CATEGORY/THEME: Epidemiology and Etiology
Introduction: Anorexia nervosa occurs mainly in adolescents and young adults, but a large proportion of children present prepubertal anorexia. This study concerns children who present anorexia nervosa but not the secondary sexual characteristics of puberty. Prepubertal anorexia is a source of concern because it can have a negative impact on a child’s pubertal development and growth. The prognosis also seems unfavorable. Recent results suggest that anorexia might present distinct profiles according to the age of onset. To our knowledge, this is the first study in which children with prepubertal anorexia nervosa are compared with children from a control group. The aim is to determine whether children with prepubertal anorexia nervosa differ from children in the general population in terms of psychological vulnerabilities.
Methods:The sample of children with prepubertal anorexia comprised 21 patients with a mean age of 12.1 ± 0.8 years. They represented all the cases of children with prepubertal anorexia admitted to the treatment program for eating disorders at three university hospital centers in Québec. The control group comprised 93 children whose mean age was 11.4 ±1.4 years. This group was recruited in an elementary school located in the Eastern Townships, Québec, Canada. The questionnaires used in this study were the Eating Disorder Inventory-3and the Beck Depression Inventory II. Both have excellent psychometric qualities and are widely used in research.
Results: The results show that the prepubertal and control groups were significantly different (p < 0.05) for the eating disorder risk variables. The results show that prepubertal patients presented, on average, significantly (p < 0.05) more difficulties for psychological variables than the control group, except for variables relating to affective problems (interoceptive deficits and emotional dysregulation) and overcontrol (perfectionism and ascetism).
Conclusions:A first likely explanation is that these variables (affective problems and to overcontrol) are less characteristic of prepubertal anorexia than of pubertal anorexia, which would support the hypothesis that different profiles exist according to the age of onset (prepubertal or pubertal) of anorexia nervosa. A second possible explanation is that these variables requires particular cognitive abilities (metacognition). We can postulate that the children in the prepubertal anorexia and control groups had fewer skills in this sphere because of their development level.Data triangulation may assist in resolving this issue, as has already been suggested by the author of the EDI.