Dell'Osso Liliana, Nardi Benedetta, Giovannoni Federico, Bonelli Chiara, Massimetti Gabriele, Cremone Ivan Mirko, Pini Stefano, Carpita Barbara
Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy.
J Clin Med. 2025 Jun 1;14(11):3891. doi: 10.3390/jcm14113891.
: Orthorexia Nervosa (ON), a condition marked by an obsessive focus on eating healthily, has drawn increasing clinical attention due to its rigid dietary patterns and social impairment. Borderline Personality Disorder (BPD), characterized by emotional dysregulation, impulsivity, and unstable interpersonal relationships, frequently co-occurs with eating disorders. Recent research suggests that autistic traits-such as cognitive rigidity and restricted interests-may underlie both ON and BPD, especially in female populations. This study aimed to assess the prevalence of orthorexic tendencies in patients with BPD compared to healthy controls (HCs) and to explore their associations with autistic traits and disordered eating behaviors. : This study involved 73 BPD patients and 52 HCs. Participants completed the Adult Autism Subthreshold (AdAS) Spectrum, Eating Disorder Inventory-2 (EDI-2), and the ORTO-15 questionnaire. : BPD patients scored significantly higher than HCs on AdAS Spectrum and EDI-2, and significantly lower on ORTO-15, indicating more pronounced autistic traits, disordered eating behavior, and orthorexic tendencies. A greater proportion of BPD individuals reported clinically relevant ON symptoms according to the ORTO-15 threshold. Orthorexic symptoms were significantly correlated with most EDI-2 and all AdAS Spectrum domains. Regression analysis revealed that autistic traits, but not feeding and eating disorder symptoms, significantly predicted orthorexic tendencies. : Orthorexic tendencies are more prevalent in individuals with BPD and are significantly associated with autistic traits. These findings suggest that ON may represent a manifestation of the autism spectrum, particularly in individuals with BPD, and support a reconceptualization of ON within a neurodevelopmental framework. : Future research is needed in order to clarify the temporal and causal relationships among autistic traits, BPD symptomatology, and the emergence of orthorexic behaviors.
正交性神经症（ON）是一种以过度关注健康饮食为特征的病症，因其严格的饮食模式和社交障碍而受到越来越多的临床关注。边缘性人格障碍（BPD）以情绪失调、冲动和人际关系不稳定为特征，经常与饮食失调同时出现。最近的研究表明，自闭症特征，如认知僵化和兴趣受限，可能是ON和BPD的潜在原因，尤其是在女性人群中。本研究旨在评估BPD患者与健康对照组（HCs）相比，正交性倾向的患病率，并探讨它们与自闭症特征和饮食紊乱行为之间的关联。
本研究涉及73名BPD患者和52名HCs。参与者完成了成人自闭症亚阈值（AdAS）量表、饮食失调问卷-2（EDI-2）和ORTO-15问卷。
BPD患者在AdAS量表和EDI-2上的得分显著高于HCs，而在ORTO-15上的得分显著低于HCs，表明其自闭症特征、饮食紊乱行为和正交性倾向更为明显。根据ORTO-15阈值，更大比例的BPD个体报告了具有临床意义的ON症状。正交性症状与大多数EDI-2和所有AdAS量表领域显著相关。回归分析表明，自闭症特征而非进食和饮食紊乱症状显著预测了正交性倾向。
正交性倾向在BPD个体中更为普遍，并且与自闭症特征显著相关。这些发现表明，ON可能代表自闭症谱系的一种表现，特别是在BPD个体中，并支持在神经发育框架内对ON进行重新概念化。
未来需要进一步研究，以阐明自闭症特征、BPD症状和正交性行为出现之间的时间和因果关系。
