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Objectives: Autism spectrum disorders and personality disorders are spectrum conditions with shared clinical features. Despite similarities, previous attempts to synthesise literature on co-existing prevalence and shared traits have employed a unidirectional focus, assessing personality characteristics of individuals with an autism spectrum disorder diagnosis. Here, we assess the prevalence of autism spectrum disorder diagnosis and/or traits among persons diagnosed with a personality disorder. Methods: We systematically reviewed the English-language literature following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, according to a pre-registered protocol (PROSPERO: CRD 42021264106). Peer-reviewed quantitative studies reporting the prevalence of autism spectrum disorder diagnosis or traits in persons with an established personality disorder diagnosis were included. Studies were critically appraised using the Appraisal tool for Cross-Sectional Studies. Results: Fifteen studies were identified, including 72,902 participants (median: 48, interquartile range: 30–77). Diagnoses included borderline, schizotypal and obsessive-compulsive personality disorders, and cohorts with unspecified personality disorder diagnoses. There was significant heterogeneity in diagnostic methodology and assessment tools used. We identified preliminary evidence of an increased prevalence of co-existing autism spectrum disorder diagnosis and traits among those diagnosed with a personality disorder, although significant limitations of the literature were identified. Conclusion: Our research suggests clinicians should consider conducting a careful developmental assessment when assessing service-users with possible or confirmed personality disorder. Future research directions may include larger studies featuring clinical control groups, an exploration of shared and differentiating behavioural-cognitive features of the two conditions, and investigation into potentially shared aetiological factors. Research investigating demographic factors that may contribute to potential diagnostic overshadowing would also be welcomed.

Letters to the Editor offer ways for readers to engage with authors' publications. Letters are the shortest manuscript for medical students to publish and medical-education journals are best suited. The UK Foundation Programme rewards medical students achieving PubMed ID publications and we hypothesise that this is a main motivation for medical students to submit Letters to the Editor. A review of 15 medical-education journals with an impact factor was conducted to identify numbers and percentages of Letters to the Editor by medical students between July 2018 and June 2020. Affiliation of medical students was collected. Our results show over two years, 299 letters were published by medical students equating to 45.9% of total letters. There was a 60% overall increase in letters by medical students published in the first 12 months compared to second 12 months. During this period overall numbers of letters published increased by 27%. 86% of the letters published by medical students over the twoyear period were from UK medical schools. Five schools accounted for 60.5% of these letters. The three medical schools with highest numbers of letters published were King's College London, Imperial College London and University of Oxford for both 2018/19 and 2019/20. The increase in letters published overall with greater numbers published by students, may indicate greater awareness of Letters to the Editor as means of dissemination amongst medical students. UK medical schools published large numbers of letters, perhaps reflecting increasing importance to students of publications due to impacting on subsequent jobs. Results from our quantitative research revealing: large numbers of letters by medical students, increase in letters published from 2018/19 to 2019/20 and overrepresentation of UK medical students supports the hypothesis that medical students are publishing letters to achieve PubMed IDs. Further qualitative research is required to test our hypothesis.

Background:Letters to the Editor offer a way for readers to engage with authors on their publications and add valuable insights into the discussion. Letters are the shortest manuscript for medical students to publish and medical education journals are best suited for this. The UK Foundation Programme rewards medical students for achieving publications with a PubMed ID. The aim of the study is to analyse the total number, percentage, and affiliation of Letters to the Editor published by medical students in medical education journals. Methods:A review of 15 medical education journals that had an impact factor was conducted to identify the number and percentage of Letters to the Editor by medical students between July 2018 and June 2020. Additionally, information on the affiliation of the medical students was collected. Results:Over a two-year period, 299 letters were published of which 45.9% were by medical students. There was a 60% overall increase in letters by medical students published in the first 12 months compared to second 12 months. During this same period the overall number of letters published increased by 27%. There was no apparent seasonal variation observed in Letters to the Editor published by medical students. A large proportion of letters by medical students were contributed by a small number of medical schools with five schools accounting for 60.5% of letters during the two-year period. The three medical schools with the highest number of letters published were King's College London, Imperial College London and University of Oxford for both 2018/19 and 2019/20. Most Letters to the Editor by medical students were by UK medical schools with 86% of letters published by UK medical students over the two-year period. Conclusion:There was an increase in the number of letters published overall but an even greater number published by students, which could represent greater awareness of letters to the editor as a means of dissemination amongst medical students. UK medical schools published many letters -it may be that this is due to the increasing importance in students\' minds about publications due to the impact on subsequent jobs when qualified. The results from our quantitative research shows a large number of letters are written by medical students, there is an increase in letters published from 2018/19 to 2019/20, and there is an overrepresentation of UK medical students -altogether this supports our hypothesis that medical students are publishing letters as a means of achieving a PubMed ID. Further qualitative research is required to prove our hypothesis. Journals should look for ways to encourage non-UK medical students to engage with their literature allowing for a more diverse range of opinions.