title: Cognitive Flexibility in Juvenile Anorexia Nervosain Relation to Comorbid Symptoms of Depression, Obsessive Compulsive Symptoms and Duration of Illness.
abstract: Whereas the evidence in adolescents is inconsistent, anorexia nervosa (AN) in adults is characterized by weak cognitive flexibility. This study investigates cognitive flexibility in adolescents with AN and its potential associations with symptoms of depression, obsessive compulsive disorder (OCD), and duration of illness.
  
  
  
  69 patients and 63 age-matched healthy controls (HC) from 9 till 19 years of age were assessed using the Trail-Making Test (TMT) and self-report questionnaires.
  
  
  
  In hierarchical regression analyses, set-shifting ability did not differ between AN and HC, whereas AN patients reported significantly higher rates of depression symptoms and OCD symptoms. Age significantly predicted set-shifting in the total sample. Only among AN patients aged 14 years and older did set-shifting decline with increasing age.
  
  
  
  The presence of AN with depression or OCD symptoms or the duration of illness do not influence cognitive flexibility in children and adolescents. Early interventions may be helpful to prevent a decline in cognitive flexibility in adolescent AN with increasing age.
authors.affiliation: 1 Charité-Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy.|2 These authors contributed equally to this manuscript.
authors.forename: Anne
authors.initials: A
authors.lastname: Rößner
authors.affiliation: 1 Charité-Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy.|2 These authors contributed equally to this manuscript.
authors.forename: Izabela
authors.initials: I
authors.lastname: Juniak
authors.affiliation: 2 These authors contributed equally to this manuscript.
authors.forename: Betteke Maria
authors.initials: BM
authors.lastname: van Noort
authors.affiliation: 2 These authors contributed equally to this manuscript.
authors.forename: Ernst
authors.initials: E
authors.lastname: Pfeiffer
authors.affiliation: 2 These authors contributed equally to this manuscript.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Lehmkuhl
authors.affiliation: 2 These authors contributed equally to this manuscript.
authors.forename: Viola
authors.initials: V
authors.lastname: Kappel
mesh_terms: D000293:Adolescent; D000856:Anorexia Nervosa / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D016022:Case-Control Studies; D003071:Cognition; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D056344:Executive Function; D005260:Female; D005858:Germany; D006801:Humans; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D012718:Set, Psychology; D013997:Time Factors
keywords: Anorexia Nervosa; Set Shifting; adolescents; anorexia nervosa; cognitive flexibility; comorbidity; set-shifting