Females in the Autism Spectrum and Eating Disorders: finding the prevalence and the ways they are different

Background: females in the Autism Spectrum are often misdiagnosed, misunderstood or missed all together. A possible way to find, and help, them, would be to assess autism in clinic specialized in other conditions. Eating... [ view full abstract ]

Background: females in the Autism Spectrum are often misdiagnosed, misunderstood or missed all together. A possible way to find, and help, them, would be to assess autism in clinic specialized in other conditions. Eating Disorders (ED) and Autism Spectrum Conditions (ASD) share a common cognitive styles and recent epidemiological studies found that many women with Anorexia Nervosa have elevated autistic traits. Objectives: Estimating the prevalence of clinical ASD in an ED sample; finding distinctive traits between the conditions in order to understand the different aetiology. Methods: we assessed all new outpatients (71) in a specialized ED hospital, aged 15 or older and without intellectual disability. After the admission, they completed self-report questionnaires and received a clinical assessment for ASD and ED according to DSM-5 criteria. Results: Thirty-three percent of patients with ED received an ASD diagnosis. A modified scoring algorithm using RAADS as a clinical interview reached a 100% classification accuracy whereas 38% of participants would have been missed using AQ only as a self-report questionnaire. The distribution is indicative of a mixed populations. Conclusion: ED and ASD share a common phenotype characterized by attention to details, difficulties with emotional perspective taking and elevated anxiety, urgency and rigidity together with an intact empathic concern, imagination and attention to social stimuli. Need for sameness, executive dysfunction and social retirement increase after the development of an ED. Proneness to sensory overload, uncommon interests, difficulties in social relatedness and conversation abilities distinguish between the two groups. We also suggested that many ASD women develop an ED due to gender dysphoria and willingness to be gender neutral instead of trying to match a culturally determined ideal of femininity.

The authors declare no conflict of interest. All the information presented in this report was gathered to inform clinical care, rather than primarily for research. Accordingly, we have sought to protect privacy and... [ view full abstract ]

The authors declare no conflict of interest. All the information presented in this report was gathered to inform clinical care, rather than primarily for research. Accordingly, we have sought to protect privacy and confidentiality by ensuring that data taken from clinical notes are not linked to any identifying information. We received no grants, fundings or payments for this research.