The co-occurence of anorexia nervosa and autism spectrum condition : implications on treatment of anorexia nervosa

Abstract

Evidence suggests a high prevalence of autism spectrum condition (ASC) among individuals with anorexia nervosa (AN). Despite the growing evidence surrounding the treatment of anorexia nervosa, approximately twenty percent of patients develop a chronic course illness. Pre-vious research has associated the co-occurrence of autism spectrum condition with worse long-term psychosocial outcomes and a chronic course of anorexia. Little evidence surrounding the treatment adaptations for this subgroup exists; although patients with co-occurring ASC are likely to benefit from treatment adaptations addressing neurodiversity.

This systematic review examines the clinical effectiveness of treatment methods for patients with co-occurring AN and ASC. Articles were identified by systematic search through the following databases: Scopus, ProQuest, EBSCOhost, and PubMed. Twelve (12) peer-reviewed articles were included in this systematic review.

Results of the synthesis implicate that patients with co-occurring anorexia nervosa and ASC seem to present more severe psychological eating disorder symptoms and have an elevated need for psychiatric care. There is mixed evidence about treatment effectiveness for the sub-group with co-occurring autism spectrum condition. Many studies report similar patterns of eating disorder symptom reduction in the patient groups with and without ASC, yet evidence of poorer response to treatment exists. Preliminary evidence of the effectiveness of cognitive remediation therapy and family-based therapy exists for this subgroup of patients. Inpatient treatment can be more efficient for this patient group than day-patient programmes. Patients with ASC might benefit from individual therapy sessions rather than group sessions.

There is preliminary evidence of suitable interventions for this comorbidity, yet more evidence of clinical effectiveness is required. Future research surrounding this topic is warranted to accommodate neurodiversity in eating disorder services.