The effectiveness of cognitive behavioral therapy on changing eating disorder symptoms and psychopathology of 32 anorexia nervosa patients at hospital discharge and one year follow-up.

BACKGROUND: This study aims to assess changes in core eating disorder psychopathology (Eating Attitudes Test, EAT; Eating Disorders Inventory-2, EDI-2), depression (Hamilton Rating Scale, HRSD; Beck Depression Inventory, BDI) and general psychopathology (MMPI-2) after inpatient treatment and one-year follow-up among patients diagnosed with anorexia. METHODS: Thirty-two patients were treated for anorexia nervosa on an inpatient unit, and were assessed before and after treatment. The inpatient milieu was designed to use cognitive therapy as the primary therapeutic intervention, along with weight restoration. RESULTS: At discharge, all patients displayed significant change in core eating disorder psychopathology in their depressive symptoms, as well as in general aspects of psychopathology. At one-year follow-up, changes in some areas of core eating disorder psychopathology and depressive symptoms continued to be significantly different than from admissions. CONCLUSIONS: The combination of CBT and weight restoration can significantly reduce eating disorder symptoms, depression, and general psychopathology during hospitalization, with some sustained benefit over a one year period. Future research is needed to identify the effect of CBT on anorexia nervosa during a wide variety of treatment settings. Also, research must focus on the influence of outpatient treatment in the outcome of anorexia nervosa.

Stability of neuropsychological performance in anorexia nervosa.

INTRODUCTION: We investigated the stability of neuropsychological performance and eating disorder (EDO) symptoms before, immediately after, and 2 years after inpatient treatment. We also examined relationships between neuropsychological and EDO measures. METHODS: Sixteen women who were admitted for inpatient treatment of anorexia nervosa participated in three evaluations: (1) at admission to the hospital, (2) at discharge, and (3) at a follow-up exam approximately two years after discharge. RESULTS: Body mass index increased significantly from each testing session to the next. Endorsement of eating disorder symptoms was significantly decreased at discharge and at follow-up compared to admission. In terms of cognitive performance, total scores on a brief neuropsychological battery (RBANS) were significantly greater at follow-up than at admission. We found no relationships between EDO symptoms and cognitive function at any of the three sessions. CONCLUSIONS: The current findings suggest that EDO symptoms and cognitive performance in anorexia nervosa patients can show improvement as long as two years after hospitalization, but there is no evidence that EDO symptoms are related to neuropsychological performance.

Cognitive impairment in anorexia nervosa is not due to depressed mood.

OBJECTIVE: Previous research has revealed cognitive deficits in patients with anorexia nervosa. It is unclear whether these deficits are linked to co-morbid depression in this population. We examined the relationship between depressive symptoms and cognitive functioning. METHOD: A large sample of subjects (N = 98) was examined using a common measure of cognitive ability and two measures of depression. RESULTS: We confirmed that there is no relationship between depression and cognitive ability in this group. DISCUSSION: This suggests that alternative explanations be explored for cognitive deficits in patients with anorexia nervosa.

Neuropsychological functioning pretreatment and posttreatment in an inpatient eating disorders program.

OBJECTIVE: This study was conducted to determine whether neuropsychological dysfunction associated with anorexia nervosa resolves with inpatient treatment. METHOD: Subjects were 28 women being treated for anorexia nervosa. Main study variables included body mass index (BMI), Beck Depression Inventory-II, and neuropsychological test scores. Subjects were tested at admission and discharge. RESULTS: Neuropsychological functioning improved across the course of treatment, with significant changes on tests of memory and psychomotor speed. This improvement was not significantly associated with change in BMI or with the other variables that were studied. DISCUSSION: Patients with anorexia nervosa exhibit subtle neuropsychological dysfunction, which resolves at least partially during treatment. This improvement does not appear to be associated with an increase in BMI. However, it is possible that BMI is not a sufficiently sensitive indicator of nutritional status or that longer-term follow-up is necessary to reveal the nutrition-cognition relationship that we were seeking.

Neuropsychological characteristics of patients in a hospital-based eating disorder program.

The existence of cognitive deficits associated with eating disorders has been debated for some time. The present study investigated cognitive impairments in a large sample of patients with anorexia nervosa from an inpatient treatment program. Fifty-nine women with anorexia nervosa were given a battery of neuropsychological tests assessing multiple cognitive domains. Over half of the patients had mild cognitive impairments in two or more neuropsychological tasks and approximately one-third failed two or more tasks. Depression level and body mass were not associated with cognitive impairment. Whether effective restoration of weight and resolution of core psychopathology contribute to reversal of cognitive deficits requires further research.