Study Links Premorbid Depression With Poor Anorexia Outcome

Premorbid depression appears to be a major impediment to the recovery of individuals with anorexia nervosa, researchers report in the International Journal of Eating Disorders. The lead researcher was Anna Keski-Rahkonen, M.D., Ph.D., an assistant professor in psychiatric epidemiology at the University of Helsinki. Out of 2,881 women from the 1975-1979 birth cohorts of Finnish twins, the researchers identified 55 women with DSM-IV anorexia nervosa, 39 of whom had recovered from their illness and 16 of whom had not.

The unrecovered women were significantly more likely to suffer from depressive symptoms prior to eating-disorder onset, to remain unemployed, to be dissatisfied with their current partner/spouse, and to report high perfectionism than were the women who had recovered. But when the researchers accounted for the duration of the illness, premorbid depression was the sole factor significantly associated with a decreased likelihood of recovery. As a result, premorbid depression in anorexia nervosa "may warrant closer clinical attention and further clinical interventions," the researchers concluded.

"While our theoretical understanding of the factors that may contribute to the unusual persistence of anorexia nervosa has evolved over the years, our ability to predict and manage chronicity among those who suffer from this devastating illness remains limited," Michael Devlin, M.D., codirector of eating disorders research at the New York State Psychiatric Institute, said in an interview with Psychiatric News. "This important study brings us a step closer by underscoring the negative impact of depressive symptoms on the goal of full long-term behavioral recovery."

More information about anorexia nervosa can be found in the American Psychiatric Publishing book "Developing an Evidence-Based Classification of Eating Disorders: Scientific Findings for DSM-5." To read more about eating disorders, see the Psychiatric News articles, "Eating Disorder Data Underscore Urgent Need for Prevention" and "When Parents Focus on Weight, Kids' Eating Disorder Risk Rises."

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