Comorbid Depression in Hospitalised Youth With Anorexia Nervosa: Characteristics, Correlates, and Impact on Weight...

Anorexia nervosa (AN) is associated with high rates of comorbidities. The impact of comorbid depression-spectrum disorders (DSDs) in AN patients on the outcomes of inpatient treatment is insufficiently studied.

Retrospective study of youth with AN (9-18 years), admission weight < 10th body mass index (BMI) percentile, consecutively hospitalised in a child and adolescent psychiatry university department. Patients with AN+DSD as the only psychiatric comorbidity were compared with AN patients without psychiatric comorbidity (ANnoComorbidity).

Among 220 female AN inpatients (median = 15.0 years) 62 had AN+DSD versus 158 had ANnoComorbidity. Patients with AN+DSD were more likely to report childhood emotional abuse (p = 0.020), and to receive psychotropic medications (any: p < 0.001; antidepressants: p < 0.001; antipsychotics: p = 0.001). Moreover, AN+DSD had less average weekly weight gain (p = 0.012) and longer inpatient treatment (p < 0.001). Independent correlates of less average weekly weight gain included lower admission BMI z-score (p < 0.001), antipsychotic (p = 0.002) and antidepressant (p = 0.004) treatment (R² = 0.17, p < 0.001). Independent correlates of longer hospitalisation included lower admission BMI z-scores (p < 0.001), antipsychotic (p < 0.001) or antidepressant (p < 0.001) treatment (R² = 0.27, p < 0.001).

AN+DSD were hospitalised longer and gained less average weight/week compared to ANnoComorbidity. Lower admission weight, antipsychotic or antidepressant co-treatment were independently associated with less average weight gain and longer inpatient stays.