Relationship of depression, anxiety, and obsessionality to state of illness in anorexia nervosa

Abstract

Objective Depression, anxiety, and obsessionality frequently are present in underweight, malnourished patients with anorexia nervosa. It is less certain if these symptoms persist after recovery. Thus, we assessed these symptoms in anorexic women at three states of illness (underweight, short‐term weight restored, and long‐term weight restored) in comparison to a group of healthy women. Method: We used standardized self‐ and trained rater instruments to assess depression (Hamilton Depression Rating Scale and Beck Depression Inventory), anxiety (Spielberger State‐Trait Anxiety Inventory and Hamilton Anxiety Rating Scale), and obsessions and compulsions (Yale‐Brown Obsessive Compulsive Scale). Results: A similar pattern was found for all symptoms. That is, scores for depression, anxiety, and obsessionality were most elevated in the underweight state. These symptoms improved with weight restoration. However, milder but significantly elevated symptoms persisted in long‐term weight‐restored anorexic women compared to healthy control women. Discussion: These data suggest that malnutrition intensifies the severity of depression, anxiety, and obsessionality in anorexia nervosa. However, the fact that mild to moderate symptoms persisted after long‐term weight restoration raises the possibility that such behaviors are related to the pathogenesis of this illness. © 1997 by John Wiley & Sons, Inc. Int J Eat Disord 21: 367–376, 1997.

Body mass index and weight change from adolescence into adulthood, waist-to-hip ratio and perceived work ability among young adults

“…Little information is available on the occurrence of mental depression among the thin, but malnutrition associated with an anorectic state increases depression, anxiety and obsessiveness. 22 Our findings give some indication that WHR is a more consistent marker of work disability than BMI, although we could not separate their effects with any certainty. Even men who were classified as severely obese in terms of BMI (435 kg/m 2 ) did not report any more disability than the other men, whereas the association was unequivocal at the high end of the WHR scale.…”

Pharmacologic treatment of anorexia nervosa: Where do we go from here?

“…In addition, the depressive symptoms seen in AN have been shown to be largely reversible with refeeding. 31 Given these contradictions, it is time to revisit the questions: What is the problem with AN? Or, more precisely: What core features of AN might be amenable to pharmacologic interventions?…”

Neurobiology of anorexia and bulimia nervosa

“…In summary, such symptoms may be susceptibility factors that make people vulnerable to developing an ED. Malnutrition tends to exaggerate premorbid behavioral traits, (29) , not cause them.…”