Absence of relationships between depression and anxiety and bone mineral density in patients hospitalized for severe ano
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ORIGINAL ARTICLE
Absence of relationships between depression and anxiety and bone mineral density in patients hospitalized for severe anorexia nervosa J. Herrou1,9 · N. Godart2,3,4 · A. Etcheto5 · S. Kolta1 · N. Barthe6 · A. Y. Maugars7 · T. Thomas8 · C. Roux1,5 · K. Briot1,5 Received: 3 June 2020 / Accepted: 3 October 2020 © Springer Nature Switzerland AG 2020
Abstract Introduction Low BMD is frequent in anorexia nervosa (AN), depression, and during SSRI treatment but relation between these elements in AN is not established. The aims of this study were to assess the relationships between depression and anxiety, SSRI prescription, and (1) low BMD during inpatient treatment and (2) BMD change 1 year after hospital discharge. Methods From 2009 to 2011, 212 women with severe AN have been included in the EVHAN study (EValuation of Hospitalisation for AN). Depression, anxiety and obsessive–compulsive symptoms and comorbidity were evaluated using psychometric scales and CIDI-SF. BMD was measured by dual-energy X-ray absorptiometry. Results According to the CIDI-SF, 56% of participants (n = 70) had a lifetime major depressive disorder, 27.2% (n = 34) had a lifetime obsessive–compulsive disorder, 32.8% (n = 41) had a lifetime generalized anxiety disorder and 25.6% (n = 32) had a lifetime social phobia disorder. Half of the sample (50.7%; n = 72) had a low BMD (Z score ≤ − 2). In multivariate analysis, lifetime lowest BMI was the only determinant significantly associated with low BMD (OR = 0.56, p = 0.0008) during hospitalization. A long duration of AN (OR = 1.40 (0.003–3.92), p = 0.03), the AN-R subtype (OR = 4.95 (1.11–26.82), p = 0.04), an increase of BMI between the admission and 1 year (OR = 1.69 (1.21–2.60), p = 0.005) and a gain of BMD 1 year after the discharge explained BMD change. Conclusion We did not find any association between depression and anxiety or SSRI treatment and a low BMD or variation of BMD. Level of evidence Level III, cohort study. Keywords Anorexia nervosa · Osteoporosis · Bone mineral density · Depression · Anxiety · Obsessive · Compulsive disorders
Introduction Anorexia nervosa (AN) is a life-threatening eating disorder with a prevalence of 0.5–2.2% in young women [1]. Adolescence is a critical period for the achievement of peak bone mass and studies have shown that adolescents girls with AN
* J. Herrou [email protected] 1
INSERM UMR-1153, Paris, France
Fondation de Santé des Etudiants de France (FSEF), Paris, France
2
3
UFR des Sciences de la Santé Simone Veil (UVSQ), Versailles, France
4
CESP, INSERM, UMR 1018, Université Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif, France
do not experience the expected increase in bone mass during puberty [2] with long-term consequences on bone mineral density (BMD, g/cm2). In the literature, 30–50% of subjects with AN have low BMD or osteoporosis [3, 4]. In addition, women with an AN onset during adolescence have a lower BMD than those who develop this condition in adult 5
Université Paris Descartes, Faculté de M
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