A retrospective review of anorexia nervosa patients admitted to a specialised eating disorders inpatient unit comparing clinical and demographic characteristics of subtypes
Date
2015
Authors
Vahed, Nadira
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Abstract
Anorexia nervosa is a debilitating illness with the highest mortality rate of all psychiatric
illnesses. Subtyping the illness into anorexia nervosa restricting subtype (AN-R) and
anorexia nervosa binge-eating/purging subtype (AN-BP) has been a contentious issue since
the inception of this subclassification in the 1994 DSM-IV. It has been proposed that there is
little difference between the two subgroups and that categorising this eating disorder is of
little utility and validity.
The aim of this study was to compare the characteristics of a group of anorexic nervosa
patients admitted to a specialised inpatient eating disorders unit in Johannesburg, South
Africa, to investigate the differences, if any, between the AN-R and AN-BP groups. The
hypothesis was that there are aspects of the subtypes which differ and therefore validate the
delineation of anorexia nervosa into the two subgroups.
The study sample consisted of 59 patients admitted to a specialised inpatient eating disorders
unit with the diagnosis of anorexia nervosa, between January 2001 and December 2002. The
study group was separated according to their sub-specific anorexia nervosa diagnosis: the
AN-R sample (n=32) and the AN-BP sample (n=27). Various demographic and clinical
features were reviewed.
This study’s only significant result was the difference between the mean percentage of goal
weight on admission between the two subtypes, with the average in the AN-R group being
lower than that found in the AN-BP group (p-value=0.039). This study therefore does not
provide sufficient evidence for the subclassification of anorexia nervosa. It is noted that a
small sample size, inaccurate record-keeping and the possibility of diagnostic crossover may
have influenced the outcome of this study.
Description
A research report submitted to the Faculty of Medicine, Department of Psychiatry,
University of the Witwatersrand
in partial fulfilment for the degree of
Master of Medicine (Psychiatry)
Johannesburg 2015