PREMORBID ONSET OF PSYCHOPATHOLOGY IN LONG-TERM RECOVERED ANOREXIA-NERVOSA

It is recognized that patients with anorexia nervosa commonly have oth er psychiatric illnesses. No study, to our knowledge, has determined w hether these other psychiatric disorders occur prior to the age of ons et of anorexia nervosa. We obtained a retrospective history from 24 su bjects who were long term (more than 1 year) recovered from anorexia n ervosa. We found that 58% reported that they had the onset of one or m ore childhood anxiety disorder diagnoses at the age of 10 +/- 5 years old. This was 5 years before the mean age of onset of anorexia nervosa . The onset of depression was about 1 year before the onset of anorexi a nervosa in about one half the subjects. Alcohol and substance abuse/ dependency tended to occur after the onset of anorexia nervosa and onl y occurred in anorexic subjects who binged and/or purged. The early an d common onset of childhood anxiety disorders in a substantial percent age of anorexics raises the possibility that childhood anxiety disorde rs herald the first behavioral expression of a biologic vulnerability in some subjects who develop anorexia nervosa. (C) 1995 by John Wiley & Sons, Inc.