Eating disorder symptom non-endorsers in hospitalised patients with anorexia nervosa: Who are they?

Autor: Vanzhula I; University of Kansas, LifeSpan Institute, Lawrence, Kansas, USA.; Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA., Hagan K; Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, USA.; Department of Psychiatry, Columbia University Irving Medical Center, Columbia, New York, USA., Duck SA; Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA., Pan I; Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA., Wang EY; Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA., Steinglass J; Department of Psychiatry, Columbia University Irving Medical Center, Columbia, New York, USA., Attia E; Department of Psychiatry, Columbia University Irving Medical Center, Columbia, New York, USA., Wildes JE; Department of Psychiatry & Behavioral Neuroscience, University of Chicago Medicine, Chicago, Illinois, USA., Guarda AS; Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA., Schreyer C; Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Jazyk: angličtina
Zdroj: European eating disorders review : the journal of the Eating Disorders Association [Eur Eat Disord Rev] 2024 Jul; Vol. 32 (4), pp. 795-808. Date of Electronic Publication: 2024 Mar 25.
DOI: 10.1002/erv.3087
Abstrakt: Objective: Impaired insight and illness denial are common in anorexia nervosa (AN). Missing an AN diagnosis may delay treatment and negatively impact outcomes.
Method: The current retrospective study examined the prevalence and characteristics of AN symptom non-endorsement (i.e., scoring within the normal range on the Eating Disorder Examination Questionnaire [EDE-Q] or the Eating Disorder Examination [EDE] interview) in three independent samples of hospitalised patients with AN (N 1  = 154; N 2  = 300; N 3  = 194). A qualitative chart review of a subsample of non-endorsers (N 4  = 32) extracted reports of disordered eating behaviours observed by the treatment team.
Results: The prevalence of non-endorsement ranged from 11% to 34% across sites. Non-endorsers were more likely to be diagnosed with AN restricting type (AN-R) and reported fewer symptoms of co-occurring psychopathology than endorsers. Groups benefitted equally from treatment. The qualitative chart review indicated that objective symptoms of AN were recorded by staff in over 90% of non-endorsers.
Conclusions: Eating disorder symptom assessments using the EDE-Q or EDE may miss symptomatology in up to a third of individuals hospitalised with AN. This study highlights the potential utility of multi-modal assessment including patient interviews, collateral informants, and behavioural observation to circumvent non-endorsement.
(© 2024 Eating Disorders Association and John Wiley & Sons Ltd.)
Databáze: MEDLINE
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