Is the Severity of the Clinical Expression of Anorexia Nervosa Influenced by an Anxiety, Depressive, or Obsessive-Compulsive Comorbidity Over a Lifetime?

• Main Authors: Elise Riquin, Agathe Raynal, Lama Mattar, Christophe Lalanne, France Hirot, Caroline Huas, Jeanne Duclos, Sylvie Berthoz, Nathalie Godart, EVHAN group, Hélène Roux, Marie Raphaële Thiébaud, Sarah Vibert, Tamara Hubert, Annaig Courty, Damien Ringuenet, Jean-pierre Benoit, Corinne Blanchet, Marie Rose Moro, Laura Bignami, Clémentine Nordon, Frédéric Rouillon, Solange Cook, Catherine Doyen, Marie-Christine Mouren Siméoni, Priscille Gerardin, Sylvie Lebecq, Marc-Antoine Podlipski, Claire Gayet, Malaika Lasfar, Marc Delorme, Xavier Pommereau, Stéphanie Bioulac, Manuel Bouvard, Jennifer Carrere, Karine Doncieux, Sophie Faucher, Catherine Fayollet, Amélie Prexl, Stéphane Billard, François Lang, Virginie Mourier-Soleillant, Régine Greiner, Aurélia Gay, Guy Carrot, Sylvain Lambert, Morgane Rousselet, Ludovic Placé, Jean-luc Venisse, Marie Bronnec, Bruno Falissard, Christophe Genolini, Christine Hassler, Jean-Marc Tréluyer, Olivier Chacornac, Maryline Delattre, Nellie Moulopo, Christelle Turuban, Auger Christelle
• Format: Article
• Language: English
• Published: Frontiers Media S.A. 2021-07-01
• Series: Frontiers in Psychiatry
• Subjects: anorexia nervosa; anxiety; depression; nutritional status; body mass index
• Online Access: https://www.frontiersin.org/articles/10.3389/fpsyt.2021.658416/full

Purpose: The relationship between anxiety or depressive comorbidities, their chronology of onset, and the severity of anorexia nervosa (AN) is not well-studied. We hypothesize that the existence of a comorbidity, particularly before the onset of AN, is associated with greater severity of AN.Methods: One hundred seventy-seven subjects were assessed. The prevalence of major depressive disorder (MDD), obsessive-compulsive disorder (OCD), generalized anxiety disorder (GAD), and social phobia (SP) as well as their chronology of onset were studied. The assessment criteria of AN severity were the overall clinical condition, body mass index (BMI) on admission, lowest BMI, intensity of the eating symptoms, age at the onset of AN, illness duration, number of hospitalizations, and quality of life.Results: Patients with AN had the greatest clinical severity when they had a comorbid disorder over their lifetime, such as MDD, GAD, or SP. These comorbidities along with OCD were associated with a higher level of eating symptoms and a more altered quality of life. A profile of maximum severity was associated with a higher prevalence of MDD and GAD. Concerning the chronology of onset, the age at the start of AN was later in cases of MDD or GAD prior to AN.Conclusion: There seems to be an association between severity of AN and both MDD and GAD. The chronology of onset of the comorbidity did not seem to be associated with the severity.