Similarities and Differences of Neuropsychological Profiles in Children and Adolescents with Anorexia Nervosa and Healthy Controls Using Cluster and Discriminant Function Analyses.
OBJECTIVE
This study aimed to identify discrete neuropsychological profiles and their relationship to clinical symptoms in 253 female children and adolescents with anorexia nervosa (AN) and 170 healthy controls (HCs) using a standardised neuropsychological assessment battery.


METHODS
Hierarchical cluster analysis was used to identify the optimum number of clusters, and participants were assigned using K-means cluster analysis. Confirmatory discriminant function analysis determined which combination of neuropsychological variables best distinguished the clusters.


RESULTS
Three distinct clusters in the AN sample emerged- AN cluster 1 (19%) - "neuropsychologically low average to average"; AN cluster 2 (33%) - "verbal/visuo-spatial discrepancy"; and AN cluster 3 (48%) - "verbally strong and neuropsychologically average to high average". Two distinct clusters in HCs were identified. HC cluster 1 (48%) demonstrated poor visuo-spatial memory scores and high verbal fluency scores, whilst HC cluster 2 (52%) scored within the average range on all neuropsychological tasks. Neuropsychological performance was associated with clinical symptoms of body mass index centile, Eating Disorder Examination subscale and global score, anxiety, depression and obsessions, and compulsions between the AN and HC groups. However, niether significant differences emerged between AN clusters only nor HC clusters only at the post-hoc level.


CONCLUSIONS
An underlying neuropsychological heterogeneity may exist in AN. We encourage future studies to investigate whether the identified profiles and their association with clinical characteristics are replicable. We cautiously suggest that neuropsychological profiling may have potential to both inform future research and have possible clinical benefits through individually tailored treatment strategies.
Feeding and Eating Disorders Service, Department of Child and Adolescent Mental Health, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.|The Huntercombe Group, Maidenhead, UK.
Mark
M
Rose
Regional Eating Disorders Service, Oslo University Hospital, Oslo, Norway.
Kristin
K
Stedal
Feeding and Eating Disorders Service, Department of Child and Adolescent Mental Health, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.|College of Life and Environmental Sciences, University of Exeter, Exeter, UK.
Marie-Claire
MC
Reville
Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charite-Universitatsmedizin Berlin, Germany.
Betteke Maria
BM
van Noort
Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charite-Universitatsmedizin Berlin, Germany.
Viola
V
Kappel
Feeding and Eating Disorders Service, Department of Child and Adolescent Mental Health, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.|Regional Eating Disorders Service, Oslo University Hospital, Oslo, Norway.|College of Life and Environmental Sciences, University of Exeter, Exeter, UK.
Ian
I
Frampton
Feeding and Eating Disorders Service, Department of Child and Adolescent Mental Health, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
Beth
B
Watkins
Feeding and Eating Disorders Service, Department of Child and Adolescent Mental Health, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.|Regional Eating Disorders Service, Oslo University Hospital, Oslo, Norway.|College of Life and Environmental Sciences, University of Exeter, Exeter, UK.|Rhodes Farm Clinic, Care UK, London, UK.
Bryan
B
Lask
Adolescents; Anorexia nervosa; Children; Neuropsychological profiles