Endocrine Abstracts (2006) 11 P610

Psychological and gastrointestinal problems in anorexia nervosa patients

M Djurovic1, D Popovic5, S Pekic1, I Jovanovic5, B Lapcevic4, M Petakov1, V Zivkovic1, M Stojanovic1, M Doknic1, FF Casanueva2, C Diguez3 & V Popovic1

1Institute of Endocrinology, Diabetes and Diseases of Metabolism, University Clinical Center, Belgrade, Serbia, Serbia and Montenegro; 2Department of Medicine, Medical Faculty University santiago de Compostela, Santiago de Compostela, Spain; 3Department of Physiology, Medical Faculty, University santiago de Compostela, Santiago de Compostela, Spain; 4Institute of Psychiatry ‘Dr Laza Lazarevic’, Belgrade, Serbia, Serbia and Montenegro; 5Institute of Gastroenterology, Univesity Clinical Center, Belgrade, Serbia, Serbia and Montenegro.

Anorexia nervosa (AN) is a product of complex interactions between physiological and psychological processes. Nausea, gastric pain and fullness are common features of AN patients. The aim of the study was to investigate the effects of therapy and psychological conditions on body weight restoration in patients with AN. In 21 AN patients (age 22.4±0.7 yrs) with gastric problems at low weight (BMI 15.9±2.3 kg/m2). oesophagogastroduodenoscopy with gastric biopsy was performed and in 13 chronic gastritis was found. They were tested for Helicobacter pylori infections and were positive. Psychological tests were performed after recovery and depression was assessed by Beck Depression Invetory Second Edition (BEK-BDI-II) and anxiety by Hamilton Anxiety Scale (HAMA).

At low weight, we did not find any statistical differences neither in BMI between the gastritis positive and negative group (15.86±1.3 vs 16.31±1.17 kg/m2, P<0.05) nor in serum leptin levels (1.69±0.56 vs 2.38±1.1 ng/ml, P>0.05). They were treated with adequate therapy and with a hypercaloric diet for a period of six to nine months. A statistical differences in BMI and leptin levels is found with weight gain in AN patients gastritis positive (BMI 15.86±1.3 kg/m2 vs 18.0±1.3 kg/m2, P<0.001, ΔITM 1.84±0.17 kg/m2, leptin 1.69±0.56 vs 4.01±0.7 ng/ml, P<0.001, Δleptin 2.11±0.56 ng/ml).

In gastritis negative AN patients we did not find statistical differences in BMI and leptin levels (BMI 16.31±1.17 kg/m2 vs 17.25±1.3 kg/m2, P>0.05, ΔITM 0.72±0.17 kg/m2, leptin 2.38±1.1 vs 3.5±0.7 ng/ml, P>0.05 Δleptin 1.12±0.56 ng/ml).

There was a signifiicant negative correlation between body weight and the score of BEK scale of depression (P=0.04) and body weight and HAMA scale score of anxiety (P=0.03) in both groups of AN. The patients with higher anxiety scores had lower body weight at baseline. Treatment directed at improving gastrointestinal morbidity and also psychological factors (depression and anxiety) are important for the presence of dissease in AN and influences their rehabilitation.