Relationship between Affective Symptoms and Malnutrition Severity in Severe Anorexia Nervosa
Identifieur interne : 000183 ( Main/Exploration ); précédent : 000182; suivant : 000184Relationship between Affective Symptoms and Malnutrition Severity in Severe Anorexia Nervosa
Auteurs : Lama Mattar [France] ; Caroline Huas [France] ; Evhan Group ; Nathalie Godart [France]Source :
- PLoS ONE [ 1932-6203 ] ; 2012.
Abstract
Very few studies have investigated the relationship between malnutrition and psychological symptoms in Anorexia Nervosa (AN). They have used only body weight or body mass index (BMI) for the nutritional assessment and did not always report on medication, or if they did, it was not included in the analysis of results, and they did not include confounding factors such as duration of illness, AN subtype or age. The present study investigates this relationship using indicators other than BMI/weight, among which body composition and biological markers, also considering potential confounders related to depression and anxiety.
155 AN patients, (DSM-IV) were included consecutively upon admission to inpatient treatment. Depression, anxiety, obsessive behaviours and social functioning were measured using various scales. Nutritional status was measured using BMI, severity of weight loss, body composition, and albumin and prealbumin levels.
No correlation was found between BMI at inclusion, fat-free mass index, fat mass index, and severity of weight loss and any of the psychometric scores. Age and medication are the only factors that affect the psychological scores. None of the psychological scores were explained by the nutritional indicators with the exception of albumin levels which was negatively linked to the LSAS fear score (p = 0.024; beta = −0.225). Only the use of antidepressants explained the variability in BDI scores (p = 0.029; beta = 0.228) and anxiolytic use explained the variability in HADs depression scores (p = 0.037; beta = 0.216).
The present study is a pioneer investigation of various nutritional markers in relation to psychological symptoms in severely malnourished AN patients. The clinical hypothesis that malnutrition partly causes depression and anxiety symptoms in AN in acute phase is not confirmed, and future studies are needed to back up our results.
Url:
DOI: 10.1371/journal.pone.0049380
PubMed: 23185320
PubMed Central: 3504017
Affiliations:
- France
- Centre-Val de Loire, Région Centre, Île-de-France
- Paris, Tours
- Sorbonne Paris Cité, Université Paris-Descartes, Université Paris-Sud
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xml:lang="fr">France</country><wicri:regionArea>Université Paris-Sud, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName><orgName type="university">Université Paris-Sud</orgName></affiliation><affiliation wicri:level="4"><nlm:aff id="aff3"><addr-line>Université Paris Descartes, Paris, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Université Paris Descartes, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName><orgName type="university">Université Paris-Descartes</orgName></affiliation><affiliation wicri:level="3"><nlm:aff id="aff5"><addr-line>Faculté de médecine Paris Descartes, Département Universitaire de Médecine Générale, Tours, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Faculté de médecine Paris Descartes, Département Universitaire de Médecine Générale, Tours</wicri:regionArea><placeName><region type="region">Centre-Val de Loire</region><region type="old region">Région Centre</region><settlement type="city">Tours</settlement></placeName></affiliation></author><author><name sortKey="Group, Evhan" sort="Group, Evhan" uniqKey="Group E" first="Evhan" last="Group">Evhan Group</name></author><author><name sortKey="Godart, Nathalie" sort="Godart, Nathalie" uniqKey="Godart N" first="Nathalie" last="Godart">Nathalie Godart</name><affiliation wicri:level="3"><nlm:aff id="aff4"><addr-line>Psychiatry Unit, Institut Mutualiste Montsouris 42, Paris, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Psychiatry Unit, Institut Mutualiste Montsouris 42, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName><placeName><settlement type="city">Paris</settlement><region type="region" nuts="2">Île-de-France</region></placeName><orgName type="university" n="3">Université Paris-Descartes</orgName><orgName type="institution" wicri:auto="newGroup">Sorbonne Paris Cité</orgName></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Very few studies have investigated the relationship between malnutrition and psychological symptoms in Anorexia Nervosa (AN). They have used only body weight or body mass index (BMI) for the nutritional assessment and did not always report on medication, or if they did, it was not included in the analysis of results, and they did not include confounding factors such as duration of illness, AN subtype or age. The present study investigates this relationship using indicators other than BMI/weight, among which body composition and biological markers, also considering potential confounders related to depression and anxiety.</p></sec><sec><title>Methods</title><p>155 AN patients, (DSM-IV) were included consecutively upon admission to inpatient treatment. Depression, anxiety, obsessive behaviours and social functioning were measured using various scales. Nutritional status was measured using BMI, severity of weight loss, body composition, and albumin and prealbumin levels.</p></sec><sec><title>Results</title><p>No correlation was found between BMI at inclusion, fat-free mass index, fat mass index, and severity of weight loss and any of the psychometric scores. Age and medication are the only factors that affect the psychological scores. None of the psychological scores were explained by the nutritional indicators with the exception of albumin levels which was negatively linked to the LSAS fear score (p = 0.024; beta = −0.225). Only the use of antidepressants explained the variability in BDI scores (p = 0.029; beta = 0.228) and anxiolytic use explained the variability in HADs depression scores (p = 0.037; beta = 0.216).</p></sec><sec><title>Conclusion</title><p>The present study is a pioneer investigation of various nutritional markers in relation to psychological symptoms in severely malnourished AN patients. The clinical hypothesis that malnutrition partly causes depression and anxiety symptoms in AN in acute phase is not confirmed, and future studies are needed to back up our results.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="American Psychiatric, A" uniqKey="American Psychiatric A">A American Psychiatric</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gerner, Rh" uniqKey="Gerner R">RH Gerner</name></author><author><name sortKey="Cohen, Dj" uniqKey="Cohen D">DJ Cohen</name></author><author><name sortKey="Fairbanks, L" uniqKey="Fairbanks L">L Fairbanks</name></author><author><name sortKey="Anderson, Gm" uniqKey="Anderson G">GM Anderson</name></author><author><name sortKey="Young, Jg" uniqKey="Young J">JG Young</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kaye, W" uniqKey="Kaye W">W 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Garner</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Jeammet, P" uniqKey="Jeammet P">P Jeammet</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Gola, E" uniqKey="Gola E">E Gola</name></author><author><name sortKey="Arosio, G" uniqKey="Arosio G">G Arosio</name></author><author><name sortKey="Benedini, G" uniqKey="Benedini G">G Benedini</name></author><author><name sortKey="Cicogna, R" uniqKey="Cicogna R">R Cicogna</name></author><author><name sortKey="Petroboni, V" uniqKey="Petroboni V">V Petroboni</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Forest, A" uniqKey="Forest A">A Forest</name></author><author><name sortKey="Lemaire, A" uniqKey="Lemaire A">A Lemaire</name></author><author><name sortKey="Boddaert, J" uniqKey="Boddaert J">J Boddaert</name></author><author><name sortKey="Verny, M" uniqKey="Verny M">M Verny</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Taylor, Hl" uniqKey="Taylor H">HL Taylor</name></author><author><name sortKey="Henschel, A" uniqKey="Henschel A">A Henschel</name></author><author><name sortKey="Keys, A" uniqKey="Keys A">A Keys</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>France</li></country><region><li>Centre-Val de Loire</li><li>Région Centre</li><li>Île-de-France</li></region><settlement><li>Paris</li><li>Tours</li></settlement><orgName><li>Sorbonne Paris Cité</li><li>Université Paris-Descartes</li><li>Université Paris-Sud</li></orgName></list><tree><noCountry><name sortKey="Group, Evhan" sort="Group, Evhan" uniqKey="Group E" first="Evhan" last="Group">Evhan Group</name></noCountry><country name="France"><region name="Île-de-France"><name sortKey="Mattar, Lama" sort="Mattar, Lama" uniqKey="Mattar L" first="Lama" last="Mattar">Lama Mattar</name></region><name sortKey="Godart, Nathalie" sort="Godart, Nathalie" uniqKey="Godart N" first="Nathalie" last="Godart">Nathalie Godart</name><name sortKey="Huas, Caroline" sort="Huas, Caroline" uniqKey="Huas C" first="Caroline" last="Huas">Caroline Huas</name><name sortKey="Huas, Caroline" sort="Huas, Caroline" uniqKey="Huas C" first="Caroline" last="Huas">Caroline Huas</name><name sortKey="Huas, Caroline" sort="Huas, Caroline" uniqKey="Huas C" first="Caroline" last="Huas">Caroline Huas</name><name sortKey="Huas, Caroline" sort="Huas, Caroline" uniqKey="Huas C" first="Caroline" last="Huas">Caroline Huas</name><name sortKey="Mattar, Lama" sort="Mattar, Lama" uniqKey="Mattar L" first="Lama" last="Mattar">Lama Mattar</name><name sortKey="Mattar, Lama" sort="Mattar, Lama" uniqKey="Mattar L" first="Lama" last="Mattar">Lama Mattar</name><name sortKey="Mattar, Lama" sort="Mattar, Lama" uniqKey="Mattar L" first="Lama" last="Mattar">Lama Mattar</name></country></tree></affiliations></record>Pour manipuler ce 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