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Comorbidity in Anorexic Adolescents: Assessment Through ASEBA System and Semistructured Interviews

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Handbook of Behavior, Food and Nutrition

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Abstract

A literature review on comorbidity in adolescent Anorexia Nervosa (AN) reveals a high rate of depressive and anxiety disorders broadly termed as internalizing conditions. The association between Axis II personality disorders (PD) and ED is also frequent with a prevalence of cluster C and B. Consequently, the accurate assessment of comorbidity is a key aspect in adolescent eating disorders to overcome the tendency to deny anorexic behavior as well as its comorbidity. The presence of comorbidity in ED is usually assessed with structured or semistructured clinical interviews, self-report questionnaires, and checklists. The assessment protocol used in the Eating Disorder Program at the Stella Maris Scientific Institute was elaborated by considering the type of patients and the clinical features of eating disorders at a young age: the Schedule for Affective Disorders and Schizophrenia for School Aged Children (K-SADS) for ED diagnosis and Axis I comorbidity; the Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II) for Axis II comorbidity; the Achenbach System of Empirically Based Assessment (ASEBA), especially the Child Behavior CheckList (CBCL) and Youth Self Report (YSR) for general psychopathology. In particular, a high percentage of our patients were found in the internalizing clinical range both at CBCL and YSR when using the ASEBA; these data were confirmed through Kiddie-SADS diagnosis with a prevalence of depressive disorders. High PD rates were found in our adolescent samples when using the SCID-II, similar to those of recent studies with a prevalence of cluster B and obsessive-compulsive personality disorder (OCPD). This accompanying comorbidity plays an important role in the outcome of ED and in the planning of therapeutic interventions.

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Abbreviations

AN:

Anorexia Nervosa

ASEBA:

Achenbach System of Empirically Based Assessment

BAI:

Beck Anxiety Inventory

BDI:

Beck Depression Inventory

BMI:

Body Mass Index

CBCL:

Child Behavior CheckList

CDI:

Children’s Depression Inventory

CDRS-R:

Children’s Depression Rating Scale Revised

DICA:

Diagnostic Interview for Children and Adolescents

DSM:

Diagnostic and Statistical Manual of Mental Disorders

EAT-26:

Eating Attitude Test

ED:

Eating Disorders

EDI-3:

Eating Disorder Inventory

EXT:

Externalizing

HDRS:

Hamilton Depression Rating Scale

INT:

Internalizing

K-SADS:

Schedule for Affective Disorders and Schizophrenia for School Aged Children

MASC:

Multidimensional Anxiety Scale for Children

OCD:

Obsessive Compulsive Disorder

OCPD:

Obsessive-Compulsive Personality Disorder

PARS:

Pediatric Anxiety Rating Scale

PD:

Personality Disorders

SCID-I:

Structured Clinical Interview for Axis I

SCID-II:

Structured Clinical Interview for Axis II

SIAB-EX:

Structured Interview for Anorexic and Bulimic Disorders-Expert Form

STAI:

State-Trait Anxiety Inventory

TP:

Total Problem

Y-BOCS:

Yale-Brown Obsessive Compulsive Scale

YSR:

Youth Self-Report

References

  • Achenbach TM. Manual for the Child behaviour Checklist/4–18 and 1991 profile. Burlington, University of Vermont department of Psychiatry; 1991a.

    Google Scholar 

  • Achenbach TM. Manual for the Youth self-Report and 1991 profile. Burlington, University of Vermont Department of Psychiatry; 1991b.

    Google Scholar 

  • Alessi NE, Krahn D, Brehm D, Wittekindt J. J Am Acad Child Adolesc Psychiat. 1989;28:380–4.

    Article  CAS  Google Scholar 

  • Ambrosini PJ. J Am Acad Child Adolesc Psychiat. 2000;39:49–56.

    Article  CAS  Google Scholar 

  • American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 4th ed.Washington, DC: APA; 1994.

    Google Scholar 

  • Beck AT, Epstein N, Brown G, Steer RA. J Consult Clin Psychol. 1988;56:893–7.

    Article  PubMed  CAS  Google Scholar 

  • Beck AT, Steer RA, Ball R, Ranieri W. J Pers Assess. 1996;67:588–97.

    Article  PubMed  CAS  Google Scholar 

  • Braun DL, Sunday SR, Halmi KA. Psychol Med. 1994;24:859–67.

    Article  PubMed  CAS  Google Scholar 

  • Bulik C, Thornton L, Pinheiro A, Plotnicov K, Klump K, Brandt H, Crawford S, Fichter M. et al. Psychosom Med. 2008;70:378–83.

    Article  PubMed  Google Scholar 

  • Chambers WJ, Puig-Antich J, Hirsch M, Paez P, Ambrosini PJ, Tabrizi MA. Arch Gen Psychiat. 1985;42:696–702.

