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Cognitive improvement following weight gain in patients with anorexia nervosa: A systematic review

  • Mental Health Centre Ballerup
  • University of Copenhagen

Research output: Contribution to journalJournal articleResearchpeer-review

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Abstract

Objective: Anorexia nervosa (AN) has been associated with cognitive impairment. While re-nutrition is one of the main treatment targets, the effect on cognitive impairments is unclear. The aim of this review was to examine whether cognitive functions improve after weight gain in patients with AN. Method: A systematic review was performed following Preferred Reporting Items for Systematic Reviews and Meta-analyses statement guidelines (PROSPERO CRD42019081993). Literature searches were conducted May 20th, 2019 in PubMed, EMBASE, PsychINFO and Cochrane Library. Pairs of reviewers screened reports independently based on titles/abstracts (N = 6539) and full texts (N = 378). Furthermore, they assessed the quality of reports, including whether practice effects were accounted for. Results: Twenty-four longitudinal reports were included featuring 757 patients and 419 healthy controls. Six studies examined children and adolescents. Four out of four studies found processing speed to improve above and beyond what could be assigned to practice effects and three out of four studies found that cognitive flexibility was unaffected after weight gain in children and adolescents. Results from studies of adults were inconclusive. Discussion: The literature on cognitive change in patients with AN following weight gain is sparse. Preliminary conclusions can be made only for children and adolescents, where weight gain appeared to be associated with improved processing speed.

Original languageEnglish
JournalEuropean Eating Disorders Review
Volume29
Issue number3
Pages (from-to)402-426
ISSN1072-4133
DOIs
Publication statusPublished - May 2021

Funding

The authors would like to thank Laura Al‐Dakhiel Winkler, MD, PhD, at the Research Unit, Child and Adolescent Psychiatry, Mental Health Services, Odense, for being part of our research group and participating in the screening of reports. We would also like to thank the statistician Pia Veldt Larsen for statistical assistance during preparation of the protocol and the manuscript. We want to thank Jesper Mogensen, Professor of Neuroscience, and Nicolaj Daugaard, Cand. Psych., at the Unit for Cognitive Neuroscience, University of Copenhagen, for fruitful discussions of interpretations of results. We would also like to thank Claire Gudex, MD, PhD, Associate Professor at the Department of Clinical Research, University of Southern Denmark, for editing the manuscript. The systematic review was supported by government funding from the Psychiatric Research Fund of Southern Denmark and the University of Southern Denmark. The funding sources had no role in preparation, execution, interpretation, analysis or publication of the review.

Keywords

  • anorexia nervosa
  • eating disorder
  • executive function
  • malnutrition
  • neuropsychology

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