Relationship between affective symptoms and malnutrition severity in severe Anorexia Nervosa.
PLoS ONE. 2012-11-21; 7(11): e49380
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1. PLoS One. 2012;7(11):e49380. doi: 10.1371/journal.pone.0049380. Epub 2012 Nov 21.
Relationship between affective symptoms and malnutrition severity in severe
Mattar L(1), Huas C; EVHAN group, Godart N.
Collaborators: Godart N, Berthoz S, Duclos J, Mattar L, Roux H, Thiébaut MR,
Wallier J, Courty A, Ringuenet D, Vindreau C, Reynaud M, Benoit JP, Blanchet C,
Moro MR, Bignami L, Nordon C, Pham A, Rouillon F, Cook S, Doyen C, Siméoni MC,
Gerardin P, Lebecq S, Podlipski MA, Gayet C, Lasfar M, Delorme M, Pommereau X,
Bioulac S, Bouvard E, Carrere J, Doncieux K, Faucher S, Fayollet C, Prexl A.
(1)INSERM U669, Maison de Solenn, Paris, France.
BACKGROUND: Very few studies have investigated the relationship between
malnutrition and psychological symptoms in Anorexia Nervosa (AN). They have used
only body weight or body mass index (BMI) for the nutritional assessment and did
not always report on medication, or if they did, it was not included in the
analysis of results, and they did not include confounding factors such as
duration of illness, AN subtype or age. The present study investigates this
relationship using indicators other than BMI/weight, among which body composition
and biological markers, also considering potential confounders related to
depression and anxiety.
METHODS: 155 AN patients, (DSM-IV) were included consecutively upon admission to
inpatient treatment. Depression, anxiety, obsessive behaviours and social
functioning were measured using various scales. Nutritional status was measured
using BMI, severity of weight loss, body composition, and albumin and prealbumin
RESULTS: No correlation was found between BMI at inclusion, fat-free mass index,
fat mass index, and severity of weight loss and any of the psychometric scores.
Age and medication are the only factors that affect the psychological scores.
None of the psychological scores were explained by the nutritional indicators
with the exception of albumin levels which was negatively linked to the LSAS fear
score (p = 0.024; beta = -0.225). Only the use of antidepressants explained the
variability in BDI scores (p = 0.029; beta = 0.228) and anxiolytic use explained
the variability in HADs depression scores (p = 0.037; beta = 0.216).
CONCLUSION: The present study is a pioneer investigation of various nutritional
markers in relation to psychological symptoms in severely malnourished AN
patients. The clinical hypothesis that malnutrition partly causes depression and
anxiety symptoms in AN in acute phase is not confirmed, and future studies are
needed to back up our results.
PMID: 23185320 [Indexed for MEDLINE]