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Autism Spectrum symptoms in a population of extremely undernourished patients with Anorexia Nervosa: a pilot study

Margherita Boltri1, Tristan Gabriel-Segard2, Walter Sapuppo3

  • 1Department of Psychology, Università Cattolica Del Sacro Cuore, Milan, Italy; I.R.C.C.S. Istituto Auxologico Italiano, Experimental Laboratory for Metabolic Neurosciences Research, Piancavallo, VCO, 28824, Italy.

Journal of Psychiatric Research
|August 16, 2025
PubMed

Insights

Autism Spectrum Disorder (ASD) traits are common in severely underweight Anorexia Nervosa (AN) patients. These traits are linked to eating disorder severity, not just malnutrition, suggesting a need for tailored treatments.

Area of Science:

  • Neuroscience
  • Psychiatry
  • Clinical Nutrition

Background:

  • Autism Spectrum Disorder (ASD) symptoms are frequently observed in individuals diagnosed with Anorexia Nervosa (AN).
  • The overlap between ASD and AN suggests potential shared underlying mechanisms or contributing factors.
  • Understanding this comorbidity is crucial for effective treatment strategies.

Purpose of the Study:

  • To determine the prevalence of ASD symptoms in severely undernourished AN inpatients.
  • To investigate the relationship between ASD symptoms, cognitive function, and nutritional status in this population.
  • To explore potential correlates of ASD traits in severe AN.

Main Methods:

  • Prospective recruitment of 33 extremely undernourished AN inpatients.
  • Assessment of ASD traits using the Autism Quotient (AQ) and eating psychopathology with the Eating Disorder Inventory-2 (EDI-2).
  • Collection of neuropsychological and bio-nutritional data, including Transthyretin levels.

Main Results:

  • 12% of participants exceeded the clinical cut-off for ASD symptoms.
  • ASD traits significantly correlated with eating disorder severity, cognitive rigidity, and sensory sensitivity, independent of BMI.
  • Specific ASD domains and altered metacognitions were linked to eating psychopathology and Transthyretin levels.

Conclusions:

  • ASD traits are highly prevalent in severe AN, even with significant malnutrition.
  • These traits are primarily associated with eating disorder psychopathology rather than solely with BMI.
  • Findings highlight the need for integrated therapeutic approaches addressing both ASD and AN.
Abstract

Keywords:
Anorexia nervosaAutism spectrum disorderCognitionEating disorderUndernutrition

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