scholarly journals Associations between autism spectrum disorder and eating disorders with and without self-induced vomiting: an empirical study

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Noriko Numata ◽  
Akiko Nakagawa ◽  
Kazuko Yoshioka ◽  
Kayoko Isomura ◽  
Daisuke Matsuzawa ◽  
...  

Abstract Background Although approximately 23% of anorexia nervosa (AN) patients have concomitant autism spectrum disorder (ASD), it is clinically difficult to determine ASD coexistence in patients with eating disorders. Restrictive AN is more common in younger patients and self-induced vomiting usually appears during adolescence/young adulthood, in order to prevent gaining weight caused by overeating. However, some patients are tolerant of weight gain even if they start overeating. It is important to understand the essential difference between those who vomit and those who do not vomit. In this study, we hypothesised that the absence of self-induced vomiting may be associated with the presence of ASD and aimed to assess the presence of ASD traits in each eating disorder (EDs). Clarifying this association helps to consider the coexistence of ASD in the clinical setting and can lead to the next detailed ASD evaluation, and as a result, helps to determine the appropriate treatment and support individually. Methods We retrospectively evaluated 43 females aged 15–45 years who attended Chiba University Hospital between 2012 and 2016 using the Eating Disorder Examination Questionnaire (EDE-Q) and Autism-Spectrum Quotient (AQ) to quantify the severity of the EDs and to identify whether ASD traits were present. Results There was no difference in the AQ score between bingeing-purging type AN and restricting type AN. However, there was significant difference in the AQ score between bulimia nervosa and binge EDs (BED). Of the 4 ED subtypes, BED had the highest ASD traits. The non-vomiting group with illness duration < 4 years had a significantly higher AQ communication score than the vomiting group with illness duration ≥4 years. Conclusions There was a difference in the AQ score by the presence or absence of self-induced vomiting. The results of this study suggest an association between high scores on AQ and non-vomiting. Thus, evaluation of patients for the absence of self-induced vomiting while assessing them for EDs may help us to understand the association with ASD traits.

2020 ◽  
Author(s):  
Noriko Numata ◽  
Akiko Nakagawa ◽  
Kazuko Yoshioka ◽  
Kayoko Isomura ◽  
Daisuke Matsuzawa ◽  
...  

Abstract Background: Although approximately 23% of anorexia nervosa (AN) patients have concomitant autism spectrum disorder (ASD), it is clinically difficult to determine ASD coexistence in patients with eating disorders. Restrictive AN is more common in younger patients and self-induced vomiting usually appears during adolescence/young adulthood, in order to prevent gaining weight caused by overeating. However, some patients are tolerant of weight gain even if they start overeating. It is important to understand the essential difference between those who vomit and those who do not vomit. In this study, we hypothesised that the absence of self-induced vomiting may be associated with the presence of ASD and aimed to assess the presence of ASD traits in each eating disorder (EDs). Clarifying this association helps to consider the coexistence of ASD in the clinical setting and can lead to the next detailed ASD evaluation, and as a result, helps to determine the appropriate treatment and support individually.Methods: We retrospectively evaluated 43 females aged 15–45 years who attended Chiba University Hospital between 2012 and 2016 using the Eating Disorder Examination Questionnaire (EDE-Q) and Autism-Spectrum Quotient (AQ) to quantify the severity of the EDs and to identify whether ASD traits were present.Results: There was no difference in the AQ score between bingeing-purging type AN and restricting type AN. However, there was significant difference in the AQ score between bulimia nervosa and binge EDs (BED). Of the 4 ED subtypes, BED had the highest ASD traits. The non-vomiting group with illness duration <4 years had a significantly higher AQ communication score than the vomiting group with illness duration ≥ 4 years.Conclusions: There was a difference in the AQ score by the presence or absence of self-induced vomiting. The results of this study suggest an association between high scores on AQ and non-vomiting. Thus, evaluation of patients for the absence of self-induced vomiting while assessing them for EDs may help us to understand the association with ASD traits.


2020 ◽  
Author(s):  
Noriko Numata ◽  
Akiko Nakagawa ◽  
Kazuko Yoshioka ◽  
Kayoko Isomura ◽  
Daisuke Matsuzawa ◽  
...  

