Abstract
BackgroundAutism spectrum disorder (ASD) and feeding and eating disorders (FEDs) such as anorexia nervosa (AN) are strongly linked as evidenced by frequent comorbidity and overlapping traits. However, eating and social behaviors are shaped by culture, so it is critical to examine these associations in different populations. Moreover, FEDs are heterogeneous, and there has been no examination of autistic traits in avoidant/restrictive food intake disorder (ARFID).MethodsTherefore, we investigated the prevalence of ASD and autistic traits among Japanese children with AN (n = 92) or ARFID (n = 32) from a prospective multicenter cohort study using the Autism Spectrum Quotient Children’s version (AQC) and Children’s Eating Attitudes Test (ChEAT26).ResultsASD prevalence was high in both AN and ARFID (16.3 and 12.5%, respectively). The AN group exhibited significantly higher scores on all AQC subscales than an age-matched healthy control (HC) group, but there were no significant correlations between AQC scores and ChEAT26 scores. In the AFRID group, AQC scores did not differ from HCs, but significant correlations were found between total AQC and ChEAT26 scores and between several AQC and ChEAT26 subscales.ConclusionsBoth the AN and ARFID groups had high prevalence rates of ASD. The AN group showed a significantly higher degree of autistic traits than the HC group; however, no difference was found between the ARFID and HC groups. Clinicians need to be aware of these rates when working with children with ED.
Highlights
Feeding and eating disorders (FEDs) are a heterogeneous group of diseases, but all are characterized by persistent pathological food consumption patterns that negatively affect health, emotion, cognition, and quality of life
There were no significant differences in sex ratio and mean age between the healthy control (HC) and ED (AN + avoidant/restrictive food intake disorder (ARFID)) groups
Body weight, BMI, and body mass index standard deviation scores (BMI-SDS) were significantly lower in the ED group than in the HC group
Summary
Feeding and eating disorders (FEDs) are a heterogeneous group of diseases, but all are characterized by persistent pathological food consumption patterns that negatively affect health, emotion, cognition, and quality of life. There is compelling evidence that FEDs are associated with autism spectrum disorder (ASD) as originally proposed by Gillberg (1983), as these two disorders are frequently comorbid and exhibit similar cognitive and behavioral features [6], such as restricted and ritual behaviors [7]. To understand similar behaviors and common cognitive dysfunctions between ASD and FEDs may lead to enhanced treatment efficacy for ASD and FEDs. On the basis of these shared features, numerous studies over the past several decades have investigated the co-occurrence of ASD or autistic traits in AN. Autism spectrum disorder (ASD) and feeding and eating disorders (FEDs) such as anorexia nervosa (AN) are strongly linked as evidenced by frequent comorbidity and overlapping traits. FEDs are heterogeneous, and there has been no examination of autistic traits in avoidant/restrictive food intake disorder (ARFID)
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