Psychopathological and nutritional correlates of plasma homovanillic acid in adolescents with anorexia nervosa.

Dopaminergic abnormalities have been described in anorexia nervosa but studies about plasma level of homovanillic acid (pHVA) have yielded conflicting results probably due to the small number and the heterogeneity of patients. Plasma HVA, nutritional and hormonal parameters and several scales - the Eating Attitudes Test (EAT), the Beck Depression Inventory (BDI), the Leyton Obsessional Inventory-child version (LOI-C) and the State and Trait Anxiety Inventory (STAI) - were assessed in 44 adolescent anorexia nervosa patients (mean age 14.7 years, SD 1.7) consecutively admitted to an Eating Disorder Unit. They were evaluated at admission, at discharge and, in 34 cases, after 9 months of follow-up. pHVA was also assessed in 16 control adolescents. Patients had significantly higher pHVA than controls (p = .002). About 31% of patients had a very high level of pHVA, a significantly higher (p = .006) mean score in the BDI and a non significantly higher mean score in the EAT. After weight recovery some laboratory parameters improved as well as the EAT (p = .019), the BDI (p = 001) and the Interference score of the LOI-C (p = .004). Moreover, pHVA decreased significantly (p=.036). At follow-up, patients with normal weight had lower (p = .037) pHVA than patients with low weight. The conclusion would be that there is a dopaminergic dysfunction in anorexic patients, specially in a subgroup with high depressive and anorexic symptomatology. With weight recovery and psychopathological improvement, pHVA tends to normalization.

Predictors of weight maintenance after hospital discharge in adolescent anorexia nervosa.

OBJECTIVE: To analyze variables that predict weight maintenance in adolescent anorexia nervosa. METHOD: The Eating Attitudes Test, the Beck Depression Inventory, the Leyton Obsessional Inventory, the State and Trait Anxiety Inventory, and the Anorexia Nervosa Stages of Change Questionnaire were administered to 49 anorexia nervosa patients (mean age 14.3 years, SD 1.7) consecutively admitted to an eating disorder unit. They were evaluated at admission, at discharge, and after nine months follow-up. RESULTS: At discharge, patients had improved in body mass index (p < .001), eating attitudes (p = .002), depressive symptomatology (p = .001), and motivation to change (p < .001). Patients with good weight maintenance at follow-up had higher body mass index (p = .017) at admission, lower abnormal eating attitudes (p = .035), depressive symptomatology (p = .026), and higher motivation to change (p = .004) at discharge. Logistic regression analysis showed a high motivation to change at discharge and a high body mass index at admission to be predictors of weight maintenance. CONCLUSION: High motivation to change, low abnormal eating attitudes, depressive symptomatology at discharge, and high body mass index at admission are associated with weight maintenance in adolescent anorexia nervosa.