The sociocommunicative deficit subgroup in anorexia nervosa: autism spectrum disorders and neurocognition in a community-based, longitudinal study

Article, Other literature type English OPEN
Anckarsäter, H. ; Hofvander, B. ; Billstedt, E. ; Gillberg, I. C. ; Gillberg, C. ; Wentz, E. ; Råstam, M. (2011)
  • Publisher: Cambridge University Press
  • Journal: Psychological Medicine, volume 42, issue 9, pages 1,957-1,967 (issn: 0033-2917, eissn: 1469-8978)
  • Related identifiers: doi: 10.1017/S0033291711002881, pmc: PMC3413193
  • Subject: cognition | personality | Original Articles | social interaction | Psykiatri | Psychiatry | Anorexia nervosa | autism spectrum disorder
    mesheuropmc: behavioral disciplines and activities | mental disorders

BACKGROUND: A subgroup of persons with anorexia nervosa (AN) have been proposed to have sociocommunicative problems corresponding to autism spectrum disorders [ASDs, i.e. DSM-IV pervasive developmental disorders (PDDs): autistic disorder, Asperger&#39;s disorder, PDD not otherwise specified (NOS)]. Here, clinical problems, personality traits, cognitive test results and outcome are compared across 16 subjects (32%) with teenage-onset AN who meet or have met ASD criteria (AN+ASD), 34 ASD-negative AN subjects and matched controls from a longitudinal Swedish study including four waves of independent assessments from the teens to the early thirties.MethodThe fourth wave included the Structured Clinical Interview for DSM-IV (SCID)-I and the SCID-II (cluster C, i.e. &#39;anxious&#39; PDs) interviews, the Asperger Syndrome Diagnostic Interview, self-assessments by the Autism Spectrum Quotient and the Temperament and Character Inventory, neurocognitive tests by subscales from the Wechsler scales, continuous performance tests, Tower of London, and Happé&#39;s cartoons.<br /> RESULTS: The ASD assessments had substantial inter-rater reliability over time (Cohen&#39;s κ between 0.70 and 0.80 with previous assessments), even if only six subjects had been assigned a diagnosis of an ASD in all four waves of the study, including retrospective assessments of pre-AN neurodevelopmental problems. The AN+ASD group had the highest prevalence of personality disorders and the lowest Morgan-Russell scores. The non-ASD AN group also differed significantly from controls on personality traits related to poor interpersonal functioning and on neurocognitive tests.<br /> CONCLUSIONS: A subgroup of subjects with AN meet criteria for ASDs. They may represent the extreme of neurocognitive and personality problems to be found more generally in AN.
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