Su1641 Audit of Gastrointestinal Symptoms and Psychopathological Traits in Patients With Eating Disorders: A Prospective Study

Abstract

BACKGROUND: Esophago-gastrointestinal (EGI) symptoms are frequently reported by patients with eating disorders (ED), who tend to use somatic disturbances to justify modifications of alimentary behaviour. It is not clear if referred symptoms are real, whether they ameliorate after controlled diet or if there are related to psychopathogical traits. AIM: (i) to analyze the prevalence of moderate-severe EGI symptoms, either individual or pooled, and of Minnesota Multiphasic Personality Inventory (MMPI-2 or MMPI-A) scales in hospitalized ED patients and symptoms modifications after 6 months of follow-up; (ii) to correlate EGI symptoms and sds-body mass index (sdsBMI) changes with MMPI scales. METHODS: We enrolled 48 consecutive patients (41 F, median age 15) hospitalized with a diagnosis of ED. Thirty-nine patients (81%) were classified as AN and 9 (19%) as BN. At admission (T1) all patients completed MMPI-2 or MMPI-A and the italian version of a validated questionnaire on gastroesophageal (E) and gastrointestinal (GI) symptoms. EGI questionnaire was then completed at discharge (T2), at 1 month of follow up (T3) and after 6 months (T4). RESULTS: (i) the most frequently reported symptoms classified as moderate-severe were postprandial fullness (70%) and abdominal distention (57%). The most prevalent pychopathological trait with abnormal MMPI score (>55) was depression (67%). During observational period of 6 months (T1-T4), E and GI symptoms significantly decreased (IR 3-19 and 0.5-6.5, IR 1444 and 4-28, p<0.05 and p<0.0001, respectively), as well as sdsBMI (-3.4 -1.7 e -1.5 -0.4; p<0.001). Patients with abnormal scores of Hypochondriasis (HS) had significantly more severe abdominal distention and pooled GI symptoms than patients with normal HS scores (p<0.05 and p<0.005, respectively). (ii) sdsBMI change did not correlate with EGI symptoms improvement (p=NS). Normal HS, Hysteria (HY), Psychoastenia (PT), Schizophrenia (SC) scores were significantly correlated with reduction of postprandial fullness compared to abnormal scores (p<0.05). Abdominal distention improved in all patients, irrespectively of MMPI scores (p<0.05). Pooled E symptoms significantly diminished in patients with normal HY scores vs abnormal (p<0.05), whereas pooled GI symptoms improved irrespectively of high HS and HY scores (p<0.05). All patients showed a reduction in sdsBMI, irrespectively of MMPI scores (p<0.05). CONCLUSIONS: Postprandial fullness and abdominal distention are the most prevalent digestive complaints reported by ED patients. An improvement of sdsBMI is observed in controlled ED patients as well as EGI symptoms. Abnormal MMPI traits may interfere with amelioration of postprandial fullness, but has no influence on abdominal distention, nor on sdsBMI.