title: A case series investigation of association between co-morbid psychiatric disorder and the improvement in body mass index among patients with anorexia nervosa and eating disorder not otherwise specified of the anorexia nervosa type.
abstract: BACKGROUND
  Anorexia nervosa and eating disorder not otherwise specified* (not fulfilling Anorexia Nervosa DSM IV criteria) are increasing in Singapore. Patients with eating disorders may also present with other psychiatric disorders such as depression and anxiety. The paper aims to investigate the association of co-morbid psychiatric disorders with the improvement of body mass index (BMI) in these patients.
  
  
  METHODS
  A retrospective cohort analysis of 182 patients with anorexia and eating disorder not otherwise specified at a tertiary hospital was done. The clinical course of co-morbid psychiatric disorders was correlated with the improvement of body mass index.
  
  
  RESULTS
  109 patients were included in the analysis and the mean BMI on resolution of co-morbid psychiatric disorders was BMI 16.9. There is a significant association between the BMI groups and the resolution of co-morbid psychiatric disorders, χ2 = 10.2, p = .03. Patients in BMI group 5 (BMI 16.6 - 18.5) were noted to be significantly less likely to resolve their psychiatric co-morbidity compared to the other 4 groups. (OR = 0.323).
  
  
  CONCLUSIONS
  Patients with anorexia nervosa and eating disorders not otherwise specified were at increased risk of having co-morbid psychiatric disorders and the clinical course of co-morbid psychiatric disorders appeared to correlate with improved BMI. Specifically patients with BMI < 16.5 with co-morbid psychiatric disorders were more likely to recover from their co-morbid psychiatric disorder with nutritional rehabilitation than patients with a higher BMI.
authors.affiliation: Department of Psychiatry, Singapore General Hospital, Outram Road, Singapore, 169608 Singapore.
authors.forename: Robin
authors.initials: R
authors.lastname: Goh
keywords: Anorexia nervosa; Body mass index; Depression; Generalized anxiety disorder; Personality
references.citation: Int J Eat Disord. 2008 Sep;41(6):559-63
references.pmid: 18454485
references.citation: J Affect Disord. 2004 Mar;78(3):279-84
references.pmid: 15013255
references.citation: Psychosom Med. 2006 May-Jun;68(3):454-62
references.pmid: 16738079
references.citation: Int J Eat Disord. 2006 Nov;39(7):587-9
references.pmid: 16941630
references.citation: Child Psychiatry Hum Dev. 2008 Sep;39(3):261-72
references.pmid: 17987378
references.citation: Behav Res Ther. 2010 Mar;48(3):194-202
references.pmid: 19945094
references.citation: Clin Psychol Rev. 2003 Feb;23(1):57-74
references.pmid: 12559994
references.citation: Eur Child Adolesc Psychiatry. 2005 Mar;14(2):106-10
references.pmid: 15793690
references.citation: Arch Gen Psychiatry. 1991 Aug;48(8):712-8
references.pmid: 1883254
references.citation: Psychiatry Res. 2012 Dec 30;200(2-3):513-7
references.pmid: 22703719
references.citation: J Psychiatr Res. 2005 May;39(3):303-10
references.pmid: 15725429
references.citation: Can J Psychiatry. 1998 Jun;43(5):507-12
references.pmid: 9653536
references.citation: J Psychiatr Res. 2013 Jul;47(7):972-9
references.pmid: 23535032
references.citation: J Child Psychol Psychiatry. 2001 Jul;42(5):603-12
references.pmid: 11464965
references.citation: Eat Weight Disord. 2009 Jun-Sep;14(2-3):e113-20
references.pmid: 19934624
references.citation: Behav Res Ther. 2008 Dec;46(12):1290-4
references.pmid: 18848697
references.citation: Singapore Med J. 2005 Jun;46(6):275-81
references.pmid: 15902355