Clinical Characteristics of Inpatients with Childhood vs. Adolescent Anorexia Nervosa

Abstract

We aimed to compare the clinical data at first presentation to inpatient treatment of children (<14 years) vs. adolescents (≥14 years) with anorexia nervosa (AN), focusing on duration of illness before hospital admission and body mass index (BMI) at admission and discharge, proven predictors of the outcomes of adolescent AN. Clinical data at first admission and at discharge in 289 inpatients with AN (children: n = 72; adolescents: n = 217) from a German multicenter, web-based registry for consecutively enrolled patients with childhood and adolescent AN were analyzed. Inclusion criteria were a maximum age of 18 years, first inpatient treatment due to AN, and a BMI <10th BMI percentile at admission. Compared to adolescents, children with AN had a shorter duration of illness before admission (median: 6.0 months vs. 8.0 months, p = 0.004) and higher BMI percentiles at admission (median: 0.7 vs. 0.2, p = 0.004) as well as at discharge (median: 19.3 vs. 15.1, p = 0.011). Thus, in our study, children with AN exhibited clinical characteristics that have been associated with better outcomes, including higher admission and discharge BMI percentile. Future studies should examine whether these factors are actually associated with positive long-term outcomes in children.

Inpatient treatment of anorexia nervosa in adolescents: A 1‐year follow‐up study

“…Although AN can occur at any age, the highest incidence rates can be found in adolescence (Zipfel, Giel, Bulik, Hay, & Schmidt, 2015). Inpatient treatment is an effective therapeutic approach for AN, that is, body weight significantly increases and eating disorder symptoms significantly decrease in the majority of both adolescent and adult patients from admission to discharge (e.g., Dalle Grave, Calugi, El Ghoch, Conti, & Fairburn, 2014; Herpertz‐Dahlmann et al, 2014; Hiney‐Saunders, Ousley, Caw, Cassinelli, & Waller, in press; Isserlin, Spettigue, Norris, & Couturier, 2020; Jaite et al, 2019; Schlegl, Quadflieg, Löwe, Cuntz, & Voderholzer, 2014; Schlegl et al, 2016). After inpatient treatment, however, there is a high risk of relapse—particularly between 4 and 12 months after discharge—with relapse rates tending to be lower in adolescents than in adults (Berends, Boonstra, & van Elburg, 2018; Carter, Blackmore, Sutandar‐Pinnock, & Woodside, 2004, Carter et al, 2012).…”

The validity of the fifth and the 10th Body Mass Index percentile as weight cut‐offs for anorexia nervosa in adolescence: No evidence from quantitative and network investigation of psychopathology

“…Therefore, we aimed to assess the validity of the fifth and 10th percentile BMI as weight cut‐off criteria for evaluating the severity of AN psychopathology in adolescents. To this purpose, we have assessed differences in specific ED symptomatology and in general psychopathology between adolescents with AN grouped by BMI percentile below or above the fifth percentile, as proposed by the CDC, and below or above the 10th percentile, as used in several clinical settings (Jaite et al., 2019; Lock et al., 2010) and proposed by literature studies (Hebebrand & Bulik, 2011). In addition to making a quantitative evaluation of differences between groups, we have also used the network analysis (NA) approach to determine whether the connections between ED and general symptoms vary between groups.…”

Childhood Eating and Feeding Disturbances

“…Jaite et al [7] examined the sociodemographic and clinical profile of children versus adolescents with anorexia nervosa, presenting for inpatient treatment and enrolled in a large consecutive multicenter registry in Germany. Compared to adolescents, children with anorexia nervosa had a shorter duration of illness and higher body mass index percentiles at both admission and discharge, suggesting a more favorable outcome at a younger age, although long-term effects remain to be examined.…”