Abstract Background: Although approximately 23% of anorexia nervosa (AN) patients have concomitant autism spectrum disorder (ASD), it is clinically difficult to determine ASD coexistence in patients with eating disorders. Restrictive AN is more common in younger patients, and self-induced vomiting usually appears during adolescence/young adulthood with the collapse of control. Some patients state that they “would never want to vomit” and are tolerant of weight gain even if they start overeating. We aimed to understand the essential difference between who vomit and who do not vomit and believed that this difference might be related to the ASD tendency. In this study, we hypothesised that the absence of self-induced vomiting may be associated with the presence of ASD and aimed to assess the presence of autism spectrum disorder tendencies in each eating disorder. Clarifying this association helps to consider the coexistence of ASD in the clinical setting and can lead to the next detailed ASD evaluation, and as a result, helps to determine the appropriate treatment and support individually. Methods: We retrospectively evaluated 43 females aged 15–45 years who attended Chiba University Hospital between 2012 and 2016 using the Eating Disorder Examination Questionnaire and Autism Spectrum Quotient to quantify the severity of the eating disorder and to identify whether ASD tendency were present. Results: There was no difference in the AQ between AN-BP and AN-R. The significant difference in the AQ score between BN and BED was clear. Of the four ED subtypes, BED had the highest ASD tendency. In the four groups, AN-BP had the longest duration of illness and was significantly longer than AN-R. Conclusions: There was a difference in the AQ score by the presence or absence of self-induced vomiting. The present results help us understand why only those with binge eating disorder (BED) do not vomit even if they gain weight and why BED is admissive even if there is weight gain. Further Therefore, evaluating patients for the presence of self-induced vomiting when assessing them for EDs may help us understand the association with ASD tendencies.


2020 ◽  
Author(s):  
Noriko Numata ◽  
Akiko Nakagawa ◽  
Kazuko Yoshioka ◽  
Kayoko Isomura ◽  
Daisuke Matsuzawa ◽  
...  

Abstract Background: Although approximately 23% of anorexia nervosa (AN) patients have concomitant autism spectrum disorder (ASD), it is clinically difficult to determine ASD coexistence in patients with eating disorders. Restrictive AN is more common in younger patients and self-induced vomiting usually appears during adolescence/young adulthood with the collapse of control. Some patients state that they “would never want to vomit” and are tolerant of weight gain even if they start overeating. It is important to understand the essential difference between those who vomit and those who do not vomit. In this study, we hypothesised that the absence of self-induced vomiting may be associated with the presence of ASD and aimed to assess the presence of ASD tendencies in each eating disorder (EDs). Clarifying this association helps to consider the coexistence of ASD in the clinical setting and can lead to the next detailed ASD evaluation, and as a result, helps to determine the appropriate treatment and support individually.Methods: We retrospectively evaluated 43 females aged 15–45 years who attended Chiba University Hospital between 2012 and 2016 using the Eating Disorder Examination Questionnaire(EDE-Q) and Autism Spectrum Quotient (AQ) to quantify the severity of the eating disorder and to identify whether ASD tendency were present. Results: There was no difference in the AQ score between binging-purging type AN and restricting type AN. However, there was significant difference in the AQ score between bulimia nervosa and binge eating disorder (BED). Of the 4 ED subtypes, BED had the highest ASD tendency. The non-vomiting group with illness duration <4 years had a significantly higher AQ communication score than the vomiting group with illness duration ≥ 4 years.Conclusions: There was a difference in the AQ score by the presence or absence of self-induced vomiting. The present results may help us understand why those with BED do not vomit even if they gain weight and why BED is admissive even if there is weight gain. Thus, evaluation of patients for the absence of self-induced vomiting while assessing them for EDs may help us to understand the association with ASD tendencies.


2020 ◽  
Author(s):  
Noriko Numata ◽  
Akiko Nakagawa ◽  
Kazuko Yoshioka ◽  
Kayoko Isomura ◽  
Daisuke Matsuzawa ◽  
...  

