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Mol Autism. 2014 Dec 20;5(1):56. doi: 10.1186/2040-2392-5-56. eCollection 2014.

An examination of autism spectrum traits in adolescents with anorexia nervosa and their parents.

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Department of Psychological Medicine, Section of Eating Disorders, King's College London, Institute of Psychiatry, Psychology and Neuroscience, PO59 103 Denmark Hill, London, SE5 8AF UK.
Department of Public Health and Community Medicine, University of Verona, P.le L.A. Scuro 10, Verona, 37134 Italy.
University of Liverpool, Psychological Sciences, Waterhouse Building, Block B, Brownlow Street, Liverpool, L69 3GL UK.
Ilia State University, Kakutsa Cholokashvili Ave 3/5, Tbilisi, 0162 Georgia.
Institute of Child Health, Behavioral and Brain Sciences Unit, University College London, 30 Guilford Street, London, WC1N 1EH UK.
Contributed equally



There may be a link between anorexia nervosa and autism spectrum disorders. The aims of this study were to examine whether adolescents with anorexia nervosa have autism spectrum and/or obsessive-compulsive traits, how many would meet diagnostic criteria for autism spectrum disorder, and whether these traits are shared by parents.


A total of 150 adolescents receiving outpatient treatment for anorexia nervosa or subthreshold anorexia nervosa and their parents completed the autism spectrum disorder and eating disorder sections of the Development and Well-being Assessment. Patients also completed the Children Yale-Brown Obsessive-Compulsive Scale and other measures of psychiatric morbidity, and parents completed the short Autism Quotient and Obsessive-Compulsive Inventory Revised.


Adolescents with anorexia nervosa had a below average social aptitude (19% below cut-off) and high levels of peer relationship problems (39% above cut-off) and obsessive-compulsive symptoms (56% above cut-off). Six cases (4%, all females) were assigned a possible (nā€‰=ā€‰5) or definite (nā€‰=ā€‰1) diagnosis of autism spectrum disorder. Parental levels of autism spectrum and obsessive-compulsive traits were within the normal range.


This study suggests that adolescents with anorexia nervosa have elevated levels of autism spectrum traits, obsessive-compulsive symptoms, and a small proportion fulfil diagnostic criteria for a probable autism spectrum disorder. These traits did not appear to be familial. This comorbidity has been associated with a poorer prognosis. Therefore, adaptation of treatment for this subgroup may be warranted.

TRIAL REGISTRATION: ISRCTN83003225. Registered on 29 September 2011.


Adolescents; Anorexia nervosa; Autism spectrum disorder; Development; Eating disorder; Obsessive-compulsive disorder; Parents; Social aptitude; Traits; Well-being assessment

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