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Anorexia Nervosa

Evaluation of cognitive function in patients with severe nervosa before and after medical stabilization

Journal of Eating Disorders
By Philip S. Mehler, MD, FACP, FAED, CEDS

Rylander M, Taylor G, Bennett S, Pierce C, Keniston A, Mehler PS. Evaluation of cognitive function in patients with severe nervosa before and after medical stabilization. J. Eating Disorders. 8:35-40, 2020.

Background

The purpose of this study was to quantify cognitive deficits in severe anorexia nervosa (AN) before and after medical stabilization.

Methods

This was a prospective study of 40 females between the ages of 18 and 50 admitted to a medical stabilization unit with severe AN (%IBW < 70). The primary outcome of the study was change in test scores on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) at baseline and after medical stabilization.

Results

There were no statistically significant differences in baseline RBANS scores between AN patients overall and controls (p = 0.0940). There was a statistically significant change in RBANS from baseline 94.1 + 12.7 to medical stabilization 97.1 + 10.6 (p = 0.0173), although notably both mean values fell within the average range. There were no significant differences in baseline RBANS scores between controls and AN-BP patients (p = 0.3320) but significant differences were found between controls and AN-R patients (p = 0.0434).

Conclusions

No baseline deficits in cognition were found in this sample of women with severe AN.

Plain English summary

This study sought to identify impairments in cognition in women suffering from severe anorexia nervosa (AN), binge purge subtypes (AN-BP) and restricting subtype (AN-R), relative to healthy volunteers. All subjects were patients on a medical refeeding unit with severe illness. Cognitive testing occurred upon entry into the program and at exit. Surprisingly, our study did not find any difference in baseline cognition between patients with AN as a whole and health volunteers. Patients with AN-R had significant improvements in cognition, but this is likely not clinically relevant.

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