Prevalence of autistic traits in functional neurological disorder and relationship to alexithymia and psychiatric comorbidity

Introduction: In a cohort of adults with Functional Neurological Disorder (FND), we aim to:1) Report the prevalence of autistic traits and alexithymia.2) Report psychiatric comorbidity associated with autistic traits and alexithymia.3) Explore whether alexithymia mediates the association between autistic traits and comorbidity.Methods: 91 patients participating in a FND 5-week outpatient program completed baseline self-report ques-tionnaires for total phobia, somatic symptom severity, attention deficit hyperactivity disorder (ADHD) and dyslexia. Patients were grouped by Autism Spectrum Quotient (AQ-10) score of <6 or >= 6 and compared for significant differences in tested variables. This analysis was repeated with patients grouped by alexithymia status. Simple effects were tested using pairwise comparisons. Multistep regression models tested direct re-lationships between autistic traits and psychiatric comorbidity scores, and mediation by alexithymia.Results: 36 patients (40%) were AQ-10 positive (scoring >= 6 on AQ-10). A further 36 patients (across AQ-10 positive and AQ-10 negative groups) (40%) screened positive for alexithymia. AQ-10 positive patients scored significantly higher for alexithymia, depression, generalised anxiety, social phobia, ADHD, and dyslexia. Alex-ithymia positive patients scored significantly higher for generalised anxiety, depression, somatic symptoms severity, social phobia, and dyslexia. Alexithymia score was found to mediate the relationship between autistic trait and depression scores.Conclusion: We demonstrate a high proportion of autistic and alexithymic traits, in adults with FND. A higher prevalence of autistic traits may highlight a need for specialised communication approaches in FND manage-ment. Mechanistic conclusions are limited. Future research could explore links with interoceptive data.

Automated summary

In a cohort of adults with Functional Neurological Disorder (FND), the prevalence of autistic traits and alexithymia is reported, along with the associated psychiatric comorbidity. Furthermore, it is explored whether alexithymia mediates the association between autistic traits and comorbidity.