Medical findings in outpatients with anorexia nervosa.
BACKGROUND
Approximately 0.5% to 1% of college-aged women have anorexia nervosa and most of them live in the community. However, few clinical data exist regarding community-dwelling women with anorexia nervosa. The objective of this study was to determine the prevalences of common medical findings for these women.


METHODS
Cross-sectional, community-based study of 214 women with anorexia nervosa as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Participants were recruited through advertisements and community-based referrals to a study investigating skeletal health in outpatients with anorexia nervosa.


RESULTS
The prevalences of medical findings among the 214 participants were as follows: anemia, 38.6%; leukocytopenia, 34.4%; hyponatremia, 19.7%; hypokalemia, 19.7%; bradycardia, 41.3%; hypotension, 16.1%; hypothermia, 22.4%; elevation of alanine aminotransferase concentration, 12.2%; osteopenia, 51.7%; osteoporosis, 34.6%; and primary amenorrhea, 14.8%. Moreover, 30% of the women reported histories of bone fractures. Except for leukocytopenia (P = .01), bone loss (P = .04), and bradycardia (P = .01), the probability of specific medical findings could not be predicted by the degree of undernutrition.


CONCLUSIONS
These results demonstrate a high prevalence of medical findings in community-dwelling women with anorexia nervosa. Therefore, women with anorexia nervosa should be carefully followed up with regular physical examinations and laboratory assessments. In addition, low weight, particularly in conjunction with the abnormalities reported, should prompt the consideration of a diagnosis of anorexia nervosa.
Miller
Karen K
KK
Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA. kkmiller@partners.org
Grinspoon
Steven K
SK
Ciampa
Julia
J
Hier
Joan
J
Herzog
David
D
Klibanski
Anne
A
D015502:Absorptiometry, Photon; D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D001774:Blood Chemical Analysis; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D009752:Nutritional Status; D010024:Osteoporosis / Q000000981:diagnostic imaging / Q000453:epidemiology; D010045:Outpatients; D015995:Prevalence; D012044:Regression Analysis