Autistic characteristics in youth with anorexia nervosa before and after treatment

Abstract

Objective: Cognitive characteristics common to autistic individuals are often seen in adults with anorexia nervosa (AN), raising the question of whether autistic people and people with AN may share an endophenotype. We need to examine autistic characteristics during the early stages of AN to accurately parse true symptom co-occurrence from behavioural alterations due to prolonged illness. Methods: We conducted a post-hoc analysis examining autistic characteristics in 59 youth with AN. Adolescents and parents participating in a randomisedclinical trial for AN completed questionnaires probing autistic characteristics at baseline and treatment end. We categorised participants as above or below cut-offs of clinical indicators of autism using the Autism Probability Index (API) and the Autism Spectrum Quotient-10.Results: Rates of high autistic characteristics ranged between 0% and 36% depending on the instrument used and how the data was obtained (i.e., by informant report or self-report). Paternal report of autistic characteristics differed across treatment completers versus non completers and maternal report indicated lower weight gain for those with elevated characteristics. Conclusions:Low rates of autism and fluctuations in autistic features during treatment underscore the importance of longitudinal examinations of autistic characteristics in adolescents with AN. Future studies need to replicate findings in a larger adolescent sample.

Autism and anorexia nervosa: Longitudinal prediction of eating disorder outcomes

“…However, notably the average duration inpatient treatment was 16 weeks making it difficult to draw long-term conclusions from these findings. Additionally, other recent studies have not reported significant association between autistic features and ED symptoms or differences in illness outcome between AN patients with and without high levels of autistic features ( 27 , 28 ). Therefore, it is of interest to examine whether and to what extent autistic features can predict complex illness presentation in AN in long term.…”

A longitudinal study of autism spectrum disorder characteristics in adolescents with restrictive type anorexia nervosa during and after underweight

“…ASD characteristics as a state in AN is further supported by earlier research that ASD characteristics are not continuously present in patients with AN: While elevated ASD characteristics are seen in AN patients, these characteristics are often not recognized by parents in earlier development (Stewart et al., 2017; Westwood et al., 2018). A recent longitudinal study from Susanin (Susanin et al., 2022) also observed fluctuations in ASD characteristics in adolescent patients before and after treatment. Thus, these studies do not advocate for ASD diagnosis despite ASD characteristics.…”

Autistic traits, sensory sensitivity and eating disturbances in a sample of young adults referring to a generalized mental health clinic

“…Conversely, individuals recovered from AN often continue to manifest ASD-related symptoms compared to healthy controls [ 12 ]. Hence, while autistic traits may vary in severity during the clinical course of AN [ 13 ], they seem to maintain a relatively consistent pattern over time and are not evidently linked to body weight and potential recovery [ 14 ].…”