Comorbid mental disorders during long‐term course in a nationwide cohort of patients with anorexia nervosa

Abstract

Objective Comorbid mental disorders in anorexia nervosa during long‐term course require detailed studies. Method This matched cohort study was based on nationwide Danish register data of all patients born 1961–2008 with a first‐time ICD‐10 diagnosis of anorexia nervosa (AN) between 1994 and 2018 at age 8–32 and matched controls taken from all individuals without an eating disorder (ED). For nine categories of non‐eating mental disorders, time from date of first AN‐diagnosis (inclusion date) to time of first diagnosis, accounting for censoring, was studied by use of time‐stratified Cox models. Results A total of 9,985 patients with AN (93.5% females) and 49,351 matched controls were followed for a median (IQR) of 9.0 (4.4–15.7) years. For patients, there was about 25% and 55% risk of receiving any non‐ED disorder during the first 2 years and two decades after inclusion, respectively. A hazard ratio (HR) of seven for any non‐ED was found for the first 12 months after inclusion, a ratio that reduced to two at five or more years after inclusion. During the first years, large HRs ranging in 6–9 were found for affective, autism spectrum, personality, and obsessive–compulsive disorders with the latter displaying the highest continuous increased risk. The HR at 12 months after inclusion was highest for any non‐ED disorder and affective disorders in patients aged 8–13 at diagnosis. Discussion Comorbid mental disorders in AN are most frequently diagnosed in the first years after diagnosis of AN and on longer terms imply a double immediate risk.

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

“…The baseline scores in the present population confirmed that depression and anxiety are among the most common comorbidities in AN [ 27 ]. Of noticeable importance, the improvement in depression scores during the hospitalization was not amplified by the pre-established pharmacologic treatment, which further underscores that inpatient treatment in itself reduces symptoms associated with AN.…”

Inpatient Weight Restoration Treatment Is Associated with Decrease in Post-Meal Anxiety

“…Patient were hospitalized due to moderate to severe AN, which was reflected in the high scores on all four EDE-Q subscales and total EDI score [20]. Current literature suggests that a significant portion of the individuals with AN suffer from additional psychiatric disorders or comorbidities with depression and anxiety being the most prevalent of all [27][28][29][30]. Indeed, the baseline scores of depression and anxiety with SCL-92 and MDI indicated moderate to severe depression, whereas the low scores in AQ ruled out that autism spectrum disorders would have impacted the results.…”

Explaining reinforcement and erroneous beliefs in pathological exercise: A commentary and expansion on Coniglio et al. (in press) using the pathways model of disordered gambling

“…Likewise, some people with AN have co-occurring psychopathologies that manifest in emotional vulnerabilities, including mood and anxiety disorders (Steinhausen et al, 2021), and emotion dysregulation (Haynos & Fruzzetti, 2011), which have been linked to excessive exercise (Peñas-Lled o, Vaz Leal, & Waller, 2002). Thus, they may engage in pathological exercise to cope with aversive affective state(s).…”