Forensic Psychiatry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
Psychol Med. 2012 Sep;42(9):1957-67. doi: 10.1017/S0033291711002881. Epub 2011 Dec 20.
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'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.
The fourth wave included the Structured Clinical Interview for DSM-IV (SCID)-I and the SCID-II (cluster C, i.e. 'anxious' 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's cartoons.
The ASD assessments had substantial inter-rater reliability over time (Cohen'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.
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.
有人提出，厌食症（AN）患者中有一个亚组存在与自闭症谱系障碍（ASD）相对应的社交沟通问题[即 DSM-IV 广泛性发育障碍（PDD）：孤独症、阿斯伯格综合征、未特定 PDD]。本研究比较了 16 名符合或曾符合 ASD 标准（AN+ASD）的青少年起病 AN 患者、34 名 ASD 阴性 AN 患者和来自瑞典纵向研究的匹配对照者的临床问题、人格特征、认知测试结果和结局，该研究包括青少年至三十出头的四次独立评估。
第四次评估包括 DSM-IV 结构临床访谈（SCID）-I 和 SCID-II（即“焦虑”PDs）访谈、阿斯伯格综合征诊断访谈、孤独症谱系商数和气质与性格量表自评、Wechsler 量表子量表的神经认知测试、连续表现测试、伦敦塔和 Happé 漫画。
即使只有六名患者在研究的全部四次评估中被诊断为 ASD，包括对 AN 前神经发育问题的回顾性评估，ASD 评估在时间上仍具有相当的评估者间可靠性（Cohen's κ 在 0.70 到 0.80 之间）。AN+ASD 组的人格障碍患病率最高，Morgan-Russell 评分最低。非 ASD AN 组在与人际功能不良相关的人格特征和神经认知测试方面也与对照组有显著差异。
一些 AN 患者符合 ASD 标准。他们可能代表了更普遍存在于 AN 中的神经认知和人格问题的极端表现。
