Autism Spectrum symptoms in a population of extremely undernourished patients with Anorexia Nervosa: a pilot study.

Researchers studied 33 people with severe anorexia nervosa and found that 12% showed signs of autism. Those with more autism-like traits had more severe eating disorder symptoms, more rigid thinking, and sensory sensitivities. Importantly, these autism traits weren't just caused by being underweight - they appeared to be genuine characteristics that might need special attention in treatment.

This pilot study examined autism spectrum disorder (ASD) traits in 33 extremely undernourished inpatients with anorexia nervosa (AN). Twelve percent scored above clinical thresholds for ASD symptoms. Eating disorder severity strongly correlated with ASD traits (r=0.62), cognitive rigidity (r=0.61), and sensory sensitivity (r=0.69), independent of age and BMI. Communication difficulties and sensory hyposensitivity predicted eating disorder severity.

Only one biomarker (Transthyretin) was associated with dysfunctional thinking patterns. The findings suggest ASD symptoms co-occur frequently in severe AN cases and appear largely independent of malnutrition status, indicating potential need for autism-specific therapeutic approaches in eating disorder treatment.

Results suggest clinicians should screen for autism traits in severe anorexia nervosa cases and consider autism-informed treatment approaches. The independence of ASD symptoms from malnutrition status indicates these may be co-occurring conditions requiring specialized therapeutic interventions rather than symptoms that will resolve with nutritional rehabilitation alone.

Small sample size (n=33) from single center limits generalizability. Cross-sectional design prevents causal inferences. Pilot study nature requires replication. Assessment relied on self-report measures rather than diagnostic interviews. Study focused only on extremely undernourished cases.

Symptoms of Autism Spectrum Disorder (ASD) are overrepresented among individuals with Anorexia Nervosa (AN). We aimed to study the prevalence of ASD symptoms in extremely undernourished inpatients with AN and focus on potential cognitive and nutritional correlates. We recruited prospectively all extremely undernourished patients with AN admitted to the Nutritional Care Unit of Paul Brousse Hospital over four months. ASD traits and AN psychopathology were assessed by administering the Autism Quotient (AQ) and the Eating Disorder Inventory-2 (EDI-2).

Neuropsychological and bio-nutritional data were also collected. Among 33 participants aged 25.5 ± 9.3 (91 % females, BMI: 12.1 ± 1.4), 12 % scored above the clinical cut-off on the AQ. Independently of age and BMI, EDI-2 scores were significantly correlated with AQ-total scores (r = 0.62; p < 0.01), higher levels of cognitive rigidity (r = 0.61; p < 0.001) and sensory sensitivity alterations (r = 0.69; p < 0.01). In the cross-sectional model, the AQ-communication domain, and the GSQ-hyposensitivity scale were significant predictors (p < 0.5) of the variance in EDI-2 scores.

Negative beliefs and cognitive confidence were associated with lower levels of Transthyretin (p < 0.02). ASD traits presented high prevalence in extremely undernourished patients with AN. Despite the impact that malnutrition can have on cognitive functioning, most of these traits appear to be independent of BMI but associated with the severity of eating psychopathology; only Transthyretin was associated with dysfunctional metacognitions. These preliminary results suggest that ASD symptoms might co-occur in severe AN and require specific therapeutic interventions.