    Article  PubMed  CAS  Google Scholar 

  • Chen EY, McCloskey MS, Keenan KE. Int J Eating Disord. 2009;42:275–83.

    Article  Google Scholar 

  • Claes L, Vandereychen W, Luyten P, Soenens B, Pieters G, Vertommen H. J Pers Disord. 2006;20:401–16.

    Article  PubMed  Google Scholar 

  • Cooper PJ, Watkins B, Bryant-Waugh R, Lask B. Psychol Med. 2002;32:873–80.

    Article  PubMed  CAS  Google Scholar 

  • Cotrufo P, Barretta V, Monteleone P. Acta Psychiat Scand. 1998;98:112–5.

    Article  PubMed  CAS  Google Scholar 

  • Couturier J. Canadian J CME. 2004; February: 81–4.

    Google Scholar 

  • Fosson A, Knibbs J, Bryant-Waugh R, Lask B. Arch Dis Childhood. 1987;62:114–8.

    Article  CAS  Google Scholar 

  • Franko DL, Keel PK. Clin Psychol Rev. 2006;26:769–82.

    Article  PubMed  Google Scholar 

  • Geist R, Davis R, Heinmaa M. Can J Psychiat. 1998;43:507–12.

    CAS  Google Scholar 

  • Godart NT, Flament MF, Lecrubier Y, Jeammet P. Eur Psychiat. 2000;15:38–45.

    Article  CAS  Google Scholar 

  • Godart NT, Perdereau F, Rein Z, Berthoz S, Wallier J, Jeammet Ph, Flament MF. J Affect Disord. 2007;97:37–49.

    Article  PubMed  CAS  Google Scholar 

  • Goodman WK, Price LH, Rasmussen SA, Mazure C, Fleischman RL, Hill KL, Heninger GR, Charney DS. Arch Gen Psychiat. 1989;46:1006–11.

    Article  PubMed  CAS  Google Scholar 

  • Grilo CM, Levy KN, Becker DF, Edell WS, McGlashan TH. Psychiat Serv. 1996;47:426–9.

    CAS  Google Scholar 

  • Halmi KA, Eckert E, Marchi P, Sampugnano V, Apple R, Cohen J. Arch Gen Psychiat. 1991;48:712–8.

    Article  PubMed  CAS  Google Scholar 

  • Heebink DM, Sunday S, Halmi KA. J Am Acad Child Adolesc Psychiat. 1995;34:378–82.

    Article  CAS  Google Scholar 

  • Herpertz-Dahlmann B. Child Adolesc Psychiatric Clin N Am. 2008;18:31–47.

    Article  Google Scholar 

  • Herzog DB, Keller MB, Lavori PW, Kenny GM, Sacks NR. J Clin Psychiat. 1992a;53:147–52.

    CAS  Google Scholar 

  • Herzog DB, Keller MB, Sacks NR, Yeh CJ, Lavori PW. J Am Acad Child Adolesc Psychiat. 1992b; 31:810–8.

    Article  CAS  Google Scholar 

  • Holliday J, Uher R, Landau S, Collier D, Treasure J. J Pers Disord. 2006;20:417–26.

    Article  PubMed  Google Scholar 

  • Kaye WH, Bulik CM, Thornton L, Barbarich N, Masters K. Am J Psychiat. 2004;161:2215–21.

    Article  PubMed  Google Scholar 

  • Kennedy SH, Kaplan AS, Garfinkel PE, Rockett W, Toner B, Abbey SE. J Psychosomatic Res. 1994;38:773–82.

    Article  CAS  Google Scholar 

  • Kovacs M. Psychopharmacol Bull. 1985;21:995–8.

    PubMed  CAS  Google Scholar 

  • Krol NP. J Am Acad Child Adolesc Psychiat. 1990;29:986–7.

    Article  CAS  Google Scholar 

  • Levy AB, Dixon KN. Int J Eating Disord. 1985;4:389–405.

    Article  Google Scholar 

  • Lewinsohn P, Striegel-Moore R, Seeley J. J Am Acad Child Adolesc Psychiat. 2000;39:1284–92.

    Article  CAS  Google Scholar 

  • Lilenfeld LR, Kaye WH, Greeno CG, Merikangas KR, Plotnicov K, Pollice C. Arch Gen Psychiat. 1998;55:603–10.

    Article  PubMed  CAS  Google Scholar 

  • March JS, Sullivan K, Parker J. J Anxiety Disord. 1999;13:349–58.

    Article  PubMed  CAS  Google Scholar 

  • Milos G, Spindler A, Schnyder U. Can J Psychiat. 2004;49:179–84.

    Google Scholar 

  • Mouren-Simeoni MC, Fontanon M, Bouvard MP, Dugas M. Revue Can. de Psychaitrie. 1993; 38:51–5.

    CAS  Google Scholar 

  • Muratori F, Viglione V, Maestro S, Picchi L. Psychopathology. 2004;37:92–7.

