Autism and anorexia nervosa: Longitudinal prediction of eating disorder outcomes

Jenni Leppanen; Felicity Sedgewick; Daniel Halls; Kate Tchanturia

doi:10.3389/fpsyt.2022.985867

Autism and anorexia nervosa: Longitudinal prediction of eating disorder outcomes

Front Psychiatry. 2022 Sep 21:13:985867. doi: 10.3389/fpsyt.2022.985867. eCollection 2022.

Authors

Jenni Leppanen¹, Felicity Sedgewick², Daniel Halls³, Kate Tchanturia^{3

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Affiliations

¹ Department of Neuroimaging, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, United Kingdom.
² School of Education, University of Bristol, Bristol, United Kingdom.
³ Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, United Kingdom.
⁴ South London and Maudsley NHS Foundation Trust National Eating Disorder Service, London, United Kingdom.
⁵ Department of Psychology, Illia State University, Tbilisi, Georgia.
⁶ Psychological Set Research and Correction Center, Tbilisi State Medical University, Tbilisi, Georgia.

Abstract

Background: Recently, elevated levels of autistic features and autism diagnoses have been reported among people with anorexia nervosa (AN). In clinical settings high levels of autistic features have been linked to more complex, highly comorbid illness presentation and poorer treatment outcome. This study aimed to examine whether autistic features predict AN symptom profile in long term.

Methods: Altogether 118 women with lived experience of AN completed two autism assessments at time 1, the Autism Diagnostic Observation Schedule (ADOS) and the short version of the Autism Quotient (AQ10). Measures assessing AN symptom profile, including eating disorders symptoms, anxiety, depression, OCD symptoms, and Body Mass Index (BMI), were also recorded. The symptom profile measures were administered again 6 months and 2 years later. We conducted two analyses to examine the extent to which the ADOS and AQ10 scores predicted broad AN symptom profile at each three time points.

Results: Overall, high levels of autistic features were consistently associated with worse psychological symptoms, but not BMI, across all time points. Both the analysis using baseline ADOS scores and self-reported AQ10 scores showed similar pattern.

Conclusion: The present findings consolidate previously reported associations between autistic features and worse psychological outcome among people with AN. The findings also suggest that self-report measures may be sufficient for assessing the impact of autistic features on illness outcome among people with AN. Importantly, the study highlights the need for development and further investigation of neurodiversity accommodations in the treatment of AN.

Keywords: ADOS; AQ10; anorexia nervosa; anxiety; autism; autistic traits; depression; eating disorder symptoms.

Abstract

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