AUTHOR=Riquin Elise , Raynal Agathe , Mattar Lama , Lalanne Christophe , Hirot France , Huas Caroline , Duclos Jeanne ,  EVHAN group , Berthoz Sylvie , Godart Nathalie , Godart Nathalie , Berthoz Sylvie , Lalanne Christophe , Duclos Jeanne , Mattar Lama , Roux Hélène , Thiébaud Marie Raphaële , Vibert Sarah , Hubert Tamara , Courty Annaig , Ringuenet Damien , Benoit Jean-pierre , Blanchet Corinne , Moro Marie Rose , Bignami Laura , Nordon Clémentine , Rouillon Frédéric , Cook Solange , Doyen Catherine , Siméoni Marie-Christine Mouren , Gerardin Priscille , Lebecq Sylvie , Podlipski Marc-Antoine , Gayet Claire , Lasfar Malaika , Delorme Marc , Pommereau Xavier , Bioulac Stéphanie , Bouvard Manuel , Carrere Jennifer , Doncieux Karine , Faucher Sophie , Fayollet Catherine , Prexl Amélie , Billard Stéphane , Lang François , Mourier-Soleillant Virginie , Greiner Régine , Gay Aurélia , Carrot Guy , Lambert Sylvain , Rousselet Morgane , Placé Ludovic , Venisse Jean-luc , Bronnec Marie , Falissard Bruno , Genolini Christophe , Hassler Christine , Tréluyer Jean-Marc , Chacornac Olivier , Delattre Maryline , Moulopo Nellie , Turuban Christelle , Christelle Auger 

TITLE=Is the Severity of the Clinical Expression of Anorexia Nervosa Influenced by an Anxiety, Depressive, or Obsessive-Compulsive Comorbidity Over a Lifetime?

JOURNAL=Frontiers in Psychiatry

VOLUME=12

YEAR=2021

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2021.658416

DOI=10.3389/fpsyt.2021.658416

ISSN=1664-0640

ABSTRACT=<p><bold>Purpose:</bold> The relationship between anxiety or depressive comorbidities, their chronology of onset, and the severity of anorexia nervosa (AN) is not well-studied. We hypothesize that the existence of a comorbidity, particularly before the onset of AN, is associated with greater severity of AN.</p><p><bold>Methods:</bold> One hundred seventy-seven subjects were assessed. The prevalence of major depressive disorder (MDD), obsessive-compulsive disorder (OCD), generalized anxiety disorder (GAD), and social phobia (SP) as well as their chronology of onset were studied. The assessment criteria of AN severity were the overall clinical condition, body mass index (BMI) on admission, lowest BMI, intensity of the eating symptoms, age at the onset of AN, illness duration, number of hospitalizations, and quality of life.</p><p><bold>Results:</bold> Patients with AN had the greatest clinical severity when they had a comorbid disorder over their lifetime, such as MDD, GAD, or SP. These comorbidities along with OCD were associated with a higher level of eating symptoms and a more altered quality of life. A profile of maximum severity was associated with a higher prevalence of MDD and GAD. Concerning the chronology of onset, the age at the start of AN was later in cases of MDD or GAD prior to AN.</p><p><bold>Conclusion:</bold> There seems to be an association between severity of AN and both MDD and GAD. The chronology of onset of the comorbidity did not seem to be associated with the severity.</p>