Details

Autor(en) / Beteiligte

• Lin, Jessica A
• man, Sara F
• Milliren, Carly
• Vitagliano, Julia
• Spigel, Rebecca
• Woods, Elizabeth R
• Richmond, Tracy K

Titel

IN EATING DISORDER RECOVERY: THE RELATIONSHIP BETWEEN MALNUTRITION AND SYMPTOMS OF ANXIETY/DEPRESSION IN YOUTH WITH RESTRICTIVE EATING DISORDERS

Ist Teil von

• Journal of adolescent health, 2021-02, Vol.68 (2S), p.S52

Ort / Verlag

New York: Elsevier BV

Erscheinungsjahr

2021

Quelle

Applied Social Sciences Index & Abstracts (ASSIA)

Beschreibungen/Notizen

• Purpose: Restrictive eating disorders (EDs) are often comorbid with other mental health conditions such as anxiety and depression. However, their relationship with degree of malnutrition remains unclear. We set out to assess how malnutrition is associated with anxiety and depression in adolescents/young adults (AYAs) with EDs. Methods: A sample of 145 AYAs (ages 10-24 years) with EDs were recruited from a large children's hospital in the northeastern U.S. for the RECOVERY study, a longitudinal web-based registry of AYAs with EDs. Patients with restrictive EDs [anorexia nervosa (AN), other specified feeding and eating disorder (OSFED), and avoidant/ restrictive food intake disorder (ARFID)] were included. Those with bulimia nervosa, binge eating disorder, or disordered behaviors without restriction were excluded. Patients whose baseline surveys took place during the COVID-19 pandemic were excluded due to concern for a confounding effect on mental health. Malnutrition was measured as a percentage of expected body mass index (%eBMI), based on participants' pre-morbid growth trajectory. We used the Generalized Anxiety Disorder 7-item (GAD-7) and Center for Epidemiologic Studies Depression (CES-D) scales to measure anxiety and depression, respectively. The BMIs measured at the time of the baseline survey were used for a cross-sectional analysis. We used multiple linear regression models to examine the association of malnutrition with anxiety and depression. Results: Patients had a mean age of 16.4±3.0 years; 87% were female; 89% white, and 7.6% Hispanic/Latinx. The majority of patients (85%) had AN, 5.5% OSFED, and 9.7% ARFID. Nearly 2/3 patients had ED symptoms for over one year, 1 /3 had previous experience with higher level of ED care (HLOC), and half were taking a psychiatric medication. Mean %eBMI was 89.7±9.7% with a range of 56.8 to 111.8%eBMl. Mean GAD-7 score was 9.4±5.9 and CES-D score was 24±13.8, indicating clinically significant anxiety and depression. In our multivar-iable model, degree of malnutrition was not significantly associated with either severity of anxiety or depression adjusting for age, sex assigned at birth, sexual orientation, ED diagnosis, and use of psychiatric medication. A second model assessing whether HLOC, length of ED symptoms, or time in our care had an effect on this relationship showed that those with <6 months of symptoms had the lowest depression scores compared to those with longer courses of illness. Conclusions: Patients with restrictive EDs are at high risk for co-morbid anxiety and depression. Severity of malnutrition may not predict extent of anxiety and depression; thus mental health support is necessary at all levels of malnutrition. However, chronicity of ED symptoms could be a clinically important predictor of depression, supporting the need for rapid and effective ED diagnosis and treatment.