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Psychological, behavioural and biological factors associated with gastrointestinal symptoms in autistic adults and adults with autistic traits

Gastrointestinal symptoms and their relation to physical and mental aspects in adults with an autism spectrum disorder (ASD) are poorly understood, despite their high prevalence. Therefore, the aim of this study is to examine psychological, behavioural and biological factors associated with gastroin...

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Autores principales: Warreman, EB, Nooteboom, LA, Terry, MB, Hoek, HW, Leenen, PJM, van Rossum, EFC, Ramlal, D, Vermeiren, RRJM, Ester, WA
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10504819/
https://www.ncbi.nlm.nih.gov/pubmed/36794469
http://dx.doi.org/10.1177/13623613231155324
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author Warreman, EB
Nooteboom, LA
Terry, MB
Hoek, HW
Leenen, PJM
van Rossum, EFC
Ramlal, D
Vermeiren, RRJM
Ester, WA
author_facet Warreman, EB
Nooteboom, LA
Terry, MB
Hoek, HW
Leenen, PJM
van Rossum, EFC
Ramlal, D
Vermeiren, RRJM
Ester, WA
author_sort Warreman, EB
collection PubMed
description Gastrointestinal symptoms and their relation to physical and mental aspects in adults with an autism spectrum disorder (ASD) are poorly understood, despite their high prevalence. Therefore, the aim of this study is to examine psychological, behavioural and biological factors associated with gastrointestinal symptoms in adults with ASD (traits). We included 31,185 adults from the Lifelines Study. Using multivariable logistic regression, we analysed the association between gastrointestinal symptoms and psychological, behavioural (questionnaire-assessed) and physically measured biological factors in adults with ASD (n = 309), without ASD (n = 30,876), and in the quartiles with highest (n = 7783) and lowest (n = 7783) Autism Spectrum Quotient-10 sum scores. In the ASD-group, gastrointestinal symptoms were associated with psychiatric comorbidity (odds ratio: 2.71, 95% confidence interval: 1.51–4.85), more stress (odds ratio: 1.15, 95% confidence interval: 1.06–1.26), and worse perceived health (odds ratio: 2.32, 95% confidence interval: 1.62–3.34). In the quartile with the highest Autism Spectrum Quotient-10 sum scores, gastrointestinal symptoms were also associated with these psychological factors, and with less physical activity (odds ratio: 0.95, 95% confidence interval: 0.92–0.98). Our study demonstrates that not only adults with ASD but also adults with autistic traits are at increased risk for gastrointestinal symptoms, which is associated with psychological and behavioural factors. This suggests that an integrated psychosomatic approach of gastrointestinal symptoms in adults with ASD (traits) is needed. LAY ABSTRACT: Little is known about factors related to the increased risk for gastrointestinal symptoms in adults with an autism spectrum disorder (ASD), while the negative impact of gastrointestinal symptoms is evident. Especially, the relationship between gastrointestinal symptoms and psychological, behavioural, and biological risk factors in adults with ASD (traits) is unclear. Autistic peer support workers and autism-advocates also emphasised the importance of identifying risk factors, because of the high prevalence of gastrointestinal problems in people with ASD. Therefore, our study investigated which psychological, behavioural, and biological factors are associated with gastrointestinal symptoms in adults with ASD or with autistic traits. We analysed data from 31,185 adults in the Dutch Lifelines Study. Questionnaires were used to evaluate the presence of an autism spectrum disorder diagnosis, autistic traits, gastrointestinal symptoms, psychological and behavioural factors. Biological factors were examined with body measurements. We found that not only adults with ASD but also adults with higher levels of autistic traits were at increased risk for gastrointestinal symptoms. Adults with ASD who experienced psychological problems (psychiatric problems, worse perceived health, chronic stress) had a higher risk for gastrointestinal symptoms than adults with ASD without these psychological problems. Moreover, adults with higher levels of autistic traits were less physically active, which was also associated with gastrointestinal symptoms. In conclusion, our study highlights the relevance of identifying psychological problems and evaluating physical activity when trying to help adults with ASD or autistic traits and gastrointestinal symptoms. This suggests that healthcare professionals should be more aware of behavioural and psychological risk factors when evaluating gastrointestinal symptoms in adults with ASD (traits).
