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Effects of autism spectrum disorders on outcome in teenage-onset anorexia nervosa evaluated by the Morgan-Russell outcome assessment schedule: a controlled community-based study

Nielsen, Sara; Anckarsäter, Henrik LU ; Gillberg, Carina; Gillberg, Christopher; Råstam, Maria LU and Wentz, Elisabet (2015) In Molecular Autism 6(14).
Abstract
Background: The purpose of the study was to evaluate time trends and effects of co-existing autism spectrum

disorders (ASD) on outcome in an ongoing long-term follow-up study of anorexia nervosa (AN).

Methods: The Morgan-Russell Outcome Assessment Schedule (MROAS) was used at 6-, 10- and 18-year follow-up

of a representative sample of 51 individuals with teenage-onset AN and a matched group of 51 healthy comparison

cases. The full multinomial distribution of responses for the full scale and each of the subscales was evaluated using

exact nonparametric statistical methods. The impact of diagnostic stability of ASD on outcome in AN was evaluated

in a dose–response model.

Results:... (More)
Background: The purpose of the study was to evaluate time trends and effects of co-existing autism spectrum

disorders (ASD) on outcome in an ongoing long-term follow-up study of anorexia nervosa (AN).

Methods: The Morgan-Russell Outcome Assessment Schedule (MROAS) was used at 6-, 10- and 18-year follow-up

of a representative sample of 51 individuals with teenage-onset AN and a matched group of 51 healthy comparison

cases. The full multinomial distribution of responses for the full scale and each of the subscales was evaluated using

exact nonparametric statistical methods. The impact of diagnostic stability of ASD on outcome in AN was evaluated

in a dose–response model.

Results: There were no deaths in either group. Food intake and menstrual pattern were initially poor in the AN

group but normalised over time. MROAS ‘mental state’ was much poorer in the AN group and did not improve

over time. The psychosexual MROAS domains ‘attitudes’ and ‘aims’ showed persistent problems in the AN group. In

the MROAS socioeconomic domain, the subscales ‘personal contacts’, ‘social activities’ and ‘employment record’ all

showed highly significant between-group differences at all three follow-ups. A statistically significant negative

dose–response relationship was found between a stable diagnosis of ASD over time and the results on the subscales

‘mental state’, ‘psychosexual state’ and ‘socio-economic state’.

Conclusions: Outcome of teenage-onset AN is favourable with respect to mortality and persisting eating disorder,

but serious problems remain in the domains ‘mental state’, ‘psychosexual function’ and ‘socioeconomic state’.

Outcome is considerably worse if ASD is present. Treatment programmes for AN need to be modified so as to

accommodate co-existing ASD. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Anorexia nervosa, Autism spectrum disorders, Long-term outcome, Psychosexual, Community-based, Prospective, Controlled
in
Molecular Autism
volume
6
issue
14
publisher
BioMed Central
external identifiers
  • wos:000351037300001
  • pmid:25774282
  • scopus:84924986016
ISSN
2040-2392
DOI
10.1186/s13229-015-0013-4
language
English
LU publication?
yes
id
dd0168dc-5b1a-4711-af5e-7490d5ccafc5 (old id 5156652)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/25774282?dopt=Abstract
date added to LUP
2015-04-13 10:13:33
date last changed
2017-11-05 03:57:13
@article{dd0168dc-5b1a-4711-af5e-7490d5ccafc5,
  abstract     = {Background: The purpose of the study was to evaluate time trends and effects of co-existing autism spectrum<br/><br>
disorders (ASD) on outcome in an ongoing long-term follow-up study of anorexia nervosa (AN).<br/><br>
Methods: The Morgan-Russell Outcome Assessment Schedule (MROAS) was used at 6-, 10- and 18-year follow-up<br/><br>
of a representative sample of 51 individuals with teenage-onset AN and a matched group of 51 healthy comparison<br/><br>
cases. The full multinomial distribution of responses for the full scale and each of the subscales was evaluated using<br/><br>
exact nonparametric statistical methods. The impact of diagnostic stability of ASD on outcome in AN was evaluated<br/><br>
in a dose–response model.<br/><br>
Results: There were no deaths in either group. Food intake and menstrual pattern were initially poor in the AN<br/><br>
group but normalised over time. MROAS ‘mental state’ was much poorer in the AN group and did not improve<br/><br>
over time. The psychosexual MROAS domains ‘attitudes’ and ‘aims’ showed persistent problems in the AN group. In<br/><br>
the MROAS socioeconomic domain, the subscales ‘personal contacts’, ‘social activities’ and ‘employment record’ all<br/><br>
showed highly significant between-group differences at all three follow-ups. A statistically significant negative<br/><br>
dose–response relationship was found between a stable diagnosis of ASD over time and the results on the subscales<br/><br>
‘mental state’, ‘psychosexual state’ and ‘socio-economic state’.<br/><br>
Conclusions: Outcome of teenage-onset AN is favourable with respect to mortality and persisting eating disorder,<br/><br>
but serious problems remain in the domains ‘mental state’, ‘psychosexual function’ and ‘socioeconomic state’.<br/><br>
Outcome is considerably worse if ASD is present. Treatment programmes for AN need to be modified so as to<br/><br>
accommodate co-existing ASD.},
  articleno    = {14},
  author       = {Nielsen, Sara and Anckarsäter, Henrik and Gillberg, Carina and Gillberg, Christopher and Råstam, Maria and Wentz, Elisabet},
  issn         = {2040-2392},
  keyword      = {Anorexia nervosa,Autism spectrum disorders,Long-term outcome,Psychosexual,Community-based,Prospective,Controlled},
  language     = {eng},
  number       = {14},
  publisher    = {BioMed Central},
  series       = {Molecular Autism},
  title        = {Effects of autism spectrum disorders on outcome in teenage-onset anorexia nervosa evaluated by the Morgan-Russell outcome assessment schedule: a controlled community-based study},
  url          = {http://dx.doi.org/10.1186/s13229-015-0013-4},
  volume       = {6},
  year         = {2015},
}