Fast Psychomotor Functioning in Anorexia Nervosa: Effect of Weight Restoration

Abstract

In a previous study young seriously underweight anorexia nervosa (AN) patients in the early phase of treatment were found to react faster in psychomotor tasks. To further understand this finding we studied the impact of weight restoration on the performance of AN patients in drawing and copying tasks. A group of 17 female AN patients, aged 14 to 25, was compared with 17 healthy controls, matched for sex, age and educational level. Patients were tested when severely underweight and after weight restoration. Control subjects were also tested twice. Using computerized recording and analysis of writing and drawing behavior, reaction times and drawing times were derived, while cognitive and motor demands were manipulated. Overall, AN patients showed shorter reaction times in copying tasks and shorter drawing time in the drawing task than normal controls, and this pattern persisted after weight restoration. No significant group (AN vs. controls) by session (test vs. retest) effect emerged. The finding of a consistent pattern of shorter reaction and drawing times in AN patients before and after weight restoration is compatible with a personality characteristic of perfectionism and overachievement in AN patients.

Neuropsychology of eating disorders: 1995–2012

“…Again, AN patients showed shorter reaction times in copying tasks and shorter drawing time in the drawing task compared to normal controls. This pattern persisted after weight gain 23. This persistence has also been reported in motor tasks after weight recovery of AN patients 24.…”

“…In this case, the weight status was expressed as a percentage of ideal body weight and changed from 70.1% to 86.8% and from 99.6% to 95.8% in AN and BN patients, respectively. Recently, Pieters et al23 reported the persistence of some altered patterns after weight restoration (change of BMI from 14.56 to 18.90) in AN inpatients after an average stay of 131 days. Another study25 showed that neuropsychological functioning improved over the course of treatment, but this improvement was not associated with a change in BMI (from 16.58 to 19.28 after a mean of 32.79 days).…”

Set-shifting abilities, central coherence, and handedness in anorexia nervosa patients, their unaffected siblings and healthy controls: Exploring putative endophenotypes

“…Although most studies have found the presence of impairments on a broad spectrum of cognitive functions in acute AN (Szmukler et al 1992;Green et al 1996;Kingston et al 1996), there are also several studies that have failed to fi nd cognitive defi cits in these patients (Touyz et al 1986;Palazidou et al 1990;Bradley et al 1997) and others that surprisingly have found cognitive performance to be superior to that of healthy controls (Pieters et al 2003(Pieters et al , 2004. In short, the current literature is inconclusive concerning the characteristics, underlying mechanisms and reversibility of cognitive abnormalities in AN (Katzman et al 2001;Pieters et al 2005). The fi rst studies suggested that cognitive defi cits observed in acute AN were a consequence of starvation and may be improved once adequate nutritional status is regained (Szmukler et al 1992;Lauer et al 1999).…”

Neuropsychological study of underweight and “weight‐recovered” anorexia nervosa compared with bulimia nervosa and normal controls

“…64 Although CDR immediate word recall was significantly impaired in BN and ''weight-recovered'' AN participants, only the BN group had significant impairment in the CDR delayed word recall task. Only one other study of word recall in BN has been conducted, 25 which found impaired free recall on initial, but not subsequent testing. The negative findings for the CDR immediate word recall tasks in underweight AN are consistent with a previous study of ''weight-recovered'' AN.…”

“…7,23 Although the remission of physical symptoms in AN generally precedes psychological recovery, 24 findings regarding the effect of weight-recovery on neuropsychological function in AN have been conflicting. 25 The duration of weight-recovery in studies of AN has also varied from 3 months in the short-term to at least 1 year in the long-term. 22,26,27 Studies comparing bulimia nervosa (BN) to NC 1 have revealed impaired recall, abstraction, 28 attention, 8,28,10 visuospatial functioning, 8,28 and problem solving.…”