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

Abstract

Purpose The 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. Methods Female 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). Results A 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. Conclusion Our 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.

Phonological working memory is adversely affected in adults with anorexia nervosa: a systematic literature review

“…The literature search yielded 25 studies examining WM capacity in AN across 14 countries, 19 of which were case versus control studies and formed the main analysis. The remaining six studies examined WM within AN-R [ 33 , 34 ], pre-and post-recovered AN [ 35 ], comorbid and medicated ED [ 36 , 37 ] or did not perform statistical comparisons between the clinical ED and non-clinical HC groups [ 38 ] (Table 3 ). The combined sample size included 850 AN participants with a mean age of 23 years and a mean BMI of 15.7.…”

“…Interestingly, AN-R did not deviate from the HC in forward Corsi Blocks, digit span, 3-back or the RCFT. Nor did the adult and mixed adolescent and adult groups of AN-R patients show altered WM functioning in the verbal/auditory digit span and LNS in comparison to HC [ 33 , 34 , 55 , 62 ] or in the visuospatial spatial span [ 62 ]. However, adolescents and adults with AN-R combined had a significantly faster recall time than the control group for the visuospatial RCFT [ 33 ].…”

“…n = 5 Natalia et al [ 56 ] Swiss F 20 20.10 (median) 21.30 (median) 20 (median) 16 (median) 4.00 14 (in) 15 (out) 29 23 6 Tamiya et al [ 62 ] Japanese F 69 34.36 N.R 29.10 15.53 N.R 16 (in) 24 (out) 40 22 18 Meds. n = 12 Adults and adolescents grouped Cholet et al [ 33 ] French F 59 21.30 21.10 20.70 15.20 3.50 N.R 59 59 Anxiety n = 34, affective dis. n = 21, ADHD n = 4, addictive behaviours n = 6, suicide risk n = 26, meds.…”

“…Harper et al [35] (pre-and post-recovered AN) Cholet et al [33] (AN-R only) Cavalera et al [38] (ED group not compared to HC) Ogata et al [34] (AN-R only)…”

Adolescents With Autism Spectrum Disorder and Anorexia Nervosa Comorbidity: Common Features and Treatment Possibilities With Cognitive Remediation Therapy and Oxytocin

“…Central coherence refers to the cognitive capacity to integrate information into a more global meaning with the assumption that executive functions and social cognition abilities are preserved ( 40 ). Weak central coherence presents itself as the preoccupation with details at the cost of global/contextual processing ( 17 ).…”