Is Alexithymia the Link Between Anorexia and Autism Spectrum Disorders?

Abstract

ObjectiveAlexithymia main features include deficits in empathy, emotion recognition and regulation. Alexithymia has been recently proposed as a potential key to explain the presence of the so-called ‘autistic spectrum disorder’ signs (ASD), in patients with Anorexia Nervosa (AN). Objective of this review is to summarize current knowledge on the potential role of alexithymia in linking ASD and AN.MethodA systematic search has been conducted on PUBMED database of the last 10 years, in accordance with PRISMA Guidelines, applying queries in the ‘PubMed Advanced Search Builder’.ResultsWe initially retrieved 18 papers; the final selection has led to seven papers. According to the available studies, alexithymia is widely represented in samples of AN patients and comorbid ASD traits. However, the specific load of alexithymia in AN with ASD features is still in debate, as well as the potential role of interoceptive deficits. We have found several limitations in the reviewed studies, which shared a cross-sectional design, with no comparison between a pre and a post-treatment condition (except for one study), small samples sizes and some heterogeneity of administered instruments.Conclusionsthe specific load of alexithymia in explaining the link between AN and ASD is still in debate. Interoception deficit has been proposed as having a crucial role. Further research should be devoted to longitudinal studies and not only to cross-sectional observations.