and biological overlaps between them. The aim of this study was to compare Rorschach profiles between young adults with SZ and those with ASD.

Methods: We evaluated quantitative tendencies on the Rorschach test among 20 patients diagnosed with SZ and 20 diagnosed with ASD. Both groups were matched for age, sex, and intelligence quotient.
Results: We found significant differences in six response variables on the Rorschach comprehensive system. Those with SZ had significantly higher scores on D score, adjusted D score (Adj D), developmental quality code reflecting ordinary response (DQo), and form quality minus (FQ -) than those with ASD. In contrast, those with SZ had significantly lower scores on the active and developmental quality code reflecting synthesized response (DQ+) subscales than those with ASD.

Conclusion: The present findings reveal that individuals with SZ might have more stress tolerance, stronger perception distortions, and simpler and poorer recognition than those with ASD. We suggest that the Rorschach test might be a useful tool for differentiating between SZ and ASD.

Keywords: autism spectrum disorder, perception, psychopathology, Rorschach test, schizophrenia


One time this psychiatrist was giving a Rorschach test to a young man. He displayed the first person, and the subject said, “I see a naked woman.” He displayed the second picture, and the subject said, “I see a naked woman having sex.” He displayed the third picture, and the subject said, “I see a naked woman at an orgy.” Then the psychiatrist said, “You seem to have a dirty mind. Every picture you see you think is about sex.” The subject responded, “Well, doc, you’re the one showing dirty pictures.”


I dunno, I SWEAR I saw the caterpiller from Alice in Wonderland smoking a hookah :slight_smile:

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after being on antipsychotics for a year and a half everything looks like its having sex but me.

I’d like to do that test. I have never done it.

Mainly, it’s to see how quickly people with ASD react/respond to changes in external input. To see how “reflective” they are or are not. This is the key point that should’ve been noted. They actually don’t need the famous Rorschach test with the patterns. Experienced clinicians can tell during an appointment by simply observing the patient. People with schizophrenia are more reflective or react quicker to external stimuli. Such as turning your head to someone trying to verbally get your attention. Things like that.

I found experienced clinicians can differentiate quickly without running any sort of tests. Pretty amazing but they have their ways to make the diagnostic stage as quick as possible so can move on to the treatment and prognosis stages.

Re-reading the article and they did make the good point (you kind of have to know what they’re really referring to) that people with ASD (once they locate the external input) will usually process or “synthesize” that input. Yeah, that’s true. People with Schizophrenia, in contrast, will usually capture/look at the new external input faster but then won’t process or interpret/comprehend the meaning of the input as quickly as people with ASD.

When you’ve been a patient, sometimes can pick up subtle little things (after the appointment) that the doctor is observing and may be diagnosing/differentiating you even when you don’t realize.

Something as simple as suddenly placing a piece of paper (like a form) in front of you could actually be a quick test the doctor/clinician is using to further prove if the diagnosis is autism or schizophrenia. Something as simple as that.