scholarly journals Association Between Autism Spectrum Disorder and Eating Disorders without Self-Induced Vomiting: An Empirical Study

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.

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.


2017 ◽  
Vol 41 (S1) ◽  
pp. S100-S100 ◽  
Author(s):  
C. Gesi ◽  
C. Carmassi ◽  
M. Luciano ◽  
L. Bossini ◽  
V. Ricca ◽  
...  

IntroductionPrevious data showed higher autistic traits in individuals with anorexia nervosa (AN) compared to healthy controls (CTL). It is not known, however, whether this characteristic is shared by other feeding and eating disorders (FEDs) or it is uniquely associated to AN.ObjectivesTo compare autistic traits among individuals with AN, bulimia nervosa (BN), binge eating disorder (BED) and CTL and to investigate which specific dimensions differentiate one group from another.MethodsA total of 241 FED patients (53 AN, 41 BN, 42 BED) and 105 CTL were administered the autism-spectrum quotient (AQ), the adult autism subthreshold spectrum (AdAS Spectrum), the Ritvo autism and Asperger diagnostic scale 14-item (RAADS-14 Screen).ResultsFED subjects reported higher AQ, AdAS spectrum and RAADS-14 total and subscales scores compared to CTL (all P < .001). No differences were found amongst AN, BN and BED subjects in questionnaires’ total scores. BN group scored higher than AN in the hyper-/hyporeactivity to sensory input domain of the AdAS spectrum (P < .001); AN group scored higher than BED in the attention switching domain of the AQ (P < .001), and BED group scored lower than both AN and BN in the mentalizing deficit domain of the RAADS-14 (all P < .001).ConclusionsWe reported for the first time that not only AN but also BN and BED patients show greater autistic traits compared to CTL. Longitudinal studies are needed to confirm this preliminary report and to elucidate whether autistic traits either precede, co-occur or follow FEDs.Disclosure of interestThe authors have not supplied their declaration of competing interest.


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.


Author(s):  
Susan McElroy ◽  
Anna I. Guerdjikova ◽  
Nicole Mori ◽  
Paul E. Keck

This chapter addresses the pharmacotherapy of the eating disorders (EDs). Many persons with EDs receive pharmacotherapy, but pharmacotherapy research for EDs has lagged behind that for other major mental disorders. This chapter first provides a brief rationale for using medications in the treatment of EDs. It then reviews the data supporting the effectiveness of specific medications or medication classes in treating patients with anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other potentially important EDs, such as night eating syndrome (NES). It concludes by summarizing these data and suggesting future areas for research in the pharmacotherapy of EDs.


Author(s):  
Susan L. McElroy ◽  
Anna I. Guerdjikova ◽  
Anne M. O’Melia ◽  
Nicole Mori ◽  
Paul E. Keck

Many persons with eating disorders (EDs) receive pharmacotherapy, but pharmacotherapy research for EDs has lagged behind that for other major mental disorders. In this chapter, we first provide a brief rationale for using medications in the treatment of EDs. We then review the data supporting the effectiveness of specific medications or medication classes in treating patients with anorexia nervosa (AN), bulimia nervosa, binge eating disorder (BED), and other potentially important EDs, such as night eating syndrome (NES) and sleep-related eating disorder (SRED). We conclude by summarizing these data and suggesting future areas for research in the pharmacotherapy of EDs.


2017 ◽  
Vol 25 (6) ◽  
pp. 601-606 ◽  
Author(s):  
Trevor Steward ◽  
Gemma Mestre-Bach ◽  
Cristina Vintró-Alcaraz ◽  
Zaida Agüera ◽  
Susana Jiménez-Murcia ◽  
...  

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.


Author(s):  
Marco La Marra ◽  
Walter Sapuppo ◽  
Giorgio Caviglia

The aim of this study has been to investigate the dissociative phenomena and the difficulties related to perceive, understand and describe the proper ones and other people's emotional states in a sample of 53 patients with Eating Disorders. The recruited sample is made by 14 Anorexia Nervosa (AN) patients, 15 with Bulimia Nervosa (BN), 12 with Eating Disorder Non Otherwise Specified (EDNOS) and 12 with Binge Eating Disorder (BED). To all subjects was administred the Eating Disorder Inventory-2, the Dissociative Experiences Scale and the Scala Alessitimica Romana. In according with literature, we confirme the relationships among Eating Disorders, the dissociative phenomena and Alexithymia.


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