Depressive disorders in teenage-onset anorexia nervosa: A controlled longitudinal, partly community-based study

The study objective was to examine the prevalence end course of depressive disorders (DDs) in teenage-onset anorexia nervosa (AN) over a period of 10 years. Fifty-one adolescents with AN and a sex- and age-matched control gro up (n = 51)were assessed at ages 16, 21, and 24 years. Probands and control s were examined in depth using semistructured and structured interviews. Th eir parents were interviewed on the occasion of the first examination. DDs were assessed using DSM-III-R criteria. Subjects with AN had a greatly incr eased rate of DDs (85%) of all hinds and at all ages as compared with contr ol subjects. The risk of DD during the follow-up period from 21 up to and i ncluding 24 years could be predicted by diagnostic group status and the pre sence of DD during the period from 16 to 21 years, while the risk of DD dur ing the follow-up period from 16 up to and including 21 years was solely pr edicted by the presence of AN at age 16 years. Long-term resolution of the eating disorder (ED) was associated with the absence of mood disorder or vi ce verse. Bipolar disorder (BP) occurred at roughly the expected rate (11%) among subjects (probands and controls) with major depression (MDD), In con clusion, depression is a very common comorbid problem in AN: more than four of five individuals with teenage-onset AN had at least one episode of DSM- III-R depression (MD or dysthymia [DT]) within 10 years after onset of the ED, AN appears to trigger the first episode of depression, but once it is m anifest, depression predicts further depressive episodes. Copyright (C) 200 0 by W.B. Saunders Company