Association Between Paranoia And Anorexia Nervosa In Adolescents: What Factors Are Involved? 

Abstract

Background: psychiatric comorbidities are of particular interest in Eating disorders. The association between anorexia nervosa and psychotic disorders is less studied than that with affective disorders (anxiety/depression). The aim of this study is to describe a psychotic symptom (paranoia) in adolescents with Eating Disorders looking at several potential explicative associated factors: eating disorder symptoms, body image concerns, depression and social anxiety. Our hypothesis is that paranoia in AN patients is more explained by the concomitant depression and social anxiety symptoms than core symptoms of the disease (eating disorder symptoms or body image concerns). Methods: this is a retrospective cross sectional study and consecutive, help-seeking adolescents admitted to the Eating Disorder service of the Integrated Pediatric Care Department, Luigi Vanvitelli University Hospital constituted the sample. Data was obtained trough retrospective collection of clinical interviews and self – report questionnaires administered by trained and expert child and adolescent psychiatrists. Results: We obtained data from 92 adolescents with Eating Disorders. Paranoia was dimensionally distributed in the sample (mean: 22,17 SD: 17,7; median 18 IQR: 7/36; range: 0-62). Our regression model explained that paranoia in this population was better explained by depression (coefficient= 0,415 SD: 0,210, p=0,052) and social anxiety symptoms (coefficient= 0,253 SD: 0,060; p<0,001) than eating disorder symptoms (coefficient= 0,092 SD: 0,107; p=0,398) and body image concerns (coefficient= 1,916 SD: 2,079; p=0,359) that did not retain their significance when all our predictive factors entered in the model. Conclusion: This study has some theoretical, clinical and treatment implications. It is important to carrying out screening for the presence of psychotic symptoms in patients with Eating Disorders. These symptoms and associated factors (depression and social anxiety) may complicate the clinical picture of the disease with the need, in certain cases, of psychopharmacological drugs and, among these, anti-psychotics. Finally in the psychotherapy context, paranoid idea may be subject of treatment for patient with EDs.