摂食障害における自閉性傾向の検討 : 自閉性スペクトラム指数(AQ)を用いた調査から  [in Japanese] Investigation of Autistic Tendency in Eating Disorders : The Follow-up Survey Using the Autism-Spectrum Quotient (AQ)  [in Japanese]

摂食障害(ED)の病態は多様化しており,精神疾患の先行・併存している可能性に留意する必要がある.近年,日本でもアスペルガー障害と神経性無食欲症(AN-R)の併存例が報告されている.しかしED全体の自閉性傾向の調査は報告されていない.今回,自閉性スペクトラム指数日本版(AQ)を用いてED全体の自閉性傾向を検討した.ED患者は健常人よりもAQ値が高い傾向にあった.また,自閉性障害圏を強く疑う33点以上を示した症例は全例排出行為を伴っていた.AN-Rにおいては,AQとBMI(body mass index)に負の相関を認め,AQとEDI(Eating Disorder Inventory)には正の相関を認めた.1年後の追跡調査では,AN-RにおいてBMIの増加はみられるものの,AQ値に変化はなかった.EDの病態評価に自閉性の観点も考慮することは重要と思われる.

Background : There have been sporadic reports on the relationship between low body weight and pervasive development disorders (PDD), and case reports of eating disorder (ED) complicated by Asperger's disorder (AD). The purpose of this study is to investigate the autistic tendency in ED patients and to conduct a short-term follow-up survey using an autism scale. Methods : In the initial survey, subjects were 45 ED patients treated between June 2004 and April 2005, and in the one-year follow-up survey, subjects were 25 patients. In both surveys, the Japanese version of the Autism-Spectrum Quotient (AQ) and Eating disorder inventory (EDI) were conducted. Results : ED patients displayed a higher autistic tendency than healthy people. In the restricting type of anorexia nervosa (AN-R) patients, there was a significant positive correlation between AQ and EDI, and a moderate negative correlation between AQ and BMI. However, no correlation was found between AQ and EDI, between AQ and BMI in other subtypes. The improvement in BMI was seen in AN-R by a follow-up survey one year later, but the AQ scores remained unchanged. Conclusion : The autistic tendency of ED patients tends to be higher than that of healthy people in both the initial and follow-up surveys. Particularly with the AN-R patients, the severity of autistic tendency affects psychopathological severity and body weight loss. We conclude that autistic tendency is useful to consider the psychopathology of ED.