SYSTEMATIC REVIEW article
Front. Psychol.
Sec. Psychopathology
Volume 16 - 2025 | doi: 10.3389/fpsyg.2025.1549886
This article is part of the Research TopicAnxiety in Autistic People: Moving the NeedleView all 5 articles
The Relationships Between Anxiety, Psychotic-like Experiences and Autism: A Systematic Review
Provisionally accepted
- King's College London, London, United Kingdom
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Introduction: Research has suggested that anxiety may be responsible for the elevated levels of psychotic-like experiences (PLEs) seen in Autism. However, there has been no previous systematic review examining this relationship. Method: We conducted three separate searches of PubMed and Ovid (MEDLINE, PsycINFO, Global Health and EMBASE) until 31st June 2024 for articles reporting on the association between anxiety, Autism and PLEs. A total of 54 articles were reviewed, including research exploring the links between anxiety and PLEs (28 studies), Autism and PLEs (12 studies), Autism and anxiety (14 systematic reviews and meta-analyses). Results: Studies of Anxiety and PLEs: Thirteen reported a significant positive correlation, and ten studies indicated that individuals with anxiety were more likely to experience PLEs. Studies of Autism and PLEs: Seven identified a significant positive correlation, with three longitudinal studies reporting that autistic traits predicted PLEs. Studies of Autism and Anxiety: Seven reviews revealed increased prevalence rates of anxiety disorders among autistic individuals, while nine identified potential mediators of this relationship, such as intolerance of uncertainty and IQ. Conclusions: These findings demonstrate the association of PLEs with Autism and anxiety disorders, suggesting that co-occurring Autism and anxiety may represent an at-risk group for psychosis. Such insights have important implications for psychosis prevention, indicating that anxiety intervention in autistic populations may reduce PLE incidence. However, application of these findings to Autistic individuals is significantly limited by the lack of included studies utilizing clinical populations. Future research is needed to establish the causal role of anxiety in this relationship, particularly using clinical adult samples.
Keywords: Psychosis1, autism2, risk3, Early intervention4, anxiety5
Received: 22 Dec 2024; Accepted: 24 Sep 2025.
Copyright: © 2025 Rowe, Shergill and Maitra. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Madeleine Rowe, maddyrowe48@gmail.com
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