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. 2020 Sep 3:8:42.
doi: 10.1186/s40337-020-00321-4. eCollection 2020.

Earlier diagnosis in anorexia nervosa: better watch growth charts!

Morgane Marion  1 , Sylvie Lacroix  1 , Marylène Caquard  1 , Laurence Dreno  2 , Pauline Scherdel  3 , Christèle Gras Le Guen  3   4 , Emmanuelle Caldagues  1 , Elise Launay  4
Affiliations

Earlier diagnosis in anorexia nervosa: better watch growth charts!

Morgane Marion et al. J Eat Disord. .

Abstract

Background: A better understanding of the healthcare pathway of children and adolescents with anorexia nervosa (AN) may contribute to earlier detection and better disease management. Here we measured and compared the symptomatic time to diagnosis (TTD) (time between the first symptoms, as reported by parents, and the diagnosis) and the auxological TTD (time between the deviation in the weight growth curve and the diagnosis).

Methods: We performed a monocentric retrospective study including all patients age 9 years to 16 years who were hospitalized in Nantes University Hospital for AN between 2013 and 2016. We analysed the two TTDs by medical record review and growth curve investigation. TTDs were described by medians and Kaplan-Meier curves. Two profiles of patients were compared according to the kinetics of growth deviation and the occurrence of symptoms.

Results: Among the 137 patients included, the median symptomatic and auxological TTDs was 7.0 months (IQR: 4.0-12.0) and 7.2 months (IQR: 2.0-18.0). TTDs were significantly different but clinically similar. For 48% of the patients, a deviation in the growth curve could have been noted at a median of 9.7 months (IQR: 3.0-18.0) before the first symptoms were reported by parents. Those patients showed significantly slower weight loss than did patients with first symptoms reported before growth deviation (weight loss rate 0.41% vs 1.90% per month, p < 0.0001).

Conclusions: Careful study of growth curves remains an essential step in detecting eating disorders, possibly allowing for earlier detection of the disease in nearly half of these patients.

Keywords: Adolescent; Anorexia nervosa.; Early diagnosis.; Eating disorder.; Feeding disorder.; Growth charts.; Time to diagnosis..

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Conflict of interest statement

Competing interestsThe authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of the participants in the study according to the REporting Studies on Time to diagnosis (REST) reporting guidelines. ICD-10, International Classification of Diseases, 10th revision
Fig. 2
Fig. 2
B1) Schema of the diagnostic process for patients with the earliest auxological time to diagnosis (N = 66); B2) Schema of the diagnostic process for patients with the earliest symptomatic time to diagnosis (N = 71). Data are mean (interquartile range)
See this image and copyright information in PMC

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