A systematic review comparing atypical anorexia nervosa and anorexia nervosa. 2023

B Timothy Walsh, and Kelsey E Hagan, and Carlin Lockwood
Department of Psychiatry, New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, New York, USA.

A description of atypical anorexia nervosa (atypical AN) was provided in DSM-5 in 2013 and a sizable literature has since developed describing the clinical features of individuals with atypical AN and comparing them to those of individuals with anorexia nervosa (AN) and those of healthy individuals. The purpose of this study was to conduct a systematic review of this literature. A systematic review following PRISMA guidelines was conducted of studies published since 2013 that compared the clinical characteristics of individuals with atypical AN to those of individuals with AN and/or healthy controls. Meta-analyses were conducted when similar measures were reported in three or more studies. Twenty-four publications met criteria for inclusion. Their results indicated that the level of eating disorder-specific psychopathology is significantly higher among individuals with atypical AN than among controls and as high or higher as among individuals with AN while levels of non-eating disorder psychopathology are similar. Individuals with atypical AN experience many of the physiological complications associated with AN, but some complications appear less frequent. The psychological symptoms and physiological complications of individuals with atypical AN are generally similar to those of individuals with AN, although there may be differences in the frequency of some physical complications. Little information is available on the course, outcome, and treatment response of individuals with atypical AN. In addition, full diagnostic criteria for atypical AN have not been developed, and the nosological relationship of atypical AN to established eating disorders such as bulimia nervosa is unclear. Atypical anorexia nervosa as described in the DSM-5 identifies individuals with many of the psychological characteristics of typical anorexia nervosa who, despite significant weight loss, are not underweight. The current systematic review found that the psychological symptoms and physiological characteristics of individuals with atypical AN are generally similar to those of individuals with AN, although there may be differences in the frequency of some physical complications.

UI MeSH Term Description Entries
D011599 Psychopathology The study of significant causes and processes in the development of mental illness.
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000856 Anorexia Nervosa An eating disorder that is characterized by the lack or loss of APPETITE, known as ANOREXIA. Other features include excess fear of becoming OVERWEIGHT; BODY IMAGE disturbance; significant WEIGHT LOSS; refusal to maintain minimal normal weight; and AMENORRHEA. This disorder occurs most frequently in adolescent females. (APA, Thesaurus of Psychological Index Terms, 1994) Anorexia Nervosas,Nervosa, Anorexia,Nervosas, Anorexia
D001068 Feeding and Eating Disorders A group of disorders characterized by physiological and psychological disturbances in appetite or food intake. Appetite Disorders,Eating Disorders,Eating and Feeding Disorders,Feeding Disorders,Appetite Disorder,Disorder, Eating,Disorder, Feeding,Disorders, Eating,Disorders, Feeding,Eating Disorder,Feeding Disorder
D013851 Thinness A state of insufficient flesh on the body usually defined as having a body weight less than skeletal and physical standards, such as BODY MASS INDEX, and dependent on age, sex, and genetic background. Leanness,Underweight
D015431 Weight Loss Decrease in existing BODY WEIGHT. Weight Reduction,Loss, Weight,Losses, Weight,Reduction, Weight,Reductions, Weight,Weight Losses,Weight Reductions
D052018 Bulimia Nervosa An eating disorder that is characterized by a cycle of binge eating (BULIMIA or bingeing) followed by inappropriate acts (purging) to avert weight gain. Purging methods often include self-induced VOMITING, use of LAXATIVES or DIURETICS, excessive exercise, and FASTING. Nervosa, Bulimia

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