Anorexia Nervosa: Reduction in Depression during Inpatient Treatment Is Closely Related to Reduction in Eating Disorder Psychopathology

Abstract

Objective: Anorexia nervosa (AN) is a severe mental disorder frequently associated with high scores of depressiveness. We examined the short-term effects of inpatient treatment on depressiveness and eating disorder (ED) psychopathology using the self-rating Major Depression Inventory (MDI) and Eating Disorder Examination questionnaire (EDEq) for patients with AN. Material: Forty-nine patients with AN, all part of the PROspective Longitudinal all-comer inclusion study on EDs (PROLED), were observed over eight weeks with baseline psychometric measures, EDE-q at baseline and endpoint, and weekly MDI self-scoring. Methods: Apart from the weekly Body Mass Index (BMI) measurements, patients were assessed at baseline using the Eating Disorder Inventory (EDI) and the Symptom Check List 92 (SCL-92). Results: Inpatient treatment reduced MDI consistently over 8 weeks (Wilks Lambda = 0.59, F = 4.1, p < 0.01) and this reduction in MDI was positively correlated with a reduction in EDEq (r = 0.44; p < 0.01) during inpatient treatment. Baseline medication did not predict changes in MDI during the inpatient treatment. BMI increased from 14.9 (week 1) to 17.2 (week 8). Conclusions: Inpatient treatment of AN is associated with a reduction in depressiveness. This improvement in depressiveness scores correlates with an improvement in ED psychopathology but not with weight gain.

Apelin-13 and Asprosin in Adolescents with Anorexia Nervosa and Their Association with Psychometric and Metabolic Variables

“…Patients diagnosed with AN presented significantly higher scores on depression scales (BDI and HAMD) than the CG group, which is consistent with reports that up to 70% of patients with AN have comorbid depressive symptoms. Our results confirm that inpatient treatment of AN is associated with reduced depression and eating disorder ed (EAT-26) as reported in previous studies [ 35 , 36 ]. Moreover, AN1 group had higher obsessiveness and compulsivity measured with the CYBOCS scale than the AN2 and the CG group.…”

Anorexia Nervosa With Comorbid Severe Depression

“…15,19 Mounting evidence implicates comorbid MDD as an especially important treatment target for achieving favorable outcomes in inpatient settings. 13,18,20 The global negative influence of depression and anxiety disorders on eating disorder psychopathology in both men and women have been further substantiated in population-representative surveys (associations that were independent of BMI, age, and income). 21 Further complicating the treatment of these patients is that weight gain in the early stages of AN inpatient treatment has been associated with exacerbation of depressive symptoms, which is believed to be an outcome conferred by effects of acute BMI increases on body dissatisfaction and weight/shape concerns.…”

“…The detrimental long-term effects of psychiatric comorbidity are borne out by studies indicating substantial increases in mortality 15,19 . Mounting evidence implicates comorbid MDD as an especially important treatment target for achieving favorable outcomes in inpatient settings 13,18,20 . The global negative influence of depression and anxiety disorders on eating disorder psychopathology in both men and women have been further substantiated in population-representative surveys (associations that were independent of BMI, age, and income) 21 .…”

“…17 There are also studies that support the existence of clinically relevant associations between MDD symptoms and eating disorder psychopathology in inpatient treatment settings. 18 Studies investigating AN inpatients indicate that comorbid depression is common. 12,16 The long-term importance of addressing comorbidities in AN is underlined by the increased risk of long-term fatal outcomes conferred by the presence of concomitant diagnoses.…”

“…Previous research explicitly states that sharing similar signs and symptoms, familial tendencies, and neuroendocrine abnormalities may make it difficult to clinically distinguish MDD and AN, which poses a risk of misdiagnosis 17 . There are also studies that support the existence of clinically relevant associations between MDD symptoms and eating disorder psychopathology in inpatient treatment settings 18 . Studies investigating AN inpatients indicate that comorbid depression is common 12,16 .…”