Diagnostic Criteria Identifies Three Subgroups of Anorexia

Anorexia Nervosa (AN) is one of the most common forms of disordered eating. People with AN often experience psychosomatic symptoms that can range from mild to extreme. Understanding how these symptoms manifest in different individuals with varying types of AN can help in interventions. Giovanni Abbate-Daga of the Department of Neuroscience at the Eating Disorders Centre at the University of Turin in Italy conducted a study to explore the various somatic and psychosomatic conditions present in people with AN. Using the Diagnostic Criteria for Psychosomatic Research (DCPR), Abbate-Daga assessed 32 AN individuals with a history of binging and purging (ANBP) and 76 individuals who exhibited restrictive eating as a symptom of AN (AN-R). The participants were all receiving emergency care in an inpatient facility when they were assessed.

Based on cluster analyses, Abbate-Daga found that there were three specific subgroups of AN among the participants. The first group was made up of mostly AN-R individuals, over half of whom were in denial about their illness. Of this group, 38% also had alexithymia, which inhibits their ability to accurately identify and explain their own emotions. The second subgroup was made up mostly of ANBP participants with high levels of somatization. These individuals had more severe symptoms and higher levels of depression than any other group in this study. The third subgroup represented participants who had symptoms of AN for the longest periods of time. They had long illness durations and also very high levels of health anxiety when compared to the other two groups. Abbate-Daga  believes that perhaps the anxiety was due in part to the chronic stress of living with AN. The third group also exhibited significantly high psychosomatic markers as indicated by the DCPR.

Another concerning finding is that participants in the third subgroup had almost no ability to identify and express their emotions, and 93% of these participants denied having any illness at all. Demoralization and irritation were also prevalent in this group of participants, which could undermine treatment effectiveness and explain why these participants had experienced such a long course of AN. In sum, the findings of this study clearly demonstrate that symptoms of AN vary by subgroups. “Psychosomatic syndromes correlated differently with both severity of eating symptomatology and duration of illness: therefore, DCPR could be effective to achieve tailored treatments,” said Abbate-Daga.

Abbate-Daga, Giovanni, Nadia Delsedime, Barbara Nicotra, Cristina Giovannone, Enrica Marzola, Federico Amianto, and Secondo Fassino. Psychosomatic syndromes and anorexia nervosa. BMC Psychiatry 13.1 (2013): 1-11. Print.

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  • delaine

    March 4th, 2013 at 10:54 AM

    Thank you for sharing, because I think that this just like any other illness has levels of intensity and seriousness, but are not to be ignored or placed into one huge box. I think that the mistake with that comes when you think that everyone needs the same level of care or that everyone will benefit with one set treatment plan and life and sickness just are not like that at all. I hope that more and more patients will now be able to get the information with the proper treatment that they need to improve their lives and become well again. For too long I think that the medical community has not recognized the seriousness of an eating disorder so I have hopes that the attention is getting stronger and that evidence is becoming more and more compelling that we still have work to do in this area.

  • Roger

    March 4th, 2013 at 11:05 PM

    That a disorder manifests itself in different ways in different people is a fact.

    It is good to see that this is being identified and recognized more and more. That will only lead to better treatment and according to the specific type of manifestation.

    People have suffered in the past because a certain disorder may be a little different in them compared to others and the lack of appropriate treatment moulded specifically to their kind can hamper recovery. This is bound to help such people and also helps us observe and study about the disorder in a completely new light.

  • Sunni

    March 5th, 2013 at 3:52 AM

    Thanks for the eye opener
    always assumed that anorexia is anorexia, same symptoms amd actions
    not so at all I see

  • blasia

    March 5th, 2013 at 11:43 PM

    with symptoms and effects so different its almost as if they need a separate classification each!its good that they are identifying the differences nevertheless. will help in adequate medication and targeted medication most importantly.

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