A case series investigation of association between co-morbid psychiatric disorder and the improvement in body mass index among patients with anorexia nervosa and eating disorder not otherwise specified of the anorexia nervosa type.

Robin Goh

doi:10.1186/s40337-015-0049-z

Abstract

BackgroundAnorexia nervosa and eating disorder not otherwise specified* (not fulfilling Anorexia Nervosa DSM IV criteria) are increasing in Singapore. Patients with eating disorders may also present with other psychiatric disorders such as depression and anxiety. The paper aims to investigate the association of co-morbid psychiatric disorders with the improvement of body mass index (BMI) in these patients.MethodsA retrospective cohort analysis of 182 patients with anorexia and eating disorder not otherwise specified at a tertiary hospital was done. The clinical course of co-morbid psychiatric disorders was correlated with the improvement of body mass index.Results109 patients were included in the analysis and the mean BMI on resolution of co-morbid psychiatric disorders was BMI 16.9. There is a significant association between the BMI groups and the resolution of co-morbid psychiatric disorders, χ2 = 10.2, p = .03. Patients in BMI group 5 (BMI 16.6 - 18.5) were noted to be significantly less likely to resolve their psychiatric co-morbidity compared to the other 4 groups. (OR = 0.323).ConclusionPatients with anorexia nervosa and eating disorders not otherwise specified were at increased risk of having co-morbid psychiatric disorders and the clinical course of co-morbid psychiatric disorders appeared to correlate with improved BMI. Specifically patients with BMI < 16.5 with co-morbid psychiatric disorders were more likely to recover from their co-morbid psychiatric disorder with nutritional rehabilitation than patients with a higher BMI.

Highlights

IntroductionAnorexia nervosa and eating disorder not otherwise specified* (not fulfilling Anorexia Nervosa DSM IV criteria) are increasing in Singapore
Anorexia nervosa and eating disorder not otherwise specified* are increasing in Singapore
Group 1 consisted of patients with body mass index less than or equal to 10.5, Group 2 consisted of body mass index from 10.6 to 12.5, Group 3 consisted of body mass index from 12.6 to 14.5, Group 4 consisted of body mass index from 14.6 to 16.5 and lastly Group 5 consisted of body mass index from 16.6 to 18.5

Summary

Introduction

Anorexia nervosa and eating disorder not otherwise specified* (not fulfilling Anorexia Nervosa DSM IV criteria) are increasing in Singapore. Patients with eating disorders may present with other psychiatric disorders such as depression and anxiety. The paper aims to investigate the association of co-morbid psychiatric disorders with the improvement of body mass index (BMI) in these patients. Depression is the most common psychiatric disorder to present concurrently with eating disorders [4,5,6]. Other psychiatric disorders commonly seen in patients with anorexia nervosa include anxiety and obsessive compulsive disorders. Aspects of personality change may differ between individuals and can range from irritability, argumentativeness and obstinacy [9]. They are often highlighted by family member who noticed such changes as their eating disorder deteriorate. Medication appeared to be not efficacious in reducing the co-morbid psychiatric disorders such as depression, anxiety and

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