Abstract PURPOSE: Previous studies have shown links between autism spectrum disorder and anorexia nervosa restricting type. However, few have examined the association between autism spectrum disorder and other eating disorder subtypes, such as bulimia nervosa, anorexia nervosa binge-purging type and binge eating disorder. In this study, we aimed to assess the presence of autism spectrum disorder tendencies in each eating disorder and to explore whether an association exists between traits of autism spectrum disorder and eating disorders with or without self-induced vomiting.METHODS: We retrospectively sampled outpatients who attended Chiba University Hospital between 2012 and 2016 (43 females aged 15–45 years). All were assessed using the Eating Disorder Examination Questionnaire and Autism Spectrum Quotient to quantify the severity of the eating disorder and to identify whether autism spectrum disorder traits were present. Additionally, the subtype at onset, the change in subtype from onset to presentation and the difference based on the presence or absence of self-induced vomiting were investigated.RESULTS: We found that the Autism Spectrum Quotient tended to be higher in the group without, than in the group with, self-induced vomiting. Patients with binge eating disorder had the highest Autism Spectrum Quotient at presentation, and most of them had transitioned from prior anorexia nervosa restricting type.CONCLUSION: Of note, although their subtype had changed over time, the trait of not vomiting had remained consistent. There was a difference in the Autism Spectrum Quotient score by the presence or absence of self-induced vomiting.Level of Evidence: LEVEL IV (Evidence obtained from multiple time series without the intervention).Plain English SummaryIt is known that 18%–23% of patients with anorexia nervosa have comorbid autism spectrum disorder. However, no study has examined the association with autism spectrum disorder by subtypes of anorexia nervosa (restring type and binge with self-induced vomiting type). In addition, no studies have examined the association of autism spectrum disorder with other subtypes of eating disorders.As a result of examining the autism spectrum disorder tendency for each eating disorders subtype, it was found that the type of eating disorders that did not self-induced vomiting had a higher autism spectrum disorder tendency than with self-induced vomiting. Overall, 80% of people diagnosed with binge eating disorder had been diagnosed with restricting type of anorexia nervosa at the time of onset. For some restricting type of anorexia nervosa patients, fear or aversion to vomiting can be stronger than the desire not to gain weight, it may be the influence of the autism spectrum disorder tendency.


Author(s):  
Cristiano Termine ◽  
Enzo Grossi ◽  
Valentina Anelli ◽  
Ledina Derhemi ◽  
Andrea E. Cavanna

Abstract Background The association of stereotypies and tics is not rare in children with severe autism spectrum disorder (ASD). The differential diagnosis between stereotypies and tics in this patient population can be difficult; however, it could be clinically relevant because of treatment implications. Methods A total of 108 video recordings of repetitive behaviors in young patients with stereotypies in the context of ASD were reviewed by a movement disorders expert and a trainee, in order to assess the prevalence of possible co-morbid tics. The Modified Rush Videotape Rating Scale (MRVS) was used to rate tic frequency and severity. Results Out of 27 patients with stereotypies (24 males; mean age 14 years), 18 (67%) reported possible tics. The most frequently observed tics were eye blinking, shoulder shrugging, neck bending, staring, and throat clearing. The mean MRVS score was 5, indicating mild tic severity. The only significant difference between patients with tics and patients without tics was the total number of stereotypies, which was higher in the subgroup of patients without tics (p = 0.01). Conclusions Expert review of video-recordings of repetitive behaviors in young patients with ASD and stereotypies suggests the possibility of a relatively high rate of co-morbid tics. These findings need to be integrated with a comprehensive clinical assessment focusing on the diagnostic re-evaluation of heterogeneous motor manifestations.


2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Takeshi Inoue ◽  
Ryoko Otani ◽  
Toshiyuki Iguchi ◽  
Ryuta Ishii ◽  
Soh Uchida ◽  
...  

Abstract Background 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. 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). Methods Therefore, 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). Results ASD 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. Conclusions Both 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.


