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- Title
The validity of the 5th BMI percentile as weight cut-off for anorexia nervosa in children and adolescents: No evidence from a psychopathology investigation.
- Authors
Cascino, G.; Mereu, A.; Zanna, V.; Monteleone, P.; Vicari, S.; Monteleone, A. M.
- Abstract
Introduction: Although the 5th Body Mass Index (BMI) percentile has been indicated by the DSM-5 in order to identify underweight in children and adolescents and to diagnose anorexia nervosa (AN), the validity of this cut-off has not been proved. Objectives: Aim of this study was to compare general and specific psychopathology between adolescents affected by AN with a BMI above or below the 5th percentile in order to test the validity of this weight cut-off. Methods: Four hundred-three adolescents with AN were recruited. They completed the Eating Disorder Inventory-3 (EDI-3) and the Youth Self Report (YSR). The sample was divided in two groups: below the 5th (n = 172) and above the 5th (n = 231). Quantitative differences between groups were investigated through t-test for independent samples. A network analysis was conducted in each group. Results: The group with BMI above the 5th percentile showed significantly higher scores in drive to thinness, body dissatisfaction, bulimia, personal and interpersonal alienation, social insecurity and asceticism. No significant differences emerged in general psychopathology measured through the YSR and in the occurrence of comorbidity between the groups. The group with BMI under the 5th percentile had a longer illness duration. No difference emerged between the network structure of the two groups. Conclusions: These findings suggest that the clinical utility of the 5th BMI percentile as weight cut-off for diagnosis of AN in children and adolescents is questionable. Indeed, it may prevent early illness detection and intervention, which are essential to improve treatment outcome.
- Subjects
ANOREXIA nervosa; SELF-evaluation; TEENAGERS; BODY mass index; PERCENTILES
- Publication
European Psychiatry, 2020, Vol 63, pS41
- ISSN
0924-9338
- Publication type
Article