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Early changes in depression predict outcomes of inpatient adolescent anorexia nervosa

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Abstract

Purpose

The aim of this study was to investigate the predictive value of early changes in depression levels during inpatient treatment of adolescent anorexia nervosa (AN).

Methods

Fifty-six adolescents (88% girls) aged 10–18 years (M = 15.35, SD = 2.23) diagnosed with AN were assessed at admission and 1 month following admission to an inpatient setting. Depression levels and eating disorder symptoms were reported at both assessments. Re-hospitalization within 12 months of discharge was documented using official national records.

Results

Whereas depression levels at baseline were found equivalent between subsequently re-hospitalized and non-re-hospitalized patients, at 1 month after admission patients who were later re-hospitalized had higher levels of depression compared to those who were not re-hospitalized. These differences remained significant after controlling for weight gain and anti-depressant medication intake. We additionally found that the proportion of boys in the non-re-hospitalized group was substantially larger than their proportion in the re-hospitalized group.

Conclusions

Our results suggest that depression at the point of hospital admission may not be a reliable predictor of treatment outcomes, and highlight the risk of relapse in AN patients whose depression levels do not alleviate after a month of inpatient treatment. Clinicians should consider providing more adjusted and intensive attention to such patients in their efforts to facilitate remission.

Level of evidence III

Well-designed cohort study.

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Authors and Affiliations

  1. Schneider Children’s Medical Center, Petah Tikva, Israel

    Michal Kahn, Anat Brunstein-Klomek, Arie Hadas, Avigal Snir & Silvana Fennig

  2. The School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel

    Michal Kahn

  3. The School of Psychology, Interdisciplinary Center, Herzlyia, Israel

    Anat Brunstein-Klomek

  4. Sackler Medical School, Tel-Aviv University, Tel-Aviv, Israel

    Silvana Fennig

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  1. Michal Kahn
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  2. Anat Brunstein-Klomek
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Correspondence to Michal Kahn.

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Ethical standards

This study was approved by the Rabin Medical Center Review Board (approval number RMC-0468-12). All the procedures performed in the present study involving human participants were in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Written informed consent was obtained from all individual participants and their parents.

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Kahn, M., Brunstein-Klomek, A., Hadas, A. et al. Early changes in depression predict outcomes of inpatient adolescent anorexia nervosa. Eat Weight Disord 25, 777–785 (2020). https://doi.org/10.1007/s40519-019-00686-9

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