Skip to main content

CASE REPORT article

Front. Psychiatry
Sec. Autism
Volume 15 - 2024 | doi: 10.3389/fpsyt.2024.1447562
This article is part of the Research Topic Case Reports in Autism: 2023 View all 8 articles

The challenge of a late diagnosis of Autism Spectrum Disorder: co-occurring trajectories and camouflage tendencies. A case-report of a young female with Autism and Avoidant Restrictive Food Intake Disorder

Provisionally accepted
Sara Passarini Sara Passarini 1,2SILVIA GUERRERA SILVIA GUERRERA 3*Maria Picilli Maria Picilli 4,5Elisa Fucà Elisa Fucà 1Laura Casula Laura Casula 3Deny Menghini Deny Menghini 1Sabine Pirchio Sabine Pirchio 2Valeria Zanna Valeria Zanna 3Giovanni Valeri Giovanni Valeri 3Stefano Vicari Stefano Vicari 3,6
  • 1 Bambino Gesù Children's Hospital (IRCCS), Rome, Italy
  • 2 Department of Dynamic, Clinical Psychology and Health, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Lazio, Italy
  • 3 Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
  • 4 Agostino Gemelli University Polyclinic (IRCCS), Rome, Lazio, Italy
  • 5 Department of Neuroscience, Catholic University of the Sacred Heart, Rome, Rome, Lazio, Italy
  • 6 Life Sciences and Public Health Department, Catholic University, Rome, Italy

The final, formatted version of the article will be published soon.

    Introduction: Autistic individuals may show several psychiatric co-occurrences, including Feeding and Eating Disorders (FEDs). Avoidant and Restrictive Food Intake Disorder (ARFID) consists of avoidance or restriction in food intake, leading to significant weight loss, nutritional deficiencies, and marked interference with psychosocial functioning. Both Autism Spectrum Disorder (ASD) and ARFID are characterized by the two main features of cognitive rigidity and sensory sensitivity, which may complicate differential diagnosis. There is a notable lack of information on the manifestation of ASD-ARFID co-occurrence, as well as tailored assessment tools and practice, and therapeutic approaches. Case description: This report provides a detailed description of L., a young girl with a late diagnosis of ASD who also developed unspecific depressive mood disorder and ARFID in co-occurrence. After the diagnosis of ASD, L. underwent multiple evaluations to address emerging psychiatric co-occurrences and symptom exacerbation, and in order to develop the most effective integrated treatment. Conclusion: The case of L. expands the knowledge on the phenotype of Autistic females and exemplifies how delayed diagnosis may exacerbate functioning differences and increase the camouflage phenomenon. Additionally, it underscores the importance of improving tailored evaluation, combined treatment plans, with both cognitive-behavioral therapy and drugs, and monitoring the evolving patterns of Autistic manifestations and associated psychiatric co-occurrences.

    Keywords: Autism Spectrum Disorder, feeding and eating disorders, Food selectivity, Depressive mood, sensory profile

    Received: 11 Jun 2024; Accepted: 16 Dec 2024.

    Copyright: © 2024 Passarini, GUERRERA, Picilli, Fucà, Casula, Menghini, Pirchio, Zanna, Valeri and Vicari. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: SILVIA GUERRERA, Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.