[Clinical and dynamic features of anorexia nervosa and its types]

To systematize current data on the clinical and dynamic characteristics of anorexia nervosa (AN) and its subtypes, detailing their clinical manifestations, progression, and potential outcomes.

A narrative review was conducted, incorporating Russian and international literature on AN and its types. Publications were sourced from Scopus, PubMed, eLibrary, and Google Scholar databases covering the years 1986 to 2026. Descriptive analysis was employed to systematize and interpret the data.

The review highlights the distinctions between the restrictive type of AN (AN-R) and the binge-eating/purging type of AN (AN-B/P), emphasizing how these differences affect cognitive control, the reward system, personal characteristics, and genetic predispositions to the disorder. Furthermore, the high frequency of transitions between these types indicates the dynamic nature of AN's clinical manifestations and complicates the definitive classification of AN types as distinct disorders. Findings suggest that AN-R is often correlated with rigid thinking, perfectionism, and hypercontrol, while AN-B/P is more frequently associated with emotional dysregulation and impulsivity.

Both the restrictive type of AN and the binge-eating/purging type exhibit shared clinical foundations alongside significant differences that influence their manifestations, course, and treatment approaches. The frequent transitions between the two types suggest a dynamic clinical relationship, indicating that they should not be viewed as entirely distinct disorders. This review underscores the need to develop individualized strategies for diagnosis, treatment, and relapse prevention, as well as to refine prognostic criteria for patients with various clinical types of the disorder.