Treatment in Anorexia Nervosa: The Role of Neuropsychological Features in Predicting Response

Abstract

Introduction

Neuropsychological impairments in anorexia nervosa (AN) have been considered both as putative risk factors and as a target for treatment. However, the role of neuropsychological variables as predictors of outcome is not clear.

Aims

Our aim is to investigate the role of neuropsychological variables as predictors of response to treatment in a group of individuals affected by AN.

Methods

The study sample consisted of 144 patients diagnosed with acute AN, according to the DSM-5 criteria, referred to the Eating Unit of the Hospital of Padova, Italy. All participants were assessed by means of a neuropsychological and clinical test battery at intake and followed during outpatient treatment for an average of 531 days. Eighty-three percent of the patients underwent cognitive behavioral therapy, the families of 75% of the patients were included in the treatment and 48% of the patients took antidepressants (SSRI).

Results

Both body mass index at assessment and illness duration appeared to be independent factors significantly affecting the outcome. The role of neuropsychological variables was explored including cognitive performance in a multivariate analysis including BMI at intake, duration of illness and diagnostic subtype. The inclusion in the model of the Wisconsin Sorting Card Task performance and the central coherence index (calculated by the Rey Figure Test) significantly increased the prediction ability of the model for full remission at the end of treatment.

Conclusions

This is the first study to show that neuropsychological characteristics may predict treatment response in AN. These data support the implementation of cognitive remediation techniques in the treatment of AN.

Disclosure of interest

The authors have not supplied their declaration of competing interest.