Abstract

BackgroundLong-term consequences of comorbid autism spectrum disorder (ASD) in individuals with anorexia nervosa (AN) are inadequately investigated.MethodsIn the 1980s, 51 adolescent-onset AN cases (AN group) and 51 matched controls (COMP group) were recruited from the community. They have been examined on five occasions. The four last assessments included the Morgan-Russell Outcome Assessment Schedule (MROAS) to assess eating disorder outcomes (weight, dieting, menstruation), and related problems including psychiatric, psychosexual and socioeconomic state. In the present study, at age 44, when 30 years had elapsed, MROAS data were compared with previous results. At age 16, 21, 24 and 32 years, all individuals had been assessed regarding ASD. At the 30-year follow-up, the impact of the ASD on the MROAS data was analysed.ResultsIn the AN group, all core anorectic symptoms (weight, dieting, menstruation) were on a par with the COMP group at the 30-year follow-up, but the positive outcomes were limited to those who had never had an ASD diagnosis. Psychiatric state was significantly worse in the AN group, particularly in the subgroup who had an ASD diagnosis assigned. The AN group—again particularly those with ASD—had a more negative attitude to sexual matters than the COMP group. The AN group had worse outcomes than the COMP group for ‘personal contacts’, ‘social contacts,’ and ‘employment record’ at the 30-year follow-up and the outcomes were worse the more often an ASD diagnosis had been assigned.LimitationsRare data collection points throughout 30 years (only 5 assessments). ASD was assessed in the first four studies but was not assessed again at the 30-year follow-up.ConclusionsMental health, psychosexual, and socioeconomic status were compromised up to 30 years after AN onset. Coexisting ASD contributed to the poor outcome. Core anorectic symptoms had “normalised” three decades after AN onset.Plain English summarySome individuals with anorexia nervosa (AN) also suffer from autism. In this study we have investigated outcome of AN 30 years after the onset of AN and whether the presence of autism affects the outcome. Since the 1980s we have followed 51 individuals with teenage-onset AN and 51 healthy controls. They have been examined on five occasions, and an instrument that measures symptoms of AN (weight, dieting, body image), psychiatric symptoms, ability to work, and relationships with partner, family, and friends has been used to assess outcome. Autism was assessed in the first four studies. Symptoms of AN had normalised at 30-year follow-up, but only among those without autism. Psychiatric symptoms, ability to work, and relationships were issues that persisted after 30 years in the AN group, and those who had both autism and a history of AN had even more pronounced problems in these areas. The AN group had a more negative attitude to sexual matters than the control group, the outcome was worse the more often an autism diagnosis had been assigned.ConclusionsMental health, psychosexual, and socioeconomic status are affected up to 30 years after AN onset, particularly among those with autism.

Highlights

  • Long-term consequences of comorbid autism spectrum disorder (ASD) in individuals with anorexia nervosa (AN) are inadequately investigated

  • In the AN group, eating disorder (ED) had successively decreased between AN Study 2 and AN Study 4; 20, 13, and 6 individuals had an ED in AN Study 2, AN Study 3, and AN Study 4, respectively

  • One individual fulfilled the criteria for an ED in the COMP group in AN Study 5, a case of OSFED, night eating syndrome

Read more

Summary

Introduction

Long-term consequences of comorbid autism spectrum disorder (ASD) in individuals with anorexia nervosa (AN) are inadequately investigated. Anorexia nervosa (AN) is characterised by starvation, underweight, fear of gaining weight, and a distorted body perception. It is one of the most severe psychiatric disorders that can affect a young person, due to a considerable risk of a chronic course and the highest mortality rate among all mental illnesses [1]. In a German long-term outcome study, more than a thousand AN inpatients were followed for an average of ten years, including a subsample with 20-year outcome data [11]. Non-eating disorder (ED) psychiatric morbidity at very long-term follow-up is dominated by affective and anxiety disorders [8, 13]. Very long-term outcome studies pertaining to Health-Related Quality of Life (HRQoL) have shown poorer mental status in individuals with a history of AN [13], and poorer mental and physical HRQoL in individuals with chronic AN [14]

Objectives
Methods
Results
Discussion
Conclusion
Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call