Evaluation of cognitive impairment in a French sample of patients with restrictive anorexia nervosa: two distinct profiles emerged with differences in impaired functions and psychopathological symptoms

M. Burlot,E. Eyzop,B. Rocher,J. Cholet,M. Pere,S. Lambert,Y. Donnio,M. Rousselet,M. Grall-Bronnec,M. Chirio-Espitalier

doi:10.1007/s40519-020-00981-w

Abstract

PurposeThe cognitive profiles of patients suffering from anorexia nervosa (AN) are currently explored as potential facilitating and/or maintenance factors. Specific data in restrictive AN (AN-R) remain contradictory. This study focused on women with AN-R to evaluate their cognitive functions to develop a more specific cognitive remediation program.MethodsFemale patients older than 15 years who were suffering from AN-R were recruited in a specialized unit for eating disorder management. Female healthy control (HC) participants were recruited who were matched with AN patients on age. All participants completed a cognitive evaluation (premorbid intelligence quotient (IQ), planning, information processing speed, cognitive flexibility) and a clinical evaluation (impulsivity, anxiety, depression).ResultsA total of 122 participants were included. Patients suffering from AN-R had significant impairment in information processing speed and planning. Patients exhibited significantly better cognitive flexibility than did the HC group when adjustments were made for other cognitive functions and impulsivity. Two distinct subgroups of patients were identified. The first subgroup had more marked cognitive impairment and fewer psychopathological symptoms than did the second subgroup of patients and the HC group.ConclusionOur results highlight cognitive impairment in patients with AN who had normal premorbid IQ. Two distinct profiles emerge. In clinical practice, these results open up perspectives for the development of more specific cognitive remediation programs (one specific program for cold cognitions and another specific program targeting emotions and hot cognitions). These results warrant confirmation by larger studies with a more specific evaluation of the impact of emotional status.Trial registration NTC02381639, Date of registration. March 6, 2015

Highlights

As a serious pathology of adolescence, anorexia nervosa (AN) represents an important public health issue
The evaluation started with the verification of eating disorder (ED) diagnosis and the cognition portion to ensure that the participant was in the best condition possible
Participants from the AN group and healthy control (HC) group did not differ in premorbid intelligence quotient (IQ), but the AN group had poorer performance on several cognitive tasks

Summary

Introduction

As a serious pathology of adolescence, anorexia nervosa (AN) represents an important public health issue. The current model of AN is multifactorial, involving predisposing, precipitating and maintenance factors of the disorder with individual factors (genetic and psychological) in close interaction with socioenvironmental factors (family, environmental and sociocultural factors). For this reason, several studies have examined the cognitive profiles of patients as a potential facilitating factor (with the question of a cognitive endophenotype) and as a maintenance factor of this eating disorder [1, 2]. The results tend to converge towards attainment of central coherence, which some authors link with clinical specificities, such as the morbid pursuit of thinness and body image distortions, or such as traits of autistic spectrum disorders or obsessive traits [9]. The impact of emotional status (depression in particular) has complemented the current models and research perspectives [11]

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