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The PANSS Autism Severity Score (PAUSS) provides a rapid measure of autistic features within the standard PANSS assessment. We aimed to determine the prevalence of autistic features in first\u2010episode psychosis (FEP), characterise their clinical, cognitive, and functional profile, and examine their impact on 2\u2010year outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A total of 328 FEP patients were included from the PEPs multicentre cohort, followed for 2\u2009years. Autistic features were rated using PAUSS (cut\u2010off \u2265\u200930), yielding autistic (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200938) and non\u2010autistic (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009290) groups. Sociodemographic, clinical, cognitive, and functional variables were analysed. Longitudinal analyses examined symptomatic remission rates and trajectories of psychopathology and functioning using logistic regression and mixed\u2010model ANOVA.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The autistic group represented 11.6% of the sample. At baseline, they exhibited lower birth weight, greater medication side effects, higher general psychopathology and depressive severity, and poorer global functioning. Cognitively, they showed significant deficits in working memory, social cognition, and cognitive reserve compared to the non\u2010autistic group. Over 2\u2009years, this group was 3.6 times less likely to achieve symptomatic remission and consistently exhibited higher symptom severity and lower functioning across all follow\u2010ups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Autistic features in FEP identify a subgroup with a possible distinct profile of neurodevelopmental markers, greater cognitive and functional impairments, and poorer clinical outcomes. Early identification may guide more personalised interventions, although further research is needed to refine PAUSS specificity and develop targeted, tailored treatments.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acps.70079","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T13:07:53Z","timestamp":1772975273000},"page":"636-648","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical Implications of Autistic Features in Patients With a First Episode of Psychosis"],"prefix":"10.1111","volume":"153","author":[{"given":"Miquel","family":"Bioque","sequence":"first","affiliation":[{"name":"Barcelona Cl\u00ednic Schizophrenia Unit (BCSU), Neuroscience Institute Hospital Cl\u00ednic de Barcelona  Barcelona Spain"},{"name":"Departament de Medicina, Institut de Neuroci\u00e8ncies (UBNeuro) Universitat de Barcelona (UB)  Barcelona Spain"},{"name":"Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS)  Barcelona Spain"},{"name":"Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM) Instituto de Salud Carlos III (ISCI\u2010III)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6515-2425","authenticated-orcid":false,"given":"Anaid","family":"P\u00e9rez\u2010Ramos","sequence":"additional","affiliation":[{"name":"Barcelona Cl\u00ednic Schizophrenia Unit (BCSU), Neuroscience Institute Hospital Cl\u00ednic de Barcelona  Barcelona Spain"},{"name":"Departament de Medicina, Institut de Neuroci\u00e8ncies (UBNeuro) Universitat de Barcelona (UB)  Barcelona Spain"},{"name":"Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS)  Barcelona Spain"},{"name":"Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM) Instituto de Salud Carlos III (ISCI\u2010III)  Madrid Spain"},{"name":"University of Cadiz  Cadiz Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8467-1335","authenticated-orcid":false,"given":"Vicent","family":"Llorca\u2010Bof\u00ed","sequence":"additional","affiliation":[{"name":"Barcelona Cl\u00ednic Schizophrenia Unit (BCSU), Neuroscience Institute Hospital Cl\u00ednic de Barcelona  Barcelona Spain"},{"name":"Departament de Medicina, Institut de Neuroci\u00e8ncies (UBNeuro) Universitat de Barcelona (UB)  Barcelona Spain"},{"name":"Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS)  Barcelona Spain"},{"name":"Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM) Instituto de Salud Carlos III (ISCI\u2010III)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Penad\u00e9s","sequence":"additional","affiliation":[{"name":"Barcelona Cl\u00ednic Schizophrenia Unit (BCSU), Neuroscience Institute Hospital Cl\u00ednic de Barcelona  Barcelona Spain"},{"name":"Departament de Medicina, Institut de Neuroci\u00e8ncies (UBNeuro) Universitat de Barcelona (UB)  Barcelona Spain"},{"name":"Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS)  Barcelona Spain"},{"name":"Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM) Instituto de Salud Carlos III (ISCI\u2010III)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. 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