Autism spectrum disorders in patients with anorexia nervosa and in their first- and second-degree relatives - a Danish nationwide register-based cohort-study

Koch, Susanne

Autism spectrum disorders in patients with anorexia nervosa and in their first- and second-degree relatives - a Danish nationwide register-based cohort-study

Sunday, 17 August 2014: 4:30 PM

Boardroom (Dena'ina Center)

Susanne V Koch, PhD , Mental Health Centre for Child and Adolescent Psychiatry, Copenhagen Region, Copenhagen, Denmark

Janne T Larsen, MS , School of Business and Social Sciences, University of Aarhus, Aarhus, Denmark

Svend Erik Mouridsen, MS , Mental Health Centre for Child and Adolescent Psychiatry, Copenhagen Region, Copenhagen, Denmark

Mette Bentz, MS , Mental Health Centre for Child and Adolescent Psychiatry, Copenhagen Region, Copenhagen, Denmark

Liselotte Petersen, PhD , School of Business and Social Sciences, University of Aarhus, Aarhus, Denmark

Cynthia Bulik, PhD , University of North Carolina at Chapel Hill, Chapel Hill, NC

Preben Bo Mortensen, PhD , School of Business and Social Sciences, University of Aarhus, Aarhus, Denmark

Kerstin J Plessen, PhD , Mental Health Centre for Child and Adolescent Psychiatry, Copenhagen Region, Copenhagen, Denmark

INTRODUCTION: Individuals with anorexia nervosa (AN) have a higher degree of social cognitive deficits compared with healthy controls in neuropsychological studies, thus resembling those seen in individuals with autism spectrum disorders (ASD). These traits may influence the course of AN and the effects of treatment. Moreover, clinical studies report increased prevalence of ASD in families with AN. This nationwide register-based cohort-study investigates the co-occurrence of ASD in families with AN.

METHODS: All individuals born in Denmark from 5.1.1981-12.31.2008 were identified in the Danish Civil Registration System. Individuals in the study population, their parents, full and half siblings were linked with the Danish Psychiatric Central Research Register and the Danish National Patient Register, including complete data on admissions to Danish psychiatric and somatic inpatient, and since 1995 also to all outpatient, facilities. Hazard ratios (HR) for being diagnosed with AN or ASD were estimated using Cox regression. We included family history of major depression for comparison.

RESULTS: The study population consisted of 1,724,189 individuals of whom 5,006 had AN (358 males; 4,648 females) and 12,606 had ASD (10,012 males; 2,594 females). A family history of AN increased the risk for ASD (HR 1.80 (95% CI, 1.43-2.28) and 1.44 (95% CI, 0.94-2.21) when exposed to first- or second-degree relatives with AN). A family history of ASD increased the risk for AN (HR 1.45 (95% CI, 1.09-1.94) and HR 1.40 (95% CI, 0.89-2.20) when exposed to first- and second-degree relatives with ASD). However, the risk for AN was not significantly different in families with a history of unipolar depression (HR 1.34 (95% CI, 1.19-1.51) and HR 1.02 (95% CI, 0.73-1.43) when exposed to first- and second-degree relatives with depression).

CONCLUSIONS: The risk of being diagnosed with ASD is elevated if there is a family history of AN or vice versa, but not more than with a family history of major depression.