The Autism–Psychosis Continuum Conundrum: Exploring the Role of the Endocannabinoid System

Marco Colizzi, Riccardo Bortoletto, Rosalia Costa, Sagnik Bhattacharyya and Matteo Balestrieri
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Marco Colizzi: Unit of Psychiatry, Department of Medicine (DAME), University of Udine, 33100 Udine, Italy
Riccardo Bortoletto: Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Integrated University Hospital of Verona, 37126 Verona, Italy
Rosalia Costa: Community Mental Health Team, Friuli Centrale University Health Service (ASUFC), 33057 Palmanova, Italy
Sagnik Bhattacharyya: Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
Matteo Balestrieri: Unit of Psychiatry, Department of Medicine (DAME), University of Udine, 33100 Udine, Italy

IJERPH, 2022, vol. 19, issue 9, 1-22

Abstract: Evidence indicates shared physiopathological mechanisms between autism and psychosis. In this regard, the endocannabinoid system has been suggested to modulate neural circuits during the early stage of neurodevelopment, with implications for both autism and psychosis. Nevertheless, such potential common markers of disease have been investigated in both autism and psychosis spectrum disorders, without considering the conundrum of differentiating the two groups of conditions in terms of diagnosis and treatment. Here, we systematically review all human and animal studies examining the endocannabinoid system and its biobehavioral correlates in the association between autism and psychosis. Studies indicate overlapping biobehavioral aberrancies between autism and schizophrenia, subject to correction by modulation of the endocannabinoid system. In addition, common cannabinoid-based pharmacological strategies have been identified, exerting epigenetic effects across genes controlling neural mechanisms shared between autism and schizophrenia. Interestingly, a developmental and transgenerational trajectory between autism and schizophrenia is supported by evidence that exogenous alteration of the endocannabinoid system promotes progression to inheritable psychosis phenotypes in the context of biobehavioral autism vulnerability. However, evidence for a diametral association between autism and psychosis is scant. Several clinical implications follow from evidence of a developmental continuum between autism and psychosis as a function of the endocannabinoid system dysregulation.

Keywords: neurodevelopment; mental health; delta-9-tetrahydrocannabinol; cannabidiol; cannabis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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