Investigating the Presence of Autistic Traits and Prevalence of Autism Spectrum Disorder Symptoms in Anorexia Nervosa: A Systematic Review and Meta‐Analysis

The present meta-analysis aims to assess whether individuals with anorexia nervosa (AN) demonstrate elevated autistic traits, to explore potential associations between autistic traits and eating disorder symptoms; as well as to estimate the prevalence of a positive screen for autism spectrum disorder (ASD) assessed via Autism Diagnostic Observation Schedule (ADOS), in AN. A systematic literature search was conducted in PsycINFO, MEDLINE, and Web of Science in August 2023 and later updated in April 2024 to identify relevant studies. Twenty-two studies with 1172 AN patients and 2747 healthy controls (HCs) met the inclusion criteria. There was a significant difference between AN and HC groups in autistic traits (g = 0.88, CI = 0.65-1.12), and a significant but modest correlation was found between autistic traits and severity of eating disorder symptoms (r = 0.28, CI = 0.11-0.44). Proportion meta-analysis indicated that 29% (CI = 0.19-0.38) of children and adults scored above the cut-off for ASD. The current findings suggest that AN frequently overlaps with both autistic traits and autistic symptomatology. Therefore, it is essential to evaluate autism and autistic traits in individuals with AN to tailor individualized treatment plans.