Do Some Cases of Anorexia Nervosa Reflect Underlying Autistic-Like Conditions?

In a sample of 51 teenagers with anorexia nervosa (AN)—which included 24 cases constituting the total population of AN cases born in 1970—several had shown social, communicative and behaviour patterns suggestive of autistic-like conditions as children, long before the onset of AN. One of the three boys in the AN group had Asperger syndrome. Three of the 48 girls had histories suggesting high functioning autism and continued to show many features typical of autism. Two further girls had Tourette syndrome and obsessive–compulsive traits in combination with social interaction problems. Eighteen other girls met criteria for obsessive–compulsive personality disorder (OCPD) and most of these also had had moderate–severe childhood social interaction problems. In a sex- and age-matched comparison group from the same schools, two girls had OCPD, but none had autistic-like conditions or Tourette syndrome. The results are discussed in the context of a recently suggested link between Asperger syndrome, Tourette syndrome and obsessive–compulsive problems, and it is suggested that AN in a subgroup of cases might represent a disorder belonging in the same class as autism and autistic-like conditions.