2020 ◽  
Author(s):  
Renáta Longauerová

Gestures play an important role in communication, but for populations with atypical language development, gestures are often an area of significant difficulty, especially for individuals with Autism Spectrum Disorder (ASD). Research on younger children with ASD show a significant delay in gesture production, as well as a complete absence of certain types of gestures. However, previous work leaves open the question of whether the frequency and variation of gesture production is impaired also in adolescents with ASD. Moreover, very little is known about the semantic integration of speech and gesture in this population. In the present study, 5 adolescents with ASD and 5 typically-developing adolescents completed a narrative task, in which they were asked to retell a story of 4 animated cartoon clips. The results show that while there is no significant difference between the two groups in the frequency of gesture production and the types of gestures they produce, the frequency of gesture production in the individuals with ASD significantly depends on their verbal working memory skills. Moreover, it seems that many impairments that were confirmed by earlier studies for ASD children in early and late childhood seem to be mere delays that get resolved over time, such as the usage of supplementary gestures.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Amany H. Abdelrahman ◽  
Ola M. Eid ◽  
Mona H. Ibrahim ◽  
Safa N. Abd El-Fattah ◽  
Maha M. Eid ◽  
...  

Abstract Background Autism spectrum disorder is a condition related to brain development that affects a person’s perception and socialization, resulting in problems in social interaction and communication. It has no single known cause, yet several different genes appear to be involved in autism. As a genetically complex disease, dysregulation of miRNA expression and miRNA–mRNA interactions might be a feature of autism spectrum disorder. The aim of the current study was to investigate the expression profile of circulating miRNA-128, miRNA-7 and SHANK gene family in ASD patients and to assess the possible influence of miRNA-128 and miRNA-7 on SHANK genes, which might provide an insight into the pathogenic mechanisms of ASD and introduce noninvasive molecular biomarkers for the disease diagnosis and prognosis. Quantitative real-time PCR technique was employed to determine expression levels of miRNA-128, miRNA-7 and SHANK gene family in blood samples of 40 autistic cases along with 30 age- and sex-matched normal volunteer subjects. Results Our study revealed a statistical significant upregulation of miRNA-128 expression levels in ASD cases compared to controls (p value < 0.001). A statistical significant difference in SHANK-3 expression was encountered on comparing cases to controls (p value < 0.001). However, miRNA-7 expression showed no significant difference between the studied groups. Conclusions MiRNA-128 and SHANK-3 gene are emerging players in the field of ASD. They are promising candidates as noninvasive biomarkers in autism. Future studies are needed to emphasize their pivotal role.


2017 ◽  
Vol 41 (S1) ◽  
pp. S221-S221
Author(s):  
F. Rad ◽  
L. Kobylinska ◽  
I. Mihailescu ◽  
A. Buica ◽  
I. Dobrescu

From assortative mating theory to genetic background, several ethipathogenic hypotheses in ASD deal with the traits of parents.Backgroundseveral ethipathogenic hypotheses in ASD deal with the traits of parents. The objectives of our study were to measure the ADHD and autism spectrum disorder quotients in parents of children diagnosed with ASD comorbid with ADHD and to correlate the measurements for the tests in parents with those in their children. The specific aim was to identify whether any significant correlations exist.MethodFifty-two pairs of parents of children with autism spectrum disorders and ADHD were included in this study, based on informed consent and the ethical committee's approval. The child's diagnosis was established by a specialist in child and adolescent psychiatry, based on the child's clinical symptoms and on specific diagnostic scales, such as the ADOS and ADHD-rating scale. The parents completed an Autism Spectrum Quotient Scale (ASQS) and an adult ADHD scale. The data were analyzed using SPSS 22.0 and Excel. The correlations were verified using Spearman's non-parametric correlation test.ResultsThere was a strong correlation between the parents’ ADHD scores (r = 0.5, P < 0.001), and a reverse medium correlation between the mother's ADHD score and the child's ADOS score (r = –0.32, P = 0.02). The father's ASQS and ADHD scores correlated between each other (r = 0.31, P = 0.02). There were no correlations between the parents’ and the child's ADHD score, nor between the child's ADOS score and the parents’ ASQS scores.ConclusionOur results suggest that ADHD symptoms in parents of children with autism spectrum disorders comorbid with ADHD might be predictors for the child's prognosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.


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