scholarly journals Adolescents With Autism Spectrum Disorder and Anorexia Nervosa Comorbidity: Common Features and Treatment Possibilities With Cognitive Remediation Therapy and Oxytocin

2021 ◽  
Vol 12 ◽  
Author(s):  
Barbara Plemeniti Tololeski ◽  
Ana Suhodolčan Grabner ◽  
Hojka Gregoric Kumperscak
Keyword(s):  
Autism Spectrum Disorder ◽  
Anorexia Nervosa ◽  
Young Patients ◽  
Cognitive Remediation ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Special Focus ◽  
Cognitive Remediation Therapy ◽  
Holistic Treatment ◽  
Common Features

Autistic traits or autism spectrum disorder (ASD) can be found in 4% to 52% of anorexic patients, which makes the treatment of these patients very challenging. In this review, possible ways to treat ASD and anorexia nervosa (AN) comorbidity in children and adolescents are summarized. Over recent years, the focus has shifted from searching for the evidence of connections between these two disorders, which have started with Gillberg's study in 1983, to searching for more effective and holistic treatment of this comorbidity. The latter is known to contribute to more severe courses and worse prognosis, which is probably related to the obstacles in both diagnosing and treating. Since AN usually starts in early adolescence and high-functioning ASD children seem to begin struggling with increased pressure in adolescence, while various comorbidities can occur, it is important to improve the treatment of this comorbidity in young patients and to tailor it specifically in terms of diagnosing. In this paper, a literature review is conducted on common features and promising treatment possibilities. We describe cognitive remediation therapy and the promising pharmacotherapeutic candidate oxytocin with a special focus on adolescents.

Cognitive Remediation Therapy as a Feasible Treatment for a Young Person With Anorexia Nervosa and Autism Spectrum Disorder Comorbidity: A Case Study

2019 ◽  
Vol 19 (2) ◽  
pp. 115-132 ◽  
Author(s):  
Yasemin Dandil ◽  
Claire Baillie ◽  
Kate Tchanturia
Keyword(s):  
Autism Spectrum Disorder ◽  
Anorexia Nervosa ◽  
Cognitive Remediation ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Self Report ◽  
Complex Case ◽  
Central Coherence ◽  
Cognitive Remediation Therapy

Anorexia nervosa (AN) is a challenging illness to treat with inefficiencies in central coherence and set-shifting known to be cognitive maintaining factors for the eating disorder. AN is further complicated by comorbidities such as autism spectrum disorder (ASD). Cognitive remediation therapy (CRT) aims to address problems with cognitive style and meta-cognition by stimulating the neural connections involved in cognitive processing through cognitive tasks, reflection, and behavioral experiments. However, to date, no reported studies are supporting individual CRT for patients with AN and ASD comorbidity. This single complex case study provides preliminary evidence to support the efficacy of individual CRT in the treatment of a 21-year-old female patient with AN and ASD comorbidity. Clinical and self-report data collected before and after CRT indicate improvements in cognitive flexibility and central coherence, alongside an increase in body mass index (BMI). This case study reflects the possible ways to adapt and calibrate treatment to individual needs and the efficacy of CRT, before proceeding to more complex individual psychological work, such as cognitive behavioral therapy.

scholarly journals Therapeutic responses to a frontal/executive programme in autism spectrum disorder: Comparison with schizophrenia

2018 ◽  
Vol 31 (2) ◽  
pp. 69-75
Author(s):  
Maki Miyajima ◽  
Hidetoshi Omiya ◽  
Kiyoko Yamashita ◽  
Kenji Yambe ◽  
Mie Matsui ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Cognitive Dysfunction ◽  
Therapeutic Response ◽  
Cognitive Remediation ◽  
Social Function ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Cognitive Remediation Therapy ◽  
Disease Concepts ◽  
Recent Debate

Introduction Studies on autism spectrum disorder in recent years have controversially indicated similarities with schizophrenia. Cognitive dysfunction is present in both disorders, and while there is a rich array of interventions for cognitive dysfunction in schizophrenia, there are few such treatments for autism spectrum disorder. In this study, we have investigated a potentially useful approach in autism spectrum disorder by comparing autism spectrum disorder with schizophrenia in regard to the characteristics of cognitive dysfunction and therapeutic response to cognitive remediation therapy. Method We studied seven patients with autism spectrum disorder and eight patients with schizophrenia, using a frontal/executive programme as the intervention. The characteristics of cognitive dysfunction in autism spectrum disorder before frontal/executive programme and the therapeutic response to frontal/executive programme in autism spectrum disorder patients were compared with those in schizophrenia patients, based on evaluation of cognitive function and social function. The changes in cognitive and social function after treatment in each patient group were compared using the Mann–Whitney’s U test. Results The severity of cognitive dysfunction did not differ significantly between autism spectrum disorder and schizophrenia. Frontal/executive programme was effective in autism spectrum disorder, with subjects showing about the same therapeutic response as in schizophrenia. Conclusion Frontal/executive programme appears to be useful for patients with autism spectrum disorder. Furthermore, the similarities in cognitive dysfunction and therapeutic response between autism spectrum disorder and schizophrenia are highly relevant to the recent debate concerning the similarity between these two disease concepts.

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

2020 ◽  
Author(s):  
Jacopo Pruccoli ◽  
Altea Solari ◽  
Letizia Terenzi ◽  
Elisabetta Malaspina ◽  
Marida Angotti ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Anorexia Nervosa ◽  
Gold Standard ◽  
Young Patients ◽  
Autistic Traits ◽  
Autism Diagnostic Observation Schedule ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Compulsive Disorder ◽  
The Impact

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.

scholarly journals Possible tics diagnosed as stereotypies in patients with severe autism spectrum disorder: a video-based evaluation

2020 ◽  
Author(s):  
Cristiano Termine ◽  
Enzo Grossi ◽  
Valentina Anelli ◽  
Ledina Derhemi ◽  
Andrea E. Cavanna
Keyword(s):  
Autism Spectrum Disorder ◽  
Rating Scale ◽  
Young Patients ◽  
Autism Spectrum ◽  
Repetitive Behaviors ◽  
Spectrum Disorder ◽  
High Rate ◽  
Video Recordings ◽  
Significant Difference ◽  
Severe Autism

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.

scholarly journals Gut Microbiome-Based Analysis of Lipid A Biosynthesis in Individuals with Autism Spectrum Disorder: An In Silico Evaluation

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 688
Author(s):  
Abdulkadir Yusif Maigoro ◽  
Soojin Lee
Keyword(s):  
Autism Spectrum Disorder ◽  
Gut Microbiome ◽  
In Silico ◽  
Lipid A ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Synthesis Rate ◽  
Special Focus ◽  
Control Subjects ◽  
Gastrointestinal Problems

The link between autism spectrum disorder (ASD) and the gut microbiome has received much attention, with special focus on gut–brain-axis immunological imbalances. Gastrointestinal problems are one of the major symptoms of ASD and are thought to be related to immune dysregulation. Therefore, in silico analysis was performed on mined data from 36 individuals with ASD and 21 control subjects, with an emphasis on lipid A endotoxin-producing bacteria and their lipopolysaccharide (LPS) metabolic pathways. Analysis of enzyme distribution among the 15 most abundant genera in both groups revealed that almost all these genera utilized five early-stage enzymes responsible for catalyzing the nine conserved lipid A synthesis steps. However, Haemophilus and Escherichia, which were significantly more abundant in individuals with ASD than in the control subjects, possess a complete set of essential lipid A synthesis enzymes. Furthermore, the 10 genera with the greatest increase in individuals with ASD showed high potential for producing late-stage lipid A products. Collectively, these results suggested that the synthesis rate of immunogenic LPS end products is likely to increase in individuals with ASD, which may be related to their gastrointestinal symptoms and elevated inflammatory conditions.

scholarly journals Prevalence of autism spectrum disorder and autistic traits in children with anorexia nervosa and avoidant/restrictive food intake disorder

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Takeshi Inoue ◽  
Ryoko Otani ◽  
Toshiyuki Iguchi ◽  
Ryuta Ishii ◽  
Soh Uchida ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Anorexia Nervosa ◽  
Food Intake ◽  
Autistic Traits ◽  
Autism Spectrum ◽  
Eating Attitudes ◽  
Spectrum Disorder ◽  
Autism Spectrum Quotient ◽  
Multicenter Cohort Study ◽  
Feeding And Eating Disorders

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.

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