Autism Spectrum Disorder and Anorexia Nervosa. Is There a Link? An Italian Experience

Abstract Background: Potential overlaps exist between psychopathological features of Anorexia Nervosa (AN) and Autism Spectrum Disorder (ASD). The impact of malnutrition on autistic traits in patients with AN should be considered. This study aims to investigate possible associations between Eating Disorders (ED) psychopathology, ASD traits and BMI in a group of young patients with AN, using the EDI-3 (Eating Disorder Inventory-3) test and gold-standard measures for ASD. Methods: Prospective study involving 23 inpatients admitted to an Italian Centre for paediatric ED. ASD traits and ED psychopathology were assessed administering ADOS-2 (Autism Diagnostic Observation Schedule-2), AQ (Autism Quotient) and EDI-3 tests. Both present and past autistic traits were investigated using different versions of AQ. Possible effect of BMI, Obsessive Compulsive Disorder (OCD) comorbidity and psychopharmacological treatments on results were evaluated with multiple linear regressions. Results: An ASD diagnosis was possible in 22% of patients. EDI-3 Interpersonal Problems (IPC), Affective Problems (APC), and Global Psychological Maladjustment (GPMC) subscales showed correlations with different ASD measures on ADOS-2 and AQ. Scores for ASD and their correlations with EDI-3 subscales were independent of BMI, age, OCD and psychopharmacological treatments. Conclusions: ASD traits presented high prevalence in a group of young inpatients with AN. These traits were significantly correlated to 3 specific EDI-3 subscales and independent of BMI. This is the first study to investigate the relationship between ASD traits as measured with gold-standard measures, EDI-3 scores, and BMI.