    Article  PubMed  Google Scholar 

  • North C, Gowers S. Int J Eating Disord. 1999;26:386–91.

    Article  CAS  Google Scholar 

  • Overholser JC, Brinkman DC, Lehnert KL, Ricciardi AM. J Clin Child Adolesc Psychol. 1995;24:443–52.

    Article  Google Scholar 

  • Piran N, Lerner P, Garfinkel PE, Kennedy SH, Brouillette C. Int J Eat Disord. 1988;7:589–99.

    Article  Google Scholar 

  • Presnell K, Stice E, Seidel A, Madeley MC. Clin Psychol Psychother. 2009;16:357–65.

    Article  PubMed  Google Scholar 

  • Rastam M. J Am Acad Child Adolesc Psychiat. 1992;31:819–29.

    Article  CAS  Google Scholar 

  • Reich W. J Am Acad Child Adolesc Psychiat. 2000;39:59–66.

    Article  CAS  Google Scholar 

  • Saccomani L, Savoini M, Cirrincione M, Verzellino F, Ravera G. J Psychosomatic Res. 1998; 44:565–71.

    Article  CAS  Google Scholar 

  • Salbach-Andrae H, Lenz K, Simmendinger N, Klinkowski N, Lehmkuhl U, Pfeiffer E. Child Psychiat Hum Dev. 2008;39:261–72.

    Article  Google Scholar 

  • Skodol AE, Rosnick L, Kellman D, Oldham JM, Hyler SE. Am J Psychiat. 1988;145:1297–9.

    PubMed  CAS  Google Scholar 

  • Smith C, Steiner H. J Am Acad Child Adolesc Psychiat. 1992;31:841–3.

    Article  CAS  Google Scholar 

  • Smith C, Feldman S, Nasserbakht A, Steiner H. J Am Acad Child Adolesc Psychiat. 1993;32:1237–45.

    Article  CAS  Google Scholar 

  • Spielberger CD, Gorsuch, RL, Lushene RE. Manual for the state-trait anxiety inventory. Palo Alto, CA: Consulting Psychologists Press; 1970.

    Google Scholar 

  • Thompson-Brenner H, Eddy KT, Satir DA, Boisseau C, Westen D. J Child Psychol Psychiat. 2008;49:170–80.

    Article  PubMed  Google Scholar 

  • Thornton C, Russell J. Int J Eat Disord. 1997;21:83–7.

    Article  PubMed  CAS  Google Scholar 

  • The Research Units on Pediatric Psychopharmacology anxiety study group. J Am Acad Child Adolesc Psychiat. 2002;41:1061–9.

    Article  Google Scholar 

  • Viglione V, Muratori F, Maestro S, Brunori E, Picchi L. Psychopathology. 2006;39:255–60.

    Article  PubMed  Google Scholar 

  • Williams JB. Arch Gen Psychiat. 1988;45:742–7.

    Article  PubMed  CAS  Google Scholar 

  • Williams JBW, Gibbon M, First MB, Spitzer RL, Davis M, Borus J, Howes MJ, Kane J, Pope HG, Rounsaville B, Wittchen H. Arch Gen Psychiat. 1992;49:630–6.

    Article  PubMed  CAS  Google Scholar 

  • Wonderlich SA, Swift WJ, Slomik HB, Goodman S. Int J Eat Disord. 1990;9:607–16.

    Article  Google Scholar 

  • Zaider TI, Johnson JG, Cockell S. Int J Eating Dis. 2000;28:58–67.

    Article  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Division of Child Neuropsichiatry, Stella Maris Scientific Institute, University of Pisa, IRCCS Stella Maris, Via dei Giacinti, 2-56018, Calambrone, Pisa, Italy

    Filippo Muratori

Authors
  1. Filippo Muratori
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  2. Valentina Viglione
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  3. Chiara Montalto
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  4. Sandra Maestro
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Corresponding author

Correspondence to Filippo Muratori .

Editor information

Editors and Affiliations

  1. Dept. Nutrition & Dietetics, King's College, Stamford St. 150, London, SE1 9NH, United Kingdom

    Victor R. Preedy

  2. Arizona Health Science Center, Mel and Enid Zuckerman College of Public, University of Arizona, 1501 N. Campbell Ave. Room 4335, Tucson, 85724-5155, Arizona, USA

    Ronald Ross Watson

  3. University of the West of Scotland, Ayr Campus, Ayr, KA8 0SR, United Kingdom

    Colin R. Martin

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Muratori, F., Viglione, V., Montalto, C., Maestro, S. (2011). Comorbidity in Anorexic Adolescents: Assessment Through ASEBA System and Semistructured Interviews. In: Preedy, V., Watson, R., Martin, C. (eds) Handbook of Behavior, Food and Nutrition. Springer, New York, NY. https://doi.org/10.1007/978-0-387-92271-3_158

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  • DOI: https://doi.org/10.1007/978-0-387-92271-3_158

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