Socioeconomic Deprivation in Adolescents Hospitalized with Anorexia Nervosa and Atypical Anorexia Nervosa

Objectives: We sought to examine associations between area-level socioeconomic deprivation and: (1) hospitalization length; (2) severity; and (3) clinical outcomes in adolescents hospitalized for atypical anorexia nervosa or anorexia nervosa (AN). We hypothesized that more socioeconomic deprivation would be associated with longer length of hospitalization, greater illness severity, and poorer clinical outcomes. Methods: We conducted a study of individuals aged 11-18 years with AN who were admitted for medical instability. Tract-level socioeconomic deprivation was characterized by using a deprivation index (range 0-1, higher scores indicating more deprivation). Outcomes of interest included (1) hospitalization length defined as duration in days between admission and discharge, (2) illness severity defined as percentage of goal weight at admission and global Eating Disorder Examination Questionnaire (EDE-Q) score and (3) clinical outcomes defined as re-admission rate, 3- and 6-month follow up percentage goal weight, and 3- and 6-month weight restoration status. We used multivariate regression to assess associations between deprivation index and outcomes of interest. Results: A total of 121 adolescents were included. The mean age was 15.4 years (range 11.0-17.9 years). Higher deprivation was associated with a lower percent of target goal weight achieved at 3-month follow up (Estimate= -19.8; p-value = 0.029; 95% CI= -37.5 to -2.1). Contrary to our initial hypothesis, higher deprivation index scores were associated with shorter hospitalization lengths (Estimate = -15.4; p < 0.001; 95% CI = -22.6 to -8.2). Conclusions: Higher deprivation was associated with a lower percent of target goal weight achieved at 3-month follow up and shorter length of hospitalization. This study adds to the extant literature by using a novel method, geocoding, to examine the relationship between socioeconomic deprivation and eating disorder outcomes. Future studies with more diverse samples (including Spanish speakers) are needed.