Rate of inpatient weight restoration predicts outcome in anorexia nervosa.

OBJECTIVE: To examine weight restoration parameters during inpatient treatment as predictors of outcome in anorexia nervosa (AN). METHOD: Adolescent and adult females admitted for inpatient eating disorder treatment were recruited for an ongoing longitudinal study. This analysis examined several weight restoration parameters as predictors of clinical deterioration after discharge among participants with AN. RESULTS: Rate of weight gain was the only restoration parameter that predicted year 1 outcome. Clinical deterioration occurred significantly less often among participants who gained >or=0.8 kg/week (12/41, 29%) than those below this threshold (20/38, 53%) (chi(2) = 4.37, df = 1, p = .037) and remained significant after adjustment for potential confounders. DISCUSSION: Weight gain rate during inpatient treatment for AN was a significant predictor of short-term clinical outcome after discharge. It is unclear whether weight gain rate exerts a causal effect or is rather a marker for readiness to tolerate weight restoration and engage in the recovery process.

Age-related characteristics of depression: a preliminary STAR*D report.

OBJECTIVE: Studies have shown that age is a determinant in the course of major depressive disorder. Age has been associated with depression severity; it has also been associated with varying depressive symptomatology. The authors explore the relationships between current age and depression severity, course of illness, presenting symptom features, and comorbid symptoms. METHODS: Baseline clinical and sociodemographic information was collected on 1,498 participants enrolled in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) Study. Five age cohorts (18-25, 26-35, 36-50, 51-65, and 66-75) were compared on both sociodemographic and clinical factors. Depressive symptoms were measured with the 30-item clinician-rated Inventory of Depressive Symptomatology. RESULTS: Clinically meaningful differences were found among age cohorts on several clinical and depressive symptom features. Older patients (51-65 and 66-75) endorsed longer durations of illness, more major depressive episodes, a later age at onset of their first major depressive episode, and more general medical comorbidities. Older patients had more middle and terminal insomnia, less irritability, and less hypersomnia. They were less likely to hold negative views of themselves or of their future and were less likely to report previous suicide attempts. Older patients were less likely to endorse symptoms consistent with generalized anxiety disorder, social phobia, panic disorder, and drug abuse. CONCLUSIONS: These cross-sectional data indicate that different age-cohorts present with varying sociodemographic and clinical characteristics, as well as general-medical and psychiatric comorbid conditions.