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spelling pubmed-105048192023-09-17 Psychological, behavioural and biological factors associated with gastrointestinal symptoms in autistic adults and adults with autistic traits Warreman, EB Nooteboom, LA Terry, MB Hoek, HW Leenen, PJM van Rossum, EFC Ramlal, D Vermeiren, RRJM Ester, WA Autism Original Articles Gastrointestinal symptoms and their relation to physical and mental aspects in adults with an autism spectrum disorder (ASD) are poorly understood, despite their high prevalence. Therefore, the aim of this study is to examine psychological, behavioural and biological factors associated with gastrointestinal symptoms in adults with ASD (traits). We included 31,185 adults from the Lifelines Study. Using multivariable logistic regression, we analysed the association between gastrointestinal symptoms and psychological, behavioural (questionnaire-assessed) and physically measured biological factors in adults with ASD (n = 309), without ASD (n = 30,876), and in the quartiles with highest (n = 7783) and lowest (n = 7783) Autism Spectrum Quotient-10 sum scores. In the ASD-group, gastrointestinal symptoms were associated with psychiatric comorbidity (odds ratio: 2.71, 95% confidence interval: 1.51–4.85), more stress (odds ratio: 1.15, 95% confidence interval: 1.06–1.26), and worse perceived health (odds ratio: 2.32, 95% confidence interval: 1.62–3.34). In the quartile with the highest Autism Spectrum Quotient-10 sum scores, gastrointestinal symptoms were also associated with these psychological factors, and with less physical activity (odds ratio: 0.95, 95% confidence interval: 0.92–0.98). Our study demonstrates that not only adults with ASD but also adults with autistic traits are at increased risk for gastrointestinal symptoms, which is associated with psychological and behavioural factors. This suggests that an integrated psychosomatic approach of gastrointestinal symptoms in adults with ASD (traits) is needed. LAY ABSTRACT: Little is known about factors related to the increased risk for gastrointestinal symptoms in adults with an autism spectrum disorder (ASD), while the negative impact of gastrointestinal symptoms is evident. Especially, the relationship between gastrointestinal symptoms and psychological, behavioural, and biological risk factors in adults with ASD (traits) is unclear. Autistic peer support workers and autism-advocates also emphasised the importance of identifying risk factors, because of the high prevalence of gastrointestinal problems in people with ASD. Therefore, our study investigated which psychological, behavioural, and biological factors are associated with gastrointestinal symptoms in adults with ASD or with autistic traits. We analysed data from 31,185 adults in the Dutch Lifelines Study. Questionnaires were used to evaluate the presence of an autism spectrum disorder diagnosis, autistic traits, gastrointestinal symptoms, psychological and behavioural factors. Biological factors were examined with body measurements. We found that not only adults with ASD but also adults with higher levels of autistic traits were at increased risk for gastrointestinal symptoms. Adults with ASD who experienced psychological problems (psychiatric problems, worse perceived health, chronic stress) had a higher risk for gastrointestinal symptoms than adults with ASD without these psychological problems. Moreover, adults with higher levels of autistic traits were less physically active, which was also associated with gastrointestinal symptoms. In conclusion, our study highlights the relevance of identifying psychological problems and evaluating physical activity when trying to help adults with ASD or autistic traits and gastrointestinal symptoms. This suggests that healthcare professionals should be more aware of behavioural and psychological risk factors when evaluating gastrointestinal symptoms in adults with ASD (traits). SAGE Publications 2023-02-16 2023-10 /pmc/articles/PMC10504819/ /pubmed/36794469 http://dx.doi.org/10.1177/13623613231155324 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Articles
Warreman, EB
Nooteboom, LA
Terry, MB
Hoek, HW
Leenen, PJM
van Rossum, EFC
Ramlal, D
Vermeiren, RRJM
Ester, WA
Psychological, behavioural and biological factors associated with gastrointestinal symptoms in autistic adults and adults with autistic traits
title Psychological, behavioural and biological factors associated with gastrointestinal symptoms in autistic adults and adults with autistic traits
title_full Psychological, behavioural and biological factors associated with gastrointestinal symptoms in autistic adults and adults with autistic traits
title_fullStr Psychological, behavioural and biological factors associated with gastrointestinal symptoms in autistic adults and adults with autistic traits
title_full_unstemmed Psychological, behavioural and biological factors associated with gastrointestinal symptoms in autistic adults and adults with autistic traits
title_short Psychological, behavioural and biological factors associated with gastrointestinal symptoms in autistic adults and adults with autistic traits
title_sort psychological, behavioural and biological factors associated with gastrointestinal symptoms in autistic adults and adults with autistic traits
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10504819/
https://www.ncbi.nlm.nih.gov/pubmed/36794469
http://dx.doi.org/10.1177/13623